multi dosing with volumatic spacer....

Do you/ Should you

A. Spray 10 puffs into the spacer at one time and breathe that in

or

B. One puff at a time, shaking inhaler between each puff. Repeating process 10 times?

Thank You

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1 puff, breathe, 1 puff, breathe etc

We were told to puff then have her breathe 5 to 10 times then next puff etc

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ok that is what I thought...........

I was always told to give the puffs separately, so one puff into the spacer, take medication. stop, shake inhaler and repeat the process. 10 times.

But this video seems to demonstrate putting 10 puffs of ventolin into spacer at once.

youtube.com/watch?v=xIFG-r9...(Not working as expected?)

IS there any reason why you should do it separately

or any reason why you should do it all at once

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I am no expert but I was told by our asthma nurse the child gets more medicine into their lungs if the puffs are separate. I'm unsure though

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I *think* there are 2 main reasons:

1. Sometimes (hopefully most of the time!) your child won't need 10 puffs of the reliever, and this gives you time to assess whether this is actually necessary or not. From personal experience I can sometimes be ok after 2 puffs or really not ok after 10. Gives you something concrete to work with.

2. if more than 1 puff is sprayed at a time, the meds aren't guaranteed to get to the lungs where they are needed, but instead just stay in the throat.

I think its more the first one though - also if multidosing is quite common or even use of reliever, it might be the right time to go to see the GP as the asthma might not be as well controlled as it could be and preventative meds might need adding/increasing.

Hope this helps.

Laura

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little nutters asthma is ok atm, not needing multi dosing. Hayfever throwing a slight spanner in the works but we're on top of it.

just asking as I saw this video and thought here wait a minute that's not what I do and was just seeing if guidelines had been changed or something as that appears to be a training video to show folk how to manage an asthma attack.

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Hi everyone,

MDI's with any drug in them delivers 1 measured dose i.e 100mcg, 250mcg etc ONLY if you wait 20-30 seconds between each puff.

The amount of breath each patient take depends on:-

1 how old they are

2 how cooperative they are

3 how well or ill they are thsi could be anything from 3 good deep breaths to 7-8 if tight, short of breath etc

Sorry but this as a specialist nurse is one of my bug beard.

If the technique is not followed the person will not get the correct dose which mean hardly any drug mainly aerosol. This is one of the main problems we see in our clinic with new patients.

Hope that helps

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PS and MDI's should only be used in conjunction with a spacer of one kind or another. Over 7yrs every patient should be assessed for a hand held device that does not require a spacer. No one should use MDI's in to mouth

Sorry another bug bear of mine

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Ann, I find your reply interesting, when I had my spirometry when first getting diagnosed, for reversability, the nurse squirted about 5 puffs one after another and got me to breathe, then did it again, she didn't shake it between squirts either, she then only waited 5 minutes before repeating spirometry. Even at the time, I wasn't convinced she'd done it correctly.....your post confirms I am correct and explains why she didn't see a great deal of reversability!!