Child health information factsheet
Managing wheeze or asthma attacks at home
Action plan for children aged over three years
• Start treatment with inhaled salbutamol, this is the blue inhaler known as a reliever. Shake the inhaler
before use
• Use two to five puffs of your reliever through the spacer every four to six hours. Put each puff into the
spacer separately and ask your child to breathe in and out five times after each puff
• If the wheezing continues increase the dose to a maximum of ten puffs of the reliever every four hours
• If you have already given five puffs of salbutamol, give another five puffs and this should relieve their
symptoms for four hours.
If your child is still wheezy, treatment with prednisolone might be necessary. Contact your GP.
If ten puffs of the reliever is not keeping your child well for four hours seek urgent medical attention.
How to use a spacer with a mouthpiece
• Check that the spacer is clean and not damaged
• Remove the inhaler cap, shake the inhaler and put it into the back of the spacer. Place the mouthpiece of
the spacer in the mouth
• Press the inhaler once to release a dose of the medicine
• Breathe in and out five times making the valve click each time
• Remove the spacer from the mouth
• Wait about 15 to 30 seconds before giving the next dose.
Repeat this process for as many puffs as needed, a maximum of ten puffs every four hours. Remember
to shake the inhaler before each puff.
Cleaning the spacer
• Clean the spacer before first use and then once a week
• Separate the sections of the spacer carefully
• Wash thoroughly with warm soapy water, and leave both sections to air dry in an upright position
• Do not rinse the sections of the spacer, dry them with a tea towel or put them in a dishwasher as this
creates static. Static can reduce the amount of medicine your child receives
• Spacers should be replaced every year or as the manufacturer advises.
www.uhs.nhs.uk
Child health information factsheet
1. Reliever treatment
Name of medication
Dose (number of puffs) and frequency
Salbutamol 100mcg inhaler
Give two to five puffs every four hours when wheezy or coughing
If very wheezy, give ten puffs every four hours
Other
2. Preventative treatment
Name of medication
Dose (number of puffs) and frequency
Preventative treatment is to be used regularly every day.
• Do not stop treatment without medical advice
• Remember to clean your teeth or rinse your mouth with water after using the preventer inhaler.
Reducing reliever treatment
When your child goes home from hospital, or after episodes of wheeze at home, gradually reduce the
amount of salbutamol that you give your child as their symptoms improve.
Day One
• Give ten puffs of salbutamol every four hours.
Days two to four
• Reduce the number of puffs of salbutamol to six puffs and then two to four puffs every four hours over
the next three or four days depending on your child’s recovery
• Stop giving salbutamol regularly when your child’s wheeze has stopped and they are feeling much better
• Make an appointment for your child to be seen by his or her GP one week after going home from hospital.
If you have any questions or concerns please contact your GP or your GP practice asthma nurse.
Other useful contact details
Asthma UK advice line Monday to Friday from 9am to 5pm 0800 121 6244 (interpreting service available)
www.asthma.org.uk
If you need a translation of this document,
an interpreter or a version in large print,
Braille or on audio tape, please telephone
023 8079 4688 for help.
V4 Revised Oct 2011 Review date Oct 2014 CHO.028.04
www.uhs.nhs.uk