title: Wheeze in childhood: is the spacer good enough?
abstract: Max was treated with SABA using an MDI and spacer with facemask and responded well to the initial treatment. You explained to the parents that nebulisers are neither required nor recommended in the treatment of wheezing in their child's situation. You advised the parents on the proper technique of MDI use with spacer and facemask, as well as care of the equipment. You also gave them a clearly written action plan regarding the efficient management of the next episode of wheeze with MDI and spacer. You further explained the side effects of oral bronchodilators and nebulisers, and why you refrained from using them. Max was given a follow-up appointment to assess his progress, and his parents were advised on the situations when they should go to a doctor or the emergency department.
authors: Veena
authors: V
authors: Rajkumar
authors: Barathi
authors: B
authors: Rajendra
authors: Choon How
authors: CH
authors: How
authors: Family Medicine Service and Menopause Unit, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899. ang.seng.bin@kkh.com.sg.
authors: Seng Bin
authors: SB
authors: Ang
mesh_terms: D001249:Asthma / Q000188:drug therapy*; D002648:Child; D003371:Cough; D016503:Drug Delivery Systems; D006801:Humans; D036503:Inhalation Spacers; D009330:Nebulizers and Vaporizers; D012135:Respiratory Sounds
references: Pediatr Pulmonol. 2000 Apr;29(4):264-9
references: 10738013
references: Arch Dis Child. 1999 May;80(5):421-3
references: 10208945
references: Pediatrics. 2000 Aug;106(2 Pt 1):311-7
references: 10920157
references: Pediatrics. 2001 Aug;108(2):389-94
references: 11483804
references: Eur Respir J. 2002 Feb;19(2):246-51
references: 11866004
references: Arch Pediatr Adolesc Med. 2003 Jan;157(1):76-80
references: 12517199
references: Paediatr Drugs. 2003;5(9):629-38
references: 12956619
references: J Pediatr. 2004 Aug;145(2):172-7
references: 15289762
references: J Fam Pract. 1982 Jun;14(6):1135-8
references: 7086365
references: Chest. 1985 Aug;88(2):276-84
references: 3893919
references: Chest. 1986 Apr;89(4):551-6
references: 3956281
references: Lung. 1990;168 Suppl:653-7
references: 2117175
references: Thorax. 1991 Oct;46(10):712-6
references: 1750017
references: Chest. 1992 Feb;101(2):305-8
references: 1346514
references: Arch Pediatr Adolesc Med. 1995 Feb;149(2):201-5
references: 7849885
references: Thorax. 1995 Jul;50(7):746-9
references: 7570408
references: Arch Dis Child. 1999 Aug;81(2):163-5
references: 10490528
references: Pediatr Pulmonol. 2005 May;39(5):466-72
references: 15786440
references: J Aerosol Med. 2005 Fall;18(3):354-63
references: 16181009
references: Respir Care. 2006 Feb;51(2):158-72
references: 16441960
references: Int J Clin Pract. 2006 Oct;60(10):1218-24
references: 16981966
references: Prim Care Respir J. 2007 Aug;16(4):207-14
references: 17625786
references: Respir Care. 2008 Jun;53(6):699-723; discussion 723-5
references: 18501026
references: Singapore Med J. 2009 Jan;50(1):54-61
references: 19224085
references: Prim Care Respir J. 2010 Sep;19(3):209-16
references: 20640390
references: Asian Pac J Allergy Immunol. 2011 Mar;29(1):25-33
references: 21560485
references: J Med Econ. 2012;15(4):704-11
references: 22400716
references: Pediatr Pulmonol. 2012 Oct;47(10):1026-33
references: 22628118
references: Cochrane Database Syst Rev. 2013;9:CD000052
references: 24037768
references: Pediatr Pulmonol. 2011 May;46(5):421-7
references: 21194171
references: Thorax. 1996 Oct;51(10):981-4
references: 8977596
references: J Pediatr. 2000 Apr;136(4):497-502
references: 10753248