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A new study finds that most parents who assist their children with inhaled asthma medications don't know all the proper instructions.

"Of the 10 steps for accurate technique, we were surprised to learn that only one out of 169 caregivers knew all 10 steps," said study author Dr. Marina Reznik, an assistant professor of pediatrics at Albert Einstein College of Medicine in New York City.

According to the U.S. Centers for Disease Control and Prevention, "Almost 10 percent of U.S. children have this potentially deadly respiratory condition."
Researchers said that the improper use of the inhalers could lead to continuous or worsening symptoms of asthma. 

"Most asthma medications are inhaled, and delivered through devices known as metered-dose inhalers," reported Healthday. "Because it's not always easy for children to use these inhalers, a device called a spacer is often used in conjunction with the inhaler." 

The spacer's job is to hold the medication in a chamber which allows the child to inhale the drug with several breaths. To make it easier for young children to use many spacers come with a mask. 

For the study, researchers matched the instructions for the usage of the inhaler based on national guidelines. 

Researchers came to a consensus that five of the instructions were critical steps for the delivery of the medication.

According to Healthday the instructions were, "shaking the inhaler before use; forming a seal between the device and the child's face; pressing down on an inhaler just once (single actuation); taking at least six slow and deep breaths before using another actuation, and waiting at least 30 seconds after the six breaths before doing the second actuation."

Researchers gathered 169 New York City families for the study.Children between the ages of 2 and 9 participated. Of the participants many had continuous asthma, asthma hospitalizations, an emergency room visit or a primary care visit within the past year.

"Three-quarters were Hispanic, and 23 percent were black," reported Healthday. "Most of the study questions were answered by the mothers of the children (95 percent), and the average age of the child's caregiver was 32."

Researchers asked the parents to give a demonstration on how to use the medication by utilizing a stuffed toy. 

Researchers found that only one person was able to accurately show all of the 10 steps and six parents were able to show the five important steps.

"A lot of physicians will hand patients prescriptions for nasal sprays and asthma inhalers and not teach them how to use them," said Dr. Jennifer Appleyard, chief of allergy and immunology at St. John Hospital and Medical Center in Detroit.

Researchers also found that the step where most of the parents did not follow through was having the child take six slow deep breaths and waiting at least 30 seconds after the breathes in order to actually give the second dose of the medication. 

"Make sure you know how to use these devices properly. It has a huge effect," said Appleyard. "If you don't know how to use them, you'll end up with more medications than you need and maybe even hospitalizations."

The findings are published in the Journal of Asthma.