HealthInfo Waitaha Canterbury

Using a spacer

Te whakamahi i tētahi whakapūaretanga

Using a spacer with your metered dose inhaler (MDI, inhaler or puffer) can reduce side effects, especially from steroid inhalers. Using a spacer can also make the medicine you breathe in up to 50% more effective by helping to get the correct dose into your lungs.

Adults and older tamariki (children) can place the mouthpiece of the spacer directly into their mouth. The mask in the picture below is only for tamariki who cannot seal their lips around the mouthpiece – usually up to 2 to 3 years of age.

Ways of using a spacer

There are 2 ways of using a spacer.

Multiple-breath method

This is best in an asthma emergency and for small tamariki.

1. Shake the inhaler vigorously to mix the medicine and propellant.
2. Insert the inhaler into the spacer.
3. Position the mouthpiece in your mouth and ensure a good seal.
4. Press the inhaler once for 1 dose.
5. For tamariki, allow 6 slow breaths through the spacer, checking that the valve is moving. Adults should only need 3 to 4 breaths.
6. Remove the inhaler from the spacer.
7. Repeat the above steps if you need further doses. Make sure you shake the inhaler between doses.

Deep-breath method

This is the recommended method, except for small tamariki or if you are very breathless.

1. Shake the inhaler vigorously to mix the medicine and propellant.
2. Insert the inhaler into the spacer.
3. Position the mouthpiece in your mouth and ensure a good seal.
4. Breathe out gently.
5. Press the inhaler once for 1 dose.
6. Take a long, slow, deep breath in and hold your breath for at least 5 seconds or as long as is comfortable.
7. Breathe out.
8. Repeat if you need more doses of medicine.

Care of your spacer

Wash a new spacer before use and then every week.

1. Remove the base from the spacer.
2. Wash it in warm water with detergent in a clean bowl.
3. Remove the spacer from the water and allow it to drip dry.
4. Replace the base when the spacer is dry.

Care of your inhaler

Clean your inhaler regularly so that the hole at the bottom where the medicine comes out does not get blocked. Otherwise, you will not get the full dose of medicine. You should clean your inhaler every week.

1. Remove the metal canister from the plastic inhaler. It is important that the metal canister does not get wet.
2. Rinse the cap and the mouthpiece of the plastic inhaler under warm water for 30 seconds.
3. Shake off the excess water and dry thoroughly with a paper towel.
4. When completely dry, replace the metal canister and mouthpiece cap.

Intal Forte or Tilade are sticky and block the inhaler easily, so you should clean them every day. They usually come with a spare plastic case so you can use one while cleaning and drying the other.

Never wash inhalers containing inhaled steroid medicine. Wipe them with a dry tissue.

Checking if your inhaler is empty

When you shake your inhaler, you should be able to feel or perhaps hear the medicine inside. If you are not sure, spray a dose of medicine into the air. You will be able to see the spray coming out of the inhaler and hear a whooshing noise. If there is no spray or noise, the inhaler is probably empty.

If you have not used your inhaler for a while

If you have not used your inhaler for a week or more, spray a dose into the air before using it. This will make sure that your inhaler will work properly.

Extra tips

Make sure you have a spacer available for home and work or school.

Replace your spacer with a new one after 6 months of regular use or 12 months of intermittent use. You can get a new spacer from your general practice or pharmacy.

  HealthInfo recommends the following videos

• National Asthma Council of Australia – How to use a Standard MDI (puffer) and Spacer

  A video showing how to use a spacer.

  HealthInfo recommends the following pages

• KidsHealth – Spacers for asthma inhalers

  Information about spacers for tamariki, including how to use and care for them. Includes a video demonstration of a tamaiti using an inhaler with a spacer.

Written by Child Health, Christchurch Hospital, Canterbury DHB. Adapted by HealthInfo clinical advisers. Last reviewed October 2024.

Sources

Page reference: 20758

Review key: HIASA-39947