Why you should use a spacer with a pediatric inhaler?
May 29, 2014
Asthma is one of the most common chronic illnesses of childhood. As a lung specialist, I often diagnose a child to have asthma based on a careful analysis of the history provided by the family, a thorough physical examination and some special breathing tests which help me prescribe the correct medicines for your child.
There are 2 types of inhaled asthma medicines—the immediate acting rescue medicines such as albuterol and long acting controller medicines such as inhaled steroids. These can be given via a nebulizer and also via the metered dose inhaler. Yes, the metered dose inhaler can be used in young kids too! These are so convenient, portable, take only a few minutes to administer and many research studies have shown that they work equally as well as the nebulizer machine. But there is one important fact to note. The best way an inhaled medicine will reach deep into your child’s lungs (where the actual problem with asthma is) is by using an ánti-static valved holding chamber’, simply called the spacer.
So what is a spacer and how does it help?
A spacer resembles a cylindrical tube creates “space” between your child’s mouth and the medicine. This space helps the medicine break into smaller droplets which can move easier and deeper into the lungs and therefore works very well to help your child breathe better. It also avoids the medicine from staying in the mouth and throat due to the high speed at which the drug is delivered when the inhaler is pressed. The anti-static coating helps keep the medicine from sticking to the sides of the chamber.
There are several types of spacers to choose from and your doctor and respiratory therapist can help identify the correct size and mouthpiece or mask that fits best for your child.
But as a picture speaks a thousand words, you can see how effective the spacer is in taking the medicine to where exactly it is needed.Lung specialists recommend using the spacer with the correct technique for all age groups-young children and adults. Many daycare teachers and school nurses know how to use the spacer device. A school aged child can use the inhaler with spacer independently after practicing good technique. Also spacers are available in most pharmacies and are often covered by medical insurance.
As a pulmonologist, I may know a lot about the structural and biochemical aspects of asthma, but as a mother with a toddler with asthma, I understand how distressing it is to watch your child struggle to breathe and the best way to help your child is to be prepared- always have the rescue medicine with you (as an asthma attack can be triggered anytime), use the controller medicines regularly and always use the spacer with the inhaler so that the medicine actually reaches deep into the lungs.
To learn more about asthma, listen to our latest PediaCastepisode.
Grace R. Paul, MD, is a member of the Section of Pediatric Pulmonary Medicine at Nationwide Children’s Hospital and an Assistant Professor of Pediatrics at The Ohio State University College of Medicine. She is trained and board-certified in pediatric pulmonology.
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