The right medicine can fail if the spacer technique is wrong. This is one of the commonest correctable causes of poor asthma control.
Severe breathing difficulty, chest indrawing, blue lips, drowsiness, poor feeding, grunting, pauses in breathing, persistent fast breathing, low oxygen — these are not for online review. Go to in-person pediatric emergency care.
What parents usually notice.
- Child coughs immediately after inhaler
- Mask leaks around cheeks or nose
- Multiple puffs are sprayed together into the spacer
- Spacer is rarely cleaned or is cleaned incorrectly
Common reasons doctors think about.
- Poor mask seal
- Incorrect timing between puff and breathing
- Crying or poor cooperation
- Device mismatch for age
What a pediatric pulmonologist checks.
- Demonstration of technique
- Spacer size and mask fit
- Breathing count after each puff if advised
- Cleaning and replacement schedule
What not to do blindly.
- Do not assume technique is correct because family “uses inhaler”
- Do not spray many puffs at once unless specifically instructed
- Do not skip technique review during follow-up
- Do not stop medicines just because technique failed
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