About Asthma Inhaler Devices

Several asthma medications are taken by an inhaler. It is very important to use the inhaler correctly. If used the wrong way, your child will not get the right amount of medication into the lungs. Remember:

• If using more than one inhaler, ask your healthcare provider which medication should be taken first.
• Store the inhaler at room temperature in a dry place away from direct heat.
• Never store the inhaler in a car or area where the temperature is below freezing or very hot.
• Keep the inhaler and all medications out of the reach of children.
• Do not share medications with other people.
• If your child has trouble using the inhaler or if you don't think that it is helping your child’s asthma, contact your healthcare provider or pharmacist for help.

Does Your Child Use a Metered-Dose Inhaler?

A Metered Dose Inhaler (MDI) is one type of inhaler that sprays a fine mist of liquid medication. Each spray or "puff" of the MDI contains the same amount of medication, but only if the MDI is shaken before each and every use to mix up the liquid. For best results have your child use a spacer when using the inhaler.

Steps for Using the Metered-Dose Inhaler

• Step 1 - Remove cap on the medication inhaler and attach to the spacer chamber. Stand up and shake the inhaler 10 times.







• Step 2 - Breathe out and place the mouthpiece of the spacer into the mouth. Push down once on top of the inhaler, and take in a slow, deep breath.






• Step 3 - When your child has completely filled his or her lungs, hold the breath for up to 10 seconds. If needed, wait a minute before taking a second puff.

Note: It's important to remember which medication is your child's rescue medicine and which is the control medicine. Use the Asthma Action Plan so you know when to use each of the medications.

Does Your Child Use a Disk-Type Inhaler?

The disk-type inhaler is one type of dry powder inhaler that delivers a very fine powder medication.

Steps for Using the Disk-Type Inhaler

• Step 1 – Open the disk-type inhaler. Hold the inhaler in a level position with the mouthpiece facing you. Slide the lever away from you as far as it goes until it clicks. A dose is now ready to inhale. DO NOT SLIDE THE LEVER MORE THAN ONCE.



• Step 2 – Put the mouthpiece to the lips and breathe in steadily and deeply through the disk (not through the nose) for a full breath. Hold the breath for about 10 seconds. Breathe out slowly. Spacers or masks should not be used with this or other dry powder inhalers.

Does Your Child Use a Nebulizer?

A number of people use a nebulizer to take their asthma medication. A nebulizer makes a mist from the asthma medication. Your child breathes the mist into the airways of the lungs.

Steps for Using the Nebulizer

• Step 1 – If the medication comes pre-mixed, open it and place it into the cup. If the medication is NOT pre-mixed, measure the amount of medication as directed by your healthcare provider and put it into the cup with the solution. Fasten the mouthpiece OR mask to the cup and attach the cup to the tubing of the compressor.



• Step 2 – Put the mouthpiece in the mouth and tighten the lips around it OR place the mask on your child's face. Turn on the nebulizer. Take slow, deep breaths in through the mouth and hold each breath 1 to 2 seconds before breathing out. Continue breathing until the mist is gone. This usually takes about 10 minutes. If it takes much more (or less) than 10 minutes to complete the nebulizer treatment, the nebulizer may not be working correctly. Contact your healthcare provider or nebulizer vendor.

Cleaning the Nebulizer
It is best to clean the nebulizer after each use to prevent
infection and to keep it from clogging.

• Wash all parts (except the tubing and compressor) with dish soap and warm water. Rinse well.
• Shake and then air dry on a clean cloth or paper towel.

If a dishwasher is available, you can wash all parts (except the tubing and compressor) by placing items on the top shelf. Remember: In addition to cleaning, it is important to disinfect the nebulizer at least once a week (or every other day when possible). Soak the nebulizer parts (except the tubing and compressor) in a mixture of 1 part distilled white vinegar and 3 parts hot water for one hour. Rinse under warm running water and air dry.

When to Replace Parts of the Nebulizer

• Replace the mask, mouthpiece and filter every six months.
• Replace the compressor and tubing every five years.

Using a Peak Flow Meter

A Peak Flow Meter (PFM) is a quick and easy way to measure how well air moves out of the lungs. This tool helps to identify problems with the lungs, before symptoms may appear.

Proper Use of a Peak Flow Meter

• Identify your child's "Personal Best" (see instructions, below).
• In most situations it is best to test daily. Your health-care provider will let you know how often to use the PFM.
• Measure first thing in the morning before taking medications or eating.
• A drop in peak flow below 80% of personal best indicates a need for added medications. Contact your healthcare provider.

A drop in peak flow below 50% of personal best indicates a severe problem. Action is needed immediately. Contact your Healthcare Provider. If the provider is not immediately available, go to the Emergency Department or call 911.

How to Measure Personal Best

• Place marker at zero.
• Stand up and take in a big breath with the mouth open.
• Quickly close the lips firmly around the tube. Blow one time as fast and hard as possible.
• Find the number where the marker stopped and write it down. This is the peak flow.
• Repeat this three times and use the highest number as your child's personal best peak flow.

Cleaning the Peak Flow Meter
Keep the PFM clean. Wash weekly with warm soapy water, rinse and allow to dry before using.