Using the MDI metered dose inhaler for children with asthma

This is an automatically translated article.

The article is professionally consulted by Master, Doctor Dang Huy Toan - Pediatrician - Neonatologist - Department of Pediatrics - Neonatology - Vinmec Nha Trang International General Hospital.
Asthma inhalers are a very important ingredient in the treatment of asthma in children. However, metered dose inhalers are only effective if used correctly. Unfortunately, many people with asthma, especially children, are not able to perform the best metered-dose inhaler technique.

1. What is mdi metered dose inhaler?

The mdi metered dose inhaler (MDI) is an instrument used to deliver a wide range of inhaled medications into the airways in a predetermined amount for each dose. An mdi metered dose inhaler has a structure consisting of a pressure canister, a pressure gauge valve, a vial body, and an outflow dispenser.
The mdi metered dose inhaler is considered the simplest and most convenient, the most portable of all asthma inhalers. However, to promote optimal effectiveness, patients need to know how and perform well the spray technique, helping the medicine to spread evenly and deeply into the airway system. Only in so doing can asthma treatment achieve its goals of acute relief and prevention of persistent attacks.
However, the use of metered-dose inhalers can be difficult to treat asthma in young children due to limitations in cognition, cooperation as well as incomplete development of respiratory force. Therefore, the effectiveness in the treatment of asthma will depend greatly on the ability of parents or daily caregivers to use MDI metered dose inhalers for asthmatic children.

2. What are the general guidelines for using an MDI metered dose inhaler in children with asthma?

When using the mdi metered dose inhaler for the first time, with or without a spacer or without a mask, the parent or caregiver should first prepare the inhaler:
Shake the vial well during the year. second. Place the vial into the mdi metered dose inhaler by pressing down on the bottom of the vial with your index finger. Keep away from face to avoid getting medicine into eyes. Press the bottle down three more times to get it ready to use After giving your child the first use of the inhaler, there is no need to reprime unless the vial or the metered dose inhaler has not been used for two weeks or more. .

Techniques for using MDI metered dose inhaler for children with asthma with spacer:
Remove mouthpiece cap and check to ensure ventilation, no foreign objects in loose objects in MDI metered dose inhaler Install MDI metered dose inhaler into the spacer Shake the MDI metered dose inhaler and the spacer chamber vigorously for about five seconds Hold the MDI metered dose inhaler upright with your index finger resting on the bottom of the vial and your thumb supporting the bottom of the MDI metered dose inhaler. The other hand may be needed to hold the spacer Ask the child to exhale normally through the mouth Place the spacer mouthpiece between the child's teeth and ask the child to close his or her lips around the spacer mouthpiece. If a mask attached to the spacer is used, place the mask to ensure a tight fit and completely cover the child's nose and mouth. Even a small leak can significantly reduce the amount of medicine reaching the lungs, and a soft inflatable mask will better fit a child's face than a hard or over-inflated mask. Make sure the child's tongue does not block the spacer mouthpiece opening. Press your index finger to the bottom of the vial to release the medicine. Also ask the child to take one slow, deep breath through his mouth until his or her lungs are completely filled, which may take three to five seconds. Ask the child to hold their breath to hold the medicine in their lungs for about 5 to 10 seconds. If the child is uncooperative in breathing or cannot hold their breath long enough, ask the child to take a second breath to completely empty the spacer and hold the breath for about 5 seconds. For infants and young children or if cooperation with a single deep breath or hold is not possible, a normal sequence of 5 to 6 breaths will allow for complete emptying of the spacer. Finish by removing the metered dose inhaler from the spacer and cap the mouthpiece. If your doctor tells your child to spray more than once, wait about 15 to 30 seconds between puffs. Repeat from shaking the MDI metered dose inhaler and the spacer one more time before administering the next puff. Do not load both puffs into the chamber and then ask the child to empty the spacer with just one inhalation. If using a metered-dose inhaler with steroid medication, ask the child to rinse his or her mouth with clean water after inhaling the medication to remove excess medication deposited in the mouth and throat. Then ask the child to spit out the water, do not swallow. One spacer can be used for more than one drug by removing the first MDI metered dose inhaler and inserting another. Technique for using MDI metered dose inhaler for children with asthma without spacer:

Remove the mouthpiece cap and check that there are no foreign objects in the MDI metered dose inhaler. Shake the MDI metered dose inhaler vigorously for about five seconds. Hold the MDI metered dose inhaler upright with your index finger. on the bottom of the vial and thumb supporting the bottom of the MDI metered dose inhaler Ask the child to exhale normally through the mouth Place the mouthpiece between the child's teeth and ask the child to close his or her lips around the mouthpiece Be sure make sure the child's tongue is not blocking the mouthpiece opening of the metered dose inhaler Press your index finger to the bottom of the vial to release the medication At the same time ask the child to take one slow, deep breath through the mouth until the child's lungs are is completely filled, this may take three to five seconds Ask the child to hold their breath to hold the medicine in their lungs for about 5 to 10 seconds before exhaling Finish by removing the metered dose inhaler from the child's mouth and putting the cap on mouthpiece If your child needs a second puff, wait about 15 to 30 seconds between puffs. Repeat from the step of the MDI metered dose inhaler one more time before the next puff If the metered dose inhaler is used with a steroid medication, ask the child to rinse his/her mouth again using the same instructions as above.

3. How to use MDI metered dose inhaler for children with asthma according to age?

Whether a child is infancy or adolescence, asthma inhalers are an important part of an asthma treatment program. When the drug is formulated as an MDI metered-dose inhaler, the effectiveness of asthma treatment depends not only on the technique used but also on the age of the child with certain cooperative skills.
For infants and toddlers, it is not appropriate to treat asthma with an MDI metered dose inhaler. Instead, a nebulizer that breaks down liquid medicine into very small particles that can be inhaled deep into the lungs becomes more appropriate.
When children are 3 years of age or older, some children may be earlier if they learn to cooperate, this is the right time to train to use asthma inhalers with metered dose inhalers. The best course of action for the child at this time is to have a spacer and mask. If applying the mask to the child's face can make the child afraid, parents need to discuss, explain to the child to understand, reassure the child and do it on themselves for the child to observe first. During the first time the child wears the mask, the child should be asked to take deep breaths and the parents check to make sure the mask fits snugly and there are no leaks.
By the age of 4 to 8, the child may no longer need a mask. However, the use of the MDI metered dose inhaler for asthmatic children with the best spacer should still be maintained. At this point, it is important to show the child how to place his or her lips snugly around the mouthpiece of the spacer chamber, to prevent medication from escaping.
For children over 8 years old, the child can use the MDI metered dose inhaler independently without adult assistance. Therefore, children need to have an MDI metered dose inhaler ready by their side to use at any time. Only then can parents fully trust that their children can participate in all activities and develop as comprehensively as their peers.
However, regardless of age, and even in adults, the use of MDI metered dose inhalers may be appropriate only when mild flare prevention or relief is needed. to average. When a severe acute asthma attack occurs, the child has severe difficulty breathing, cannot inhale effectively nor hold his breath, the child needs to be relieved by using medicine in liquid form and a nebulizer.

4. How to store and clean aerosol inhalers, tools to assist in using asthma inhalers for children

Until the child can use the metered dose inhaler on their own, the maintenance and cleaning of the MDI metered dose inhaler and aerosol aids such as spacers and masks still need support from parents. or caregiver.
The MDI metered dose inhaler is the most important instrument, which needs to be cleaned regularly to prevent drug build-up and blockage. Most manufacturers recommend cleaning the mouthpiece at least once per week. Steps to clean the MDI metered dose inhaler are as follows:
Remove the vial and cap from the mouthpiece of the metered dose inhaler. Temporarily store the vial in a cool and dry place, away from moisture or contamination. Do not immerse the metered dose inhaler in water, but run it from the top to the bottom of the mouthpiece under running water for 30 to 60 seconds. Wash the inside and outside of the lid. Absorb excess water or allow the mouthpiece to dry completely. Insert the vial and test spray twice to get it ready to use. Take care to stay away from the face. Put the cap back on the mouthpiece. As for the spacer or respirator, although the powder residue left in the chamber is not harmful, the instruments should be cleaned periodically. Parents can clean the plating as usual for other children's tools. However, the buffer chamber alone needs to be washed with warm water and diluted dishwashing liquid or suitable cleaning solution. Rinsing with water alone can cause an electrical charge to develop, increasing the adhesion of drug particles to the inner wall of the spacer and reducing the effectiveness of the tool.
Parents need to know how to correctly use the MDI metered dose inhaler for children with asthma to help get the medicine into the lungs and help the child better control the disease. Conversely, if an asthma inhaler is used incorrectly, little or no medication can reach the lungs. Therefore, the instruction on how to use the metered dose inhaler mdi is an indispensable component in the treatment of asthma in children.
Respiratory - Allergy and Clinical Immunology Unit at Vinmec Times City International Hospital was established and expanded with the desire to provide professional services with high expertise for medical examination and treatment. respiratory, allergic and autoimmune diseases.
The unit brings together professors, doctors and specialists with more than 30 years of experience, well-trained young doctors in advanced countries who are always ready to treat and take care of people. sick. In addition, the Unit is equipped with the most modern equipment and machinery in Vietnam to support the diagnosis and treatment of diseases.
In particular, for patients with bronchial asthma, patients are measured FeNO to support early diagnosis of asthma, especially in children. This is an effective monitoring tool for asthma management, treatment, and prognosis of acute asthma attacks (only address in the North). In addition, with the desire to work with you to control asthma, the Asthma Club is opened regularly to supplement knowledge, help patients exchange knowledge with leading experts in Vietnam and the world about asthma. asthma. Currently, the Unit has professional cooperation and scientific research with hospitals and universities in Australia, the United States and France.
Respiratory unit - Clinical immuno-allergy is currently becoming a reliable examination address for many customers because when they come to the clinic, the patient will be examined and thoroughly consulted by the doctor about the disease and treatment plan. Patients are also provided with comprehensive supplemental information about the disease.
Customers who need medical examination and treatment can go directly to the Respiratory - Allergy Clinical Immunology Unit or contact to book an online appointment HERE.

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