Spacers


Worried about prescribing errors? These simple steps will help you to stay safe and keep your children safe.
Spacers in brief

  • Spacers are devices that help you get the best from your medicine if you use a metered dose inhaler (MDI). 
  • There are several different brands of spacer that fit different inhalers. They are available on prescription.
  • If you use a spacer, you get many benefits: it’s easier to get the right amount of medicine, it’s easier to get the medicine into your lungs, where it’s needed, it may mean you can use less medicine and it can reduce the risk of side effects.
  • Your GP, asthma nurse or pharmacist should show you how to use your inhaler and spacer properly so that every dose is effective.
  • Spacers with facemasks can be used with babies or with younger children who find it hard to use an ordinary spacer with a mouthpiece.

How does a spacer help me manage my asthma better?

  1. Spacers make it easier to get the right amount of medicine. MDIs deliver a dose of medicine in a fine spray (aerosol) form. It can be difficult to use them correctly as they need you to breathe in at the exact same time as you press down to release the medicine. You also need to be able to breathe in slowly and deeply or some of the medicine ends up in your mouth or the back of your throat instead of going down into your lungs where you need it.

    Using a spacer makes it easier – and helps to get the medicine into your lungs to work at reducing your asthma symptoms. Spacers are large, empty containers that are usually made out of plastic. You fix your inhaler on one end, and use the mouthpiece at the other end. When you press on your inhaler to release the medicine, the medicine collects in the chamber of the spacer, so you can then breathe in the medicine without needing to get the timing and speed exactly right. 

  2. Using a spacer may mean you can use less medicine. Spacers slow the speed of the medicine coming out of the inhaler, so more of it gets taken down into your lungs, where it’s needed, rather than hitting the back of your throat and your upper airways. As it makes your medicine more efficient, you may need to use less of it. An inhaler with a spacer is also quick and easy to use in an emergency.

  3. Using a spacer reduces the risk of side effects. Spacers reduce the small risk of side effects if you’re taking high doses of preventer medicine. As it helps to get more of the medicine down to your lungs, using a spacer can reduce the amount that lands in the upper airways, the back of the throat and in the mouth. This means less medicine is absorbed into the rest of your body, lowering the risk of side effects. And, because less medicine hits the throat, using a spacer also reduces the risk of oral thrush, a fungal infection that can be a side effect of asthma inhalers, particularly in children.

How to use a spacer

You can watch videos on how to attach your inhaler and use a spacer here.

Your doctor, asthma nurse or pharmacist should show you how to use your inhaler and spacer properly and will check your technique at your annual asthma review. Spacers with face masks can be used with babies or with younger children who find it hard to use an ordinary spacer with a mouthpiece. Speak to your doctor or asthma nurse if your child doesn’t have a spacer or if you think they have the wrong one for their age. 

  1. Take off the cap and shake the inhaler
  2. Put the inhaler into the end of your spacer
  3. Breathe out gently as long as comfortable
  4. Put the mouthpiece between your teeth and lips, making a seal so no medicine can escape
  5. Press the canister to put one puff of your medicine into the spacer
  6. Breathe in slowly and steadily (not hard and fast) through the mouthpiece
  7. Remove the spacer from your mouth and hold your breath for 10 seconds (or for as long as is comfortable) then breathe out slowly
  8. If you need a second dose, wait 30 seconds, remove the inhaler, shake it and repeat the steps above.

OR, if you find it hard to hold your breath, carry out steps 1 to 6 as above, then:

Keep the spacer in your mouth with your lips sealed around it and breathe in and out of the mouthpiece five times. Repeat the steps for each dose needed. Research has shown breathing in and out in this way, using your spacer, is just as effective as holding your breath for 10 seconds as above.

How to help your child use a spacer

Your child’s GP or asthma nurse should show you how to help your child use their inhaler and spacer. If you’re not sure you’re doing it properly, you can check with the GP, asthma nurse or pharmacist.

  1. Explain to your child what’s going to happen and what they need to do
  2. Remove the cap and shake the inhaler – your child can help with this
  3. Put the inhaler into the end of the spacer
  4. Place the mouthpiece between your child’s teeth and lips, making a seal so no medicine can escape
  5. Press the canister once to put one puff of your child’s inhaler medicine into the spacer
  6. Get them to breathe in and out of the mouthpiece five times
  7. Repeat from step 2 for each puff of the inhaler needed, remembering to take out the inhaler and shake it before each puff

How to use a spacer and a mask with your baby

Before you start:

  • Cuddle your baby on your knee or cradle them in your arms. Gently tuck their arms out of the way with one hand if they try to knock the mask away
  • Be positive and smile! Your baby will be aware if you are anxious
  • Gently stroke your baby’s cheek with the mask so that they get used to the feel of it
  • Reassure your child by pretending to take the medicine yourself or giving it to a favourite toy
  • You can distract your baby with music or a video if it helps, or wait and use the medicine when your baby’s asleep.

When you’re ready, follow these steps:

  1. Remove the cap and shake the inhaler
  2. Place the inhaler in the end of the spacer
  3. Put the mask over your child’s nose and mouth, making a good seal so no medicine can escape
  4. Press the canister once so that one puff of medicine goes into the inhaler
  5. Count to 10 slowly (in your head, say ‘One, and two, and three, etc’ to get the timing right)
  6. If you need to give further doses, repeat all the steps again, remembering to remove the inhaler and shake it between puffs
  7. Wipe your baby’s face afterwards, to remove any medicine that might have landed on their skin

If you find it difficult to use the spacer with very young children, don’t worry – you’re not alone! But do keep trying, and remember you can always ask your GP or asthma nurse for help. Getting your child to take inhaled medicine is the most important way to reduce their asthma symptoms and the risk of an asthma attack.

Cleaning your spacer

Wash your spacer once a month using detergent, such as washing-up liquid. Don’t scrub the inside of the spacer as this affects the way it works. Leave it to air-dry as this helps to prevent the medicine sticking to the sides of the chamber and reduces the static. Wipe the mouthpiece clean of detergent before you use it again. Don’t worry if your spacer looks cloudy - that doesn’t mean it’s dirty. Your spacer should be replaced at least every year, especially if you use it daily, but some may need to be replaced sooner – ask your GP, asthma nurse or pharmacist if you’re unsure. 

Types of spacer

There are several different brands of spacer that fit different inhalers and are available on prescription (including Volumatic, Nebuhaler, AeroChamber, Able Spacer and Space Chamber and Space Chamber plus). 

Want to know more?

Always speak to your GP, asthma nurse or pharmacist if you’re not sure whether you’re using your spacer and inhaler properly. They can check your technique to make sure you’re getting the most from your medicine. If you’re concerned the type of inhaler you have doesn’t fit properly on the end of the spacer, never put up with this or try to manage without the spacer. Speak to your GP or asthma nurse for help. You can also speak to an asthma nurse specialist by calling our Helpline on 0800 121 62 44 (Mon – Fri; 9am – 5pm).

Last reviewed April 2015


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