Avery Wheezing Treatment - Salbutamol Inhaler Guide
Date: April 26, 2026 Context: Viral URI with wheezing, doctor visit with nebulizer treatment Video guide: How to use a metered dose inhaler with a spacer for children
How to Use the Inhaler with Spacer (Step-by-Step)
Source: KKH Health Videos — Metered Dose Inhaler with Spacer for Children
Before first use of a new inhaler — PRIME it: Release 2 puffs of medication into the air (or until a fine mist is seen).
For each dose:
- Check the dose counter — make sure the inhaler is not empty
- Hold inhaler upright, remove cap, shake well
- Insert the inhaler into the end of the spacer
- Sit or stand Avery upright, preferably facing you
- Place the face mask securely over her mouth and nose — ensure it fits tightly with no gap between the mask and her face
- Press down the canister ONCE (1 puff)
- Encourage Avery to breathe in and out normally
- Remove the spacer after 6–8 slow and steady breaths
- Ask her to breathe out gently away from the spacer
- For the second puff, wait about 1 minute from the first puff, then repeat steps 2–9
After each dose: - Clean the face mask with a dry tissue - Wipe Avery's face with a damp cloth - Rinse her mouth with water or brush her teeth
Dosing Schedule (Tapering)
| Period | Frequency | Duration |
|---|---|---|
| Days 1–2 (Apr 26–27) | Every 4 hours | 2 days |
| Days 3–4 (Apr 28–29) | Every 6 hours | 2 days |
| Days 5–6 (Apr 30–May 1) | Every 8 hours | 2 days |
What It Is
The inhaler is almost certainly salbutamol (Ventolin) — a bronchodilator that opens airways. Very safe, commonly used even for infants. Not a steroid.
Why It Matters
- The tapering schedule keeps airways open while the viral infection clears
- Stopping early or skipping doses risks wheezing returning → hospitalisation
- Doctor warned that if wheezing comes back, Avery would need to be sent to hospital
Childcare Concern
- Childcare staff may not be familiar with spacer technique
- Risks of botched dose: not waiting between puffs, poor mask seal, wrong timing
- Options: 1. Train childcare staff with a demo 2. Parent goes during lunch/afternoon to administer daytime doses 3. Jane (on leave till Apr 28) handles daytime doses
Practical Tips
- Set phone alarms for every scheduled dose
- Mark the schedule changes on calendar (interval changes every 2 days)
- Track when doses are given — easy to lose track with changing intervals
When to See Doctor Again
- Wheezing returns despite medication
- Breathing difficulty worsening
- Fever returns or persists
- Avery seems lethargic or is refusing fluids