An inhaler works most effectively when it delivers the medication in a slow, controlled way. Adding a spacer to an inhaler can help.
Spacers are especially useful for children, who may otherwise have difficulty using an inhaler.
In this article, we describe how spacers work, their benefits, and how to use and clean them effectively.
Using a spacer extends the amount of time it takes for the medication to enter the lungs. This gives the person more time to inhale, so the medication can enter the lungs more effectively.
The spacer also concentrates the medication into a tube, which prevents it from escaping into the air.
Spacers are especially advantageous for younger children or people just starting to use an inhaler.
Below are the steps for using most inhalers and spacers:
- Check the inhaler, spacer, and mouthpiece to make sure that there is no dirt or debris and there is enough of the medication left.
- Sit, or preferably stand, with your back straight, keeping your head in a regular position, not too far backward or forward, throughout this process.
- Exhale as much air as possible from your lungs.
- Place the inhaler in your mouth.
- Spray one puff of medicine and inhale slowly over about 3–5 seconds, sealing your mouth tightly around the inhaler so air cannot escape. If you hear a whistling noise when you inhale, you are breathing in too fast.
- Hold your breath for 10 seconds, counting in your head or using a timer on your watch or phone.
- Remove the inhaler from your mouth and exhale.
- Repeat by taking as many puffs as your doctor prescribes. Wait about 1 minute between puffs if using inhalers that contain albuterol, such as Ventolin or ProAir.
- Rinse your mouth with water if you use an inhaled corticosteroid. This reduces the risk of an oral infection.
A person might periodically show their doctor how they use their inhaler to make sure they are still doing it correctly.
Here are some strategies for using an inhaler and spacer effectively:
- Shake before use. Shake the inhaler well before use, usually about 10–15 times. If a person has not used their inhaler in 2–3 weeks, they should “prime” it by squirting out 2–3 puffs into the air.
- Avoid towel-drying the spacer. Drying it with any cloth could cause the spacer to take on an electric charge. This can make the medication stick to the sides of the spacer and reduce its effectiveness.
- Place the mouthpiece under the top teeth. If it is difficult to make a tight seal around the inhaler’s mouthpiece, try placing the mouthpiece under the top teeth.
- Check the equipment regularly. This includes checking the chamber for any cracks or breaks and replacing a spacer that has cracks.
- Help children with the proper technique. A parent or another caregiver can have the child sit in front of them, steady their head, and help them maintain an upright posture. Encourage any child who has trouble holding their breath to take six practice breaths before using the inhaler.
A person can also ask their doctor or child’s pediatrician for advice specific to the type of medication.
After use, clean the spacer following the manufacturer’s instructions. Here are some general tips for cleaning and maintaining an inhaler spacer, though specific directions may vary.
- Wash the work surface and hands.
- Remove the spacer’s rubber end and wash it in warm, soapy water.
- Allow the pieces to air dry thoroughly on a clean towel or another surface.
- If required, disinfect the spacer according to the manufacturer’s instructions.
Some advantages of using a spacer with an inhaler include:
- A spacer gives someone more time to inhale, making the process simpler. It also reduces the need for coordination when pressing the inhaler and breathing in the medicine.
- Spacers extend the amount of time the inhaler takes to deliver medicine. This means that the lungs absorb the medicine more slowly and smoothly.
- A person inhales a greater concentration of medication into their lungs.
- Using a spacer reduces the risk of side effects, such as oral thrush, when inhaling corticosteroids.
For anyone with concerns about using their inhaler effectively, a doctor may recommend a spacer.