C. Marguet et al., Inhalation treatment: Errors in application and difficulties in acceptanceof the devices are frequent in wheezy infants and young children, PEDIAT A IM, 12(4), 2001, pp. 224-230
The recent availability of small-volume spacers has facilitated the general
use of inhaled treatment in infants. The purpose of this study was to eval
uate any errors made by parents when using this new inhalation technique an
d the child's behavior during the inhalation. Ninety-four young children (6
1% boys) under 5 years of age were enrolled in the study. Inhalation treatm
ent was recommended either by a general practitioner or by a pediatrician.
Data concerning treatment regimens, the ability of parents to use the space
r and metered-dose inhalers (MDIs), and the acceptance of the devices, were
collected by means of a demonstration and questionnaire. Unexpectedly, the
doses, administration times, and duration of the treatments varied from on
e child to the next. No explanation or training in administering the treatm
ent via the spacers was given to 12% and 47% of the parents, respectively.
Fourteen per cent of parents did not shake the MDIs, 12% did not monitor th
e valves, and 22% allowed too short a time for inhalation. The lack of expl
anation increased the occurence of errors in manipulation of the devices. T
he procedure was judged to be easy to follow by 78% of the parents, but the
face mask was accepted with difficulty by 22% of the children. Repeated cr
ying during administration of the treatment was observed in 38% of the pati
ents, particularly the youngest. Crying influenced the acceptance of the fa
ce mask. reduced parental compliance, and made the use of the devices more
difficult. Errors altering the efficiency of inhalation treatment in infant
s are frequent. Most of these errors could be avoided by spending more time
to inform the parents about correct usage. Furthermore, repeated crying du
ring inhalation is common in young children and this problem should to be t
aken into consideration in the evaluation of treatment.