Summary: For children under age 2 seen in an emergency department with acute wheezing, giving albuterol (salbutamol) by metered-dose inhaler (MDI) with a spacer and facial mask may lead to faster clinical improvement than giving albuterol by nebulizer (the albuterol dosing in this study was 2 puffs at 100 microg/puff by MDI every 10 min for 5 doses, or 0.25 mg/kg every 13 min for 3 doses by nebulizer).

Strength of Recommendation = B