Most kids with asthma have no idea how to use their inhalers, doctors warn

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MANY kids living with asthma think that they’re using their inhalers correctly – when they’re not, experts have warned.

Because of that, they’re putting themselves at risk from a potentially deadly asthma attack.

Lots of children are at risk from ashtma attacks due to incorrect inhaler technique
Lots of children are at risk from asthma attacks due to incorrect inhaler technique
PA:Press Association

A new study published in the American College of Allergy, Asthma and Immunology (ACAAI) found that African American children and their parents were overly confident about inhaler usage.

Scientists look at 65 pairs of parents and children at four Chicago schools.

Aged between 8 and 14, 97 per cent of the children used their inhalers wrongly.

Just 5 per cent of kids who were confident in their inhaler technique used their inhaler properly.

Parents overestimate their children’s abilities

None of the parents doubted threat their kids could use their inhalers.

“We know from past studies that both parents and children overestimate the ability of children to properly use their inhaler,” said Dr Anna Volerman lead study author.

“We examined whether parent and child confidence were the same and whether either was a good sign of the child’s actual ability to use the inhaler correctly.

“We found most parents and children overestimated the children’s ability based on high confidence by the child – despite inhaler misuse.”

GPs need to start checking inhaler technique

Allergist Todd Mahr, ACAAI president, said that it wasn’t enough for a health care provider to simply ask if a kid or a parent if their kids know how to use their inhaler.

“Simply asking is not a reliable screening tool to determine who needs additional education on how to properly use an inhaler. If your child has asthma, check with your allergist to make sure your child has proper inhaler technique.

“Bring the inhaler with you to your next appointment and have your allergist or one of their staff watch your child use it.”

The study’s authors concluded that one reason behind the fact that so many children are using their inhalers wrongly is that their parents can’t recognise what’s good or bad practice.

Not the first warning

This is just the latest stark warning after a series of studies have made similar conclusions.

We reported at the start of the month that a study by experts at Northwestern University Feinberg School of Medicine which found that half of kids with asthma were making “potentially fatal mistakes” when using inhalers – because they weren’t using their spacers.

“We know that asthma can be well managed in the majority of patients and using your inhaler correctly is a key factor to managing asthma,” said lead author Dr Waheeda Samady.

“Improper inhaler technique can contribute to children having uncontrolled asthma and needing to come to the hospital for their asthma.

“Our study suggests that as healthcare providers we can do a better job showing patients and families the correct inhaler and spacer technique, and checking it frequently to ensure they master it.”


Using a wrong technique can mean that you’re more likely to get side effects like oral thrush or a sore throat, because the medicine is hitting hte back of the throat or just staying on the tongue.

Correct technique, on the other hand, sees the medicine go down into the airways where it’s needed.

They’ve uploaded a series of helpful videos which can tell you if you or your child is using certain inhalers correctly.

COMMON ASTHMA MISTAKES

According to Asthma UK, there are 11 common mistakes many people make when it comes to using an inhaler:

1. not breathing in the right way for your type of inhaler

  • If you have a pressurised Metered Dose Inhaler (pMDI), you need to breathe in slow and steady. At the same time, press the canister on the inhaler once. Continue to breathe in slowly over 3 to 4 seconds, until your lungs feel full.
  • If you have a dry powder inhaler you need to breathe in quickly and deeply until your lungs feel full, to be sure you inhale all the medicine.

2. forgetting to shake the inhaler first

  • Not all inhalers need to be shaken – check first

3. not waiting between puffs

  • With some inhalers, you need to wait least 30 to 60 seconds before taking the next puff. This gives the medicine and propellant enough time to mix together.

4. not breathing out before using an inhaler

  • When you breathe out as fully as you can just before taking your inhaler, you create more space in your lungs for your next breath in. This means that you can breathe in deeper and for longer when you inhale your asthma medicine – giving it the best chance of reaching the small airways deep inside your lungs.

5. not having a tight lip seal

  • Making sure that your lips are tightly sealed around your inhaler will make sure that the medicine goes where it’s needed

6. not lifting your chin slightly before breathing in

  • Lifting your chin will help the medication go into the lungs more effectively

7. breathing in too early before pressing the inhaler canister

  • If you’re already halfway through breathing in by the time the medicine is released from the inhaler, you won’t have enough time to finish breathing in all the medicine because your lungs will already be full. If this happens, some of the medicine will end up being sprayed in your mouth and hitting the back of your throat. It won’t be carried down to your lungs where it’s needed.

8. breathing in too late after pressing the inhaler canister (unless you’re using a spacer)

  • It takes less than half a second from the time the canister is pressed for all the medicine inside the inhaler to be released. If you breathe in after this time, some of the medicine will end up in your mouth instead of being carried down to your lungs where it’s needed.

9. not holding your breath after taking your inhaler

  • If you’ve been advised to hold your breath after using your inhaler, it’s important you do – holding your breath keeps your airways still, giving the medicine more time to settle into your lungs. Ten seconds is ideal, but if this isn’t possible, you’ll still benefit by holding your breath for as long as you feel comfortable.

10. not using a spacer

  • They’re not just for kids!

11. forgetting to take your inhaler at the same time every day

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