title: Nebulizer and spacer device maintenance in children with asthma.
abstract: OBJECTIVE
  To evaluate inhalation device cleaning practices of children with asthma and its effect on their asthma morbidity.
  
  
  METHODS
  A survey of patients aged 4 to 18 years admitted to an urban pediatric emergency department (ED) with an acute asthma exacerbation. Questions included demographics, asthma history, preference of delivery devices, and frequency of device cleaning. Patients were followed until their disposition from the ED, or until the end of their hospitalization, if admitted.
  
  
  RESULTS
  220 subjects completed the survey. Mean age was 9.2 (+/- 3.9) years-old. One hundred and four (47.3%) patients used both nebulizers and spacer devices, while 18 (8.1%) used spacers only and 98 (44.5%) used nebulizers alone. Seventy-seven (38.1%; 95%CI: 31.7%-45.0%) patients cleaned their nebulizers and 57 (46.7%; 95%CI: 38.1%-55.4%) cleaned their spacer devices after each use as recommended by the Centers for Disease Control. There were no detectable differences in visit admission rate, total number of previous admissions, number of asthma exacerbations per year, and number of ED visits in one year between users who cleaned their devices after every, or every other use, compared to those who cleaned their devices less frequently.
  
  
  CONCLUSIONS
  Although the majority of patients did not follow accepted guidelines for inhalation device cleaning, further studies are necessary to correlate cleaning practices to patients' clinical outcome.
authors.affiliation: Division of Pediatric Emergency Medicine, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, New York, USA. ee.tay@nyumc.org
authors.forename: Ee Tein
authors.initials: ET
authors.lastname: Tay
authors.forename: Joshua P
authors.initials: JP
authors.lastname: Needleman
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Avner
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D003625:Data Collection; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008283:Maintenance / Q000706:statistics & numerical data; D008297:Male; D036501:Metered Dose Inhalers; D009330:Nebulizers and Vaporizers