If your child has viral wheeze/ bronchospasm (tightening of the airways), or suffers from asthma attacks, it is likely that he will need treatment with inhaled bronchodilators or anti-inflammatory medication. Three important clarifications are needed here:
Α. The direct use of inhaled medications used by adults is not appropriate for small children, nor is it reliable, so they should be administered through a mask and an aero-chamber. Around the age of 8 or 9, or older, a child is able to cooperate effectively enough to successfully take the medication directly by mouth with an inhaler.
B. It is important to note that it is almost always preferable to administer medication for the above situations topically, in the form of a medication inhaled through a mask, and not systemically, in the form of syrup, for two reasons:
1) The topical use of a bronchodilator for the respiratory system, like the topical use of cortisone, has fewer side effects for the child. Medication in the form of syrup is absorbed and passed into the blood stream, resulting in a greater risk for the child to present systematic side effects from its use – for example, tachycardia, excitability from the use of salbutamol, suppression of the immune system from the use of cortisone.
2) The absorption of bronchodilators by the stomach and the intestine is small and fairly unreliable, resulting in insufficient dosage for the desirable result.
C. It is also important to emphasize that inhalations with an aero-chamber are equally as effective as inhalations from a nebulizer, and safer. Except for in extraordinary cases, parents should not use a nebulizer at home to treat an asthma attack or viral croup.
– The aero-chamber mask is portable, it can be carried in the child’s schoolbag, and the child learns to use it whenever he has symptoms, wherever he is, at school, while doing sport, at a friend’s house etc., which cannot be done with nebulizers.
– Nebulizer use at home can provide a false sense of security. The child may be suffering from an attack that requires monitoring in a hospital, or oxygen, and transfer to hospital is delayed by the use of a nebulizer at home. Nebulizers are essentially a hospital treatment that should be administered with close medical monitoring.
– Nebulizers are much more expensive, and are not as safe or effective as aero-chambers for attacks that are treated at home. CONSEQUENTLY, NEVER BUY NEBULIZERS FOR HOME USE; however, make sure that both you and your child are familiar with the use of the aero-chamber. This method of treatment with medications is easy to use, cheap, portable, and needs only simple care.
Aero-chambers are available as infantile (up to the age of 12-18 months), and children’s devices, depending on their size and the age of the child.
How to use an aero-chamber:
• Assemble the aero-chamber according to the instructions included in the packaging.
• Remove the cap of the inhaler (e.g. Aerolin), shake it well, and administer the first dose into the air.
• Shake the inhaler well, and attach it to the end of the aero-chamber.
• Holding the child in a sitting position, place the front part of the aero-chamber with the mask over the child’s nose and mouth, fitting it as well as possible so that no air escapes.
• Press the inhaler once so that a dose of the medication is released.
• Slowly count to 10, while the child is breathing in the aero-chamber. Hold the aero-chamber steadily so that the medication mist is not released into the air. The medication has been successfully administered if the child has taken 4 to 5 good breaths. Even in case of crying during the procedure, the child effectively inhales the medication.
• If a second dose of the medication is needed, shake the inhaler again, and repeat the above procedure.
Care of the aero-chamber:
• Clean the aero-chamber weekly.
• Disassemble the individual parts of the aero-chamber, and wash it with warm water and mild soap.
• Leave it to air-dry, do not dry with a towel.
• Reassemble the parts of the aero-chamber the following morning.
• It is best for each child to use his own aero-chamber.
Stelios Papaventsis MRCPCH DCH IBCLC 2012