From the Guidelines
To use a spacer with an inhaler, first remove the caps from both the inhaler and spacer, then shake the inhaler well for 5 seconds, insert it into the end of the spacer, and breathe in slowly and deeply through your mouth after releasing one puff of medication into the spacer, holding your breath for about 10 seconds before exhaling slowly, as recommended by the most recent guidelines 1.
Key Steps for Using a Spacer
- Remove the caps from both the inhaler and spacer
- Shake the inhaler well for 5 seconds
- Insert the inhaler into the end of the spacer
- Place the mouthpiece of the spacer between your teeth and close your lips to form a seal
- Press down on the inhaler canister once to release one puff of medication into the spacer
- Breathe in slowly and deeply through your mouth
- Hold your breath for about 10 seconds before exhaling slowly
- Wait about 30-60 seconds before taking a second puff if prescribed
Importance of Proper Technique
Using a spacer with an inhaler improves medication delivery by slowing down the spray and allowing more medicine to reach your lungs rather than depositing in your mouth or throat, which reduces side effects and increases the effectiveness of your inhaled medication, particularly beneficial for children, elderly patients, or anyone who struggles with proper inhaler technique, as supported by recent studies 1.
Cleaning and Maintenance
Clean your spacer according to manufacturer instructions, typically once weekly with mild soap and water, allowing it to air dry, and rinse your mouth with water after using steroid inhalers, as advised by guidelines 1.
From the Research
Using a Spacer
To use a spacer effectively, it is essential to follow the correct steps:
- Attach the spacer to the mouthpiece of the pressurized metered dose inhaler (pMDI) 2
- Ensure the spacer is clean and free from electrostatic charge accumulation on the walls of plastic devices 2
- Inhale the medication through the spacer, taking slow and deep breaths
- Hold the breath for a few seconds to allow the medication to settle in the lungs
Benefits of Using a Spacer
The use of a spacer can:
- Minimize coordination difficulties when using a pMDI 2
- Reduce oropharyngeal deposition and increase lung deposition of the medication 2
- Allow for maintenance dosages of bronchodilators and corticosteroids to be reduced 2
- Be a viable alternative to a nebulizer for delivering large bronchodilator doses in patients with severe acute asthma or severe chronic obstructive pulmonary disease 2
Types of Spacers
There are different types of spacers available, including:
- Tube spacers with a volume of <50 mL
- Holding chambers with a volume of 750 mL 2
- Volumatic spacers, which can be used with metered dose inhalers (MDIs) 3, 4
Clinical Effectiveness
Studies have shown that the use of a spacer can be as effective as nebulization in treating mild to moderate degrees of acute exacerbation of asthma in children 3
- The use of a spacer can also reduce systemic absorption of inhaled corticosteroids from a metered dose inhaler and dry powder inhaler 4