Inhaler with Spacer to Tracheostomy Tube

A metered dose inhaler is a small aerosol can in a plastic holder. This gives a burst of medicine straight to the lungs.

A spacer or inhaler adapter is easier to use for a ventilator. This helps to make sure the right amount of medicine gets into the lungs. The spacer holds the medicine. It is the released from the inhaler. This allows more time to inhale into the lungs. Using a spacer may lessen side effects.

Getting Inhaler and Spacer Ready

Prime the inhaler by shaking it for 5 seconds. Spray 4 puffs into the air away from you. You need to prime your child's inhaler:

• Before the first use.

• If it has not been used in 2 weeks.

• If it has been dropped.

Using the Inhaler and Spacer with Tracheostomy Tube

1. Place child in an upright position if able.

2. Remove the mouthpiece cap from the inhaler.

3. Put the inhaler mouthpiece into the larger end of the spacer.

4. Shake the inhaler and spacer well to mix the medicine.

5. Connect the spacer to your child’s tube. Squeeze the inhaler once to release a puff.

6. Keep spacer connected to tube for 5-6 breaths. The flap inside the spacer should open slightly with each breath.

7. Remove the spacer from your child’s tube.

8. Wait 1 minute before the next puff of medicine. Shake inhaler well between puffs while you wait.

9. Repeat steps 5 through 8 for more puffs.

How to Use the Inhaler with a Ventilator

1. Gather all needed supplies. This includes inhaler and inhaler adapter. This is to be used in-line with ventilator tubing (circuit).

2. Place child in an upright position if able.

3. Shake the inhaler well to mix the medicine.

4. Placement in-line with ventilator:

   1. With a Single-Limb Circuit: Place inhaler adapter. Place between exhalation valve and patient airway.

   2. With a Dual-Limb Circuit: Place inhaler adapter. Place on inspiratory limb of circuit. This is closest to patient airway. Remove the aerosol can from the inhaler’s plastic container. Connect the nozzle of aerosol can into the inhaler adapter

      

5. Squeeze the inhaler once to release a puff of medicine

6. Wait 1 minute before the next puff of medicine. Remove the aerosol can from your inhaler adapter while you wait. Then shake the canister to mix up medicine between puffs. If your child needs more puffs, replace it in the adapter.

7. Remove the aerosol can and inhaler adapter from circuit.

8. Repeat steps 6 through 8 for more puffs.

Metered Dose Inhaler Facts

Store the inhaler at room temperature. Avoid storing in a car. Extreme hot and cold can affect the medicine. Check the expiration date on the inhaler. Each inhaler has a certain number of puffs. Figure out how many puffs are used a day if the inhaler does not have this. Mark it on a calendar so you know when to start a new inhaler. Be sure to refill inhaler before it’s empty.

Cleaning the Inhaler and Spacer

• Wash the spacer with dish soap and warm water weekly. Rinse with warm water. Then air dry on a clean towel.

• Do not scrub the inside of the spacer. It has a special coating inside.

• Do not put the inhaler in water.

• Use a dry cotton swab. Clean the opening where the puff sprays out of the inhaler. Repeat once a week.