Face masks - aerochamber and volumatic spacers

Wanted to share with everyone in the hope it might help other children struggling to stay out of hospital every time they catch a cold...

Our 3 year old has been in and out of hospital on a 1 to 2 monthly basis with viral induced wheeze/asthma for 2 years now. He had 2 weeks worth of admissions in December alone. During December he was even diagnosed as having a status asthmaticus during one of his emergency admissions.

So... things were pretty bad despite religious following of asthma plan and him being on 400mcg clenil per day. At no point during any of our A&E visits, stays in hospital or trips to the consultant did anyone mention trying his spacer without a mask. Finally, 2 weeks ago, it was explained to me by new resp consultant that the aerochamber with face mask delivers about 10% of the inhaler dose, the volumatic with face mask delivers about 15% of the dose but that the volumatic used without a face mask delivers 60% of dose!!

This may be old news to a lot of you, but just in case it isn't... please, anybody out there with a child over 2 who is still using a face mask, get your nurse/gp/consultant to show you how to use the volumatic without the face mask as soon as possible. Sam picked it up after 2 attempts and uses the volumatic mouthpiece very happily (re-breathing technique, not 1 deep breath and hold).

After 6 weeks off nursery Sam went back 3 weeks ago, predictably he was off again 10 days later with a bad cold. He went into an attack at the weekend. BUT a miracle happened - 10 puffs of blue four hourly (including through the night) for 3 days and we managed the whole thing at home without pred!! First time we've done it for a year, and almost certainly all thanks to using the volumatic spacer without a mask. Fingers' crossed for staying at home with the next cold.

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Wow that's fantastic.

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AeroChamber Plus

Did you know that the AeroChamber Plus product is also available in a mouthpiece version without a mask? From what I have read from the literature, drug delivery is comparible to Volumatic but is much easier to use and not as bulky. If I am not mistaken, GSK (they make puffers such as Flovent, Ventolin and Seretide) also recommend the use of AeroChamber.

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Thanks for the info James M, that's useful to know. Son's consultant did make very brief reference to aerochamber with mouthpiece as something we might try at next appointment so he can swap to other inhalers the consultant prefers. Just wish someone had told me earlier about what a difference using a mouthpiece makes to delivery of inhalers compared to using a mask.

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Well done on spreading the message

Hi Sammum

I'm so glad you've posted this. I've been told a number of times by doctors my inhaler technique was to blame for my 4-yr-old son's hospital admissions when he needed nebulisers (8 admissions last year after catching colds).

At no time did anyone (consultants, GPs, asthma nurses) tell me about this difference between using a mask and not using one.

Only when I phoned the Asthma UK nurse helpline was I told to try it. I started using a volumatic spacer, as was also told the inhalers we use should be used with this type of spacer. Both made by the same company.

I started in December and my son picked it up really fast for his daily flixotide, though we breathe in, hold for two counts and breathe out six times. (Don't know what re-breathe is but I'd like to find out).

He got a bad cold when he went back to nursery in January but, like you, we managed for the first time without hospital admission. I felt absolutely elated.

Unfortunately, we were admitted overnight last weekend after another cold set in, but I have to say the admission was much better than usual, with lighter treatment and it was over with within 20 hours.

So he's gone from December to mid Feb without a hosp admission and this is definitely an improvement, though I can't prove the spacer was responsible.

When I told both my son's respiratory paediatric consultants about this, plus his asthma nurse, they were ALL dismissive. I wonder if there is any published research I could show them to make them realise that this could be a really important and valuable piece of information for parents?

The only thing I will say though is that I've found it hard to wake my son up in the night when he's got a cold and get him to use a mouthpiece rather than a mask.

But overall, this is really worth knowing I think.

[yaf_user681_25874]

Hi

Just to add one other plus about the aerochamber if you've never used one... if you're technique isn't right it whistles...

So if you're wondering how well it's working, so long as there isn't a whistling noise and they are appearing to use it correctly, then they probably are... works well for my 9 yo... she can take all her inhalers herself with only minimal supervision and knows it mustn't whistle...