Inhaler with a Spacer or Valved Holding Chamber

By Adem Lewis / in , , , , , , , , /

Inhaler with a spacer
or valved holding chamber. Things to consider. Attempt to provide the student
with as much privacy as possible, given the urgency
of the situation. Procedure for medication administration. Gather needed supplies
and place on a clean surface. Position student providing
as much privacy as possible. Wash hands. If student will be administering
medication, have student wash hands. Check for authorization forms or record. Review the medication
administration form, the medical provider form, and
the parent or guardian consent form. Check for the five rights —
right student, correct time, the medicine container
matches authorization forms and medication
administration record, the dose on medication container
matches authorization form and records, the medication is in the correct route
as identified on medication container, authorization forms,
and medication record. Ensure that the medication
has not expired. Make sure the inhaler and spacer
are free of foreign objects. Shake the inhaler for 5 seconds
to mix the medicine. Remove the cap
from the mouthpiece. Prime the inhaler,
if indicated. When the MDI is brand-new
or has not been used for a while, the medication may separate
from the other ingredients in the canister
and the metering chamber. Shaking the MDI will mix the
ingredients in the drug reservoir but may not produce
enough turbulence to re-blend the ingredients
in the metering chamber. Priming, or releasing
one or more sprays into the air, ensures your next dose will contain
the labeled amount of medication. Place the inhaler mouthpiece
onto the end of the spacer. Hold the inhaler between
your index finger and thumb. Have the student stand up and
take a deep breath in and breathe out. Place the spacer mask
over the student’s mouth and nose. For older students, spacers
without a mask may be used. Follow the individual
spacer instructions. Press down on the
top of the inhaler once. Hold the mask over the child’s nose
and mouth for 10 to 15 seconds. This should allow the child
to take 3-6 slow deep breaths; if a second puff is ordered,
there is no need to wait between puffs. The procedure is slightly different for the child using a mouthpiece and spacer, or if the child is not using a spacer at all.
Check with your school nurse for specific instructions. Have student rinse out their mouth
with water, and spit as needed. Wash hands. Document medication administration in
student’s medication administration log. Follow up as needed with parents
or guardian and healthcare provider. Procedure for
cleaning the spacer. It is recommended to
clean the spacer every one to two weeks,
or more often if needed. Remove the mouthpiece and the
rubber piece that holds the inhaler. Soak the mouthpiece, rubber piece,
and plastic chamber in warm water and a small amount
of dish soap. Rinse with clean water. Shake off excess water
and dry on a clean surface in a vertical position
with the mouthpiece side up. Do not dry with
a cloth or paper towel. Once dry, store in a
clean container or bag. Procedure for
cleaning the inhaler. Remove the canister
from the actuator. Run warm water through the top
and bottom of the plastic actuator. Do not boil or place
the actuator in the dishwasher. Shake off the excess water. Allow the actuator
to air dry on a clean surface prior to putting
the canister back in.

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