Child inhaler technique
Hello! I'm new here and today has been a stressful day so hoping someone can reassure me!
Background: my 4 year old daughter had her tonsils and adenoids removed in August. It was a very very traumatic putting under and is now petrified of anything medical and especially masks (flash back to trying to put her under).
We are currently trialling an inhaler starting today. We did try last year but due to adenoids issues, it wasn't a fair trial. Due to ongoing cough, trying again.
Last year she used the aerochamber flow vu with mask perfectly. Now due to op that is completely out the window. To say she had a meltdown is an understatement.
We managed to have a bit more success with the peadatric volumatic spacer. However we had another issue of actually spraying the inhaler as she said she could taste it.
Now the only way I could get her to do breaths was to distract her, and while she wasn't looking spray the inhaler into the spacer and then immediately put it in her mouth. And she did breaths. So the inhaler stayed in, she just didn't think I'd pressed it.
My concern is that by not putting her mouth on the mouth piece first, me spraying then quickly putting it in her mouth, means she loses most of the spray??
Or is something better than nothing.
I am at my wits end today and need some hopeful reassurance!
Thanks!
Hi
- I hear you - what an ordeal for your daughter (and you)!! I have read all you so candidly shared here, and will try to help you through this with the reassurances you deserve.
There are so many good products available commercially nowadays, which seemingly cover every eventuality. However, when we are talking about pediatric-aged children, it is fair to say that all bets are off!
So, first, I want to tell you that, your present technique is better than not administering any medication at all. You will lose some of the dose, but certainly not all of the dose! From a clinician's perspective, anything a caring and compassionate parent can do to help deliver medication to their child is all we are looking for. If, during any of the treatments (with the spacer) or, when you put her mouth on the mouthpiece after actuating the inhaler, you feel that the dose has been 'lost' to the air, you can ask her physician if providing another dose would be acceptable.
What do you think?
I have some other ideas when it comes to children and the administration of nebulized liquid medication - is this something that is available to treat your daughter instead of the inhaler/spacer/mouthpiece treatment?
I do hope this brief reply has been helpful for you, Bex.
All the best,
Leon L (author/moderator asthma.net)Hi and thanks for your lovely response! In terms of other ideas of administrating the inhaler, what we're you thinking?
It's just so unfortunate..she did seem a fraction better later tonight but she's so up and down. One minute I think she's cool with something then the next it's all hell breaks loose!Hi again, Bex - you are most welcome!!
That seems to be what 4-year-olds are all about! We have a 4-year-old granddaughter (turns 5 next month-February), and it can be quite a roller coaster ride. I have also found similar challenges managing this age patient in the hospital setting. Hang in there, Bex!
Perhaps I wasn't quite clear - the idea involved the administration of medication nebulizer treatments (for young ones), not the metered dose inhalers (MDI's). Is this something that has been given to your daughter as yet or, has it just been MDI's?
Leon L (author/moderator asthma.net)
