Spacers

A spacer is a large plastic or metal container with a mouthpiece and a hole for the aerosol inhaler.

Spacers in brief

  • Spacers are large, empty devices (or tubes) that are usually made out of plastic. They help you get the best from your asthma medicine if you use a metered dose inhaler (MDI).
  • There are several different brands of spacer that fit different inhalers. They are all available on prescription, or you can buy them from a pharmacist.
  • If you, or your child, use a spacer, it’s easier to get the right amount of medicine straight to your lungs where it’s needed. This may mean you need to use less medicine overall. Using a spacer device can also reduce the risk of side effects from your medicine.  
  • 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?

  • Spacers make it easier to get the right amount of medicine. Metered dose inhalers (MDIs) deliver a dose of medicine in a fine spray (aerosol) form. It can be difficult to use them correctly as you need 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 very slowly and deeply when you take your inhaler, otherwise some of the medicine may end up in your mouth or the back of your throat instead of going down into your lungs where you need it.
  • Using a spacer with an inhaler makes it easier to take your asthma medicines and helps to get it straight to your lungs so it can 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 of the spacer, 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. 
  • Using a spacer may mean you can use less medicine. This is because 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 asthma inhaler with a spacer is also quick and easy to use in an emergency.
  • 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 voice changes and oral thrush, which is a fungal infection that can be a side effect of asthma inhalers, particularly in children.

How to use a spacer

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. 

Take a look at our video on how to use a spacer so you can get the best from your asthma medicines:

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

8 steps to get the correct inhaler technique

  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 feels 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 through your nose
  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. 

“The nurse showed us how to use Ellis’s inhaler and spacer. He’s so little that it can be quite daunting, so to know how to use it right was really helpful. And we picked up loads of useful ideas to help Ellis take his medicines – like giving the inhaler to a favourite toy first. That really helped.” – Sharon Woodward, mum to Ellis 3. 

7 steps to help your child use a spacer:

  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 wait 30 seconds between puffs, and to take out the inhaler and shake it before each one.

For more useful tips, take a look at our page on How to help your child use their inhaler

How to use a spacer and a mask with your baby

If you find it difficult to use the spacer with very young children, don’t worry – you’re not alone! You can always ask our GP or asthma nurse for help, or call our Helpline on 0300 222 5800 (Mon-Fri, 9am – 5pm) to speak to one of our friendly asthma nurses for advice. 

To help you use a spacer and a mask with your baby, here’s a simple guide: 

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 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, waiting 30 seconds between each puff. Remember 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 which could cause redness and irritation. 

“When Emelia was first given an inhaler the asthma nurse at the doctor’s surgery showed me how to use it with a spacer which has a baby mask. I’d cuddle her on my lap and we got used to it pretty quickly. As she got older, she learned to take her inhaler with a bigger mask and then just a spacer. She’s really good at using her inhaler with a spacer.” – Maria Brain, mum to Emelia, aged 9. 

Even if you’re finding it difficult using a spacer with your baby, it’s important that you keep trying. 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

Keeping your spacer clean will help you to get the full benefits of your asthma medicines each time you use it. If it’s a new spacer, clean it before you use it for the first time, then once a month afterwards. Don’t worry if your spacer looks cloudy – that doesn’t mean it’s dirty. 

Here are some tips to help you keep your spacer clean and working properly: 

  • Start by carefully taking your spacer apart so you can clean each piece easily.
  • Soak your spacer in warm water for 15 minutes and gently clean using a detergent,  such as washing-up liquid. Only a small number of brands of spacer are dishwasher safe, so check the instructions on the label.  
  • Be careful not to scrub the inside of your spacer as this might affect the way it works. You can scrub the outside of the spacer and the mouthpiece.
  • Leave it to air-dry as this helps to prevent the medicine sticking to the sides of the chamber and reduces the static.
  • When it’s completely dry, put your spacer back together ready for use.
  • Wipe the mouthpiece clean of detergent before you use it again. 

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. 

Storing your spacer  

When you’re not using your spacer, keeping it in a safe place will help to keep it in good condition. The following spacer storage tips will help you or your child to get the best from your asthma medicines when you come to use it: 

  • Don’t put your spacer in a plastic bag as this will cause it to become static (builds up an electrical charge) which reduces the effect of the asthma medicine.
  • Keep your spacer away from dust and liquids.
  • If you carry your spacer in your bag, keep it in a sealed purse or smaller bag so it doesn’t get scratched and small objects don’t get stuck inside the chamber. 
  • You may find it useful giving your child a special medicine bag or pencil case to keep their inhalers and spacer in. You could help them to decorate and personalise the case so they are more likely to use it.      

Types of spacer

There are several different brands of spacer that fit different inhalers and are available on prescription (including Volumatic, AeroChamber, Able Spacer, Space Chamber plus and Compact 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 0300 222 5800 (9am – 5pm; Mon - Fri) or by emailing our asthma nurses directly.

Last reviewed August 2016