Children should never use a metered-dose inhaler (MDI) without a spacer device because the delivery of the medicine to the lung is much less if a direct technique is used.
- Shake the inhaler well.
- Remove cap, and insert the inhaler in the spacer.
- Grip the mouthpiece gently between teeth, and close lips around it. If the child is using a spacer with a mask (usually less than 6 years) place the mask over the child’s mouth and nose, making sure there is a good seal.
- Press the inhaler once to release one puff in the chamber.
- Have the child breathe in slowly and deeply for 3 times (or for about 15 seconds in younger children). The movement of the valve indicates that the technique is correct.
- Shake inhaler again and repeat steps 3-5 if more than 1 puff has been prescribed.
- Unhook the inhaler from the spacer and replace the cap.
- For older children, rinse the mouth with water (oral candida is uncommon).
In short, (1) shake, (2) spacer, (3) 3 slow, deep breaths!
The spacer should be cleaned only occasionally. Take the spacer apart and wash it in warm soapy water. Do not rinse. Allow the spacer to drip dry. Do not wipe the spacer dry with a towel to avoid static.