Yes, we are using Salbutamol multidosing in toddlers with an MDI via a
spacer device often with a mask attached. We prefer soft round "Laerdal"
masks which make a good seal. "Aerochambers" are a good compromise - and can
be given single-handed. Toddlers don't like nebuliser masks any more than
they like MDI/spacer combinations. But if you do have to hold them "firmly"
to administer the dosage - it is a lot quicker than holding them for a
Yes, the parents do do this for their children. We would expect them to
administer oral medication to an unwilling child so why not inhaled
medication? We often tell the parents to allow the toddlers to play with the
spacer device (& put stickers on it etc) so that it is more child-friendly
and so that they associate it less with being ill. We would normally
discharge these patients with spacer-delivered drugs anyway so the kids
should be using this device at least twice daily.
I admit sometimes it is impossible. But all children have to sleep - and
they breath in their sleep - so their medication can be given then.
It's not really as difficult as it sounds (usually).
Specialist Registrar in Paediatrics
Royal Hospital for Sick Children
----- Original Message -----
From: <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, September 09, 1999 3:18 AM
Subject: Re: Fw: MDI
> Dear Doctor,
> How are you administering MD! to toddles? are the parents doing it for the
> children? does it really work?
> Maimonides NYC
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