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| Main > Asthma Center > Using a MDI
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Using a MDI
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Most kids are able to use a metered dose inhaler (MDI) when they are 4-6 years old. A younger child may also be able to use a MDI with a spacer and mask.
- Shake the inhaler.
- Breath out normally.
- Hold the inhaler in your mouth (closed mouth technique) or right in front of your open mouth (open mouth technique). If using a spacer and a mask, place the inhaler in the spacer and place the mask firmly over your child's mouth (see below).
- Press down on the inhaler once to release the medicine at the same time that you start to breathe in slowly (or wait until your infant takes a breath if using a spacer and mask).
- Breathe in slowly for 3-5 seconds and then hold your breath for 10 seconds.
- Breathe out comfortably.
- Wait about 1 minute before taking additional puffs.
To find out how much medicine is left in your inhaler, place the canister (without the mouthpiece) in a container of water. It will sink if it is full and float if empty. Do not do this with Intal or Proventil HFA or with dry powder inhalers.
If using a steroid inhaler, possible side effects include thrush, a fungal infection that causes white patches in his mouth. To prevent thrush, use a spacer (see below) and rinse out your child's mouth after he uses his inhaler.
If you are using a bronchodilator (such as albuterol, ventolin or proventil) and a steroid inhaler, you should use the bronchodilator first, as it can help to open up his airways so that the steroid medication reaches his lungs more effectively.
Older children may be able to use some of the newer dry powder inhalers, including the Flovent and Serevent Diskus. |
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Spacers
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| Using a spacer or holding chamber with your metered dose inhaler can help to make sure that your asthma medications are delivered to your child's lungs, and that they don't get wasted on his tongue or back of his throat. The spacer acts as a reservoir for the medication, until the child takes a breath. This is very useful for younger children without the proper coordination to use an inhaler by itself.
Many studies have shown that an MDI with a spacer can be as effective as using a nebulizer for an asthma attack. You will likely have to use more than the common dosage of 2 puffs at a time though. Some studies used up to 6-10 puffs of a bronchodilator as treatment for an asthma attack with good results. It is also usually faster to give a medicine with a spacer and MDI than with a nebulizer, and it may cause less side effects.
There are many different models and types of spacers or holding chambers, including those with a collapsible bag, such as the E-Z Spacer, and those without, such as the OptiChamber, OptiHaler, AeroChamber and Easivent.
- To use your spacer, shake the inhaler well and then attach the inhaler to your spacer according to the manufacturers instructions.
- Next, press down on the inhaler, which will dispense the medicine into the holding chamber. Do not dispense multiple doses of medicine into the spacer at one time, as this is not the same as taking multiple puffs at different times. Also, don't wait more than a few seconds between dispensing the medicine into the spacer and having your child take a breath.
- Now, your child can put the mouthpiece of the spacer in his mouth (or place the mask over his mouth) and take a long slow deep breath. He should then hold his breath for a few seconds and then breath out. He should repeat this step (step 3 only) two more times (although most of the medicine will be inhaled with the first breath).
- Repeat steps 2 and 3 to get the necessary amount of medicine as prescribed by your Pediatrician (usually 2 or more puffs), being sure to shake the MDI and wait about a minute between puffs.
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