Spacers

Asthma spacers are tube-like devices that attach to inhalers and help you get the best from your medicine. Find out more about using your spacer

How does a spacer help me to manage my asthma better?
How to use a spacer
Help your child use a spacer 
How to use a spacer and facemask with your baby
Cleaning your spacer

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)
  • Using a spacer makes it easier to get the right amount of medicine straight to your lungs, where it’s needed
  • Using a spacer can also reduce the risk of side effects from your medicine.

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 exactly the same time as you press down on your inhaler to release the medicine. You also need to breathe in very slowly and deeply.

Using a spacer helps the medicine get straight to your lungs.

You fix your inhaler on one end of the spacer, and use the mouthpiece at the other end.

When you press on your inhaler, the medicine collects in the chamber of the spacer, so you can breathe it in without needing to get the timing and speed exactly right.

An asthma inhaler with a spacer can also help you if you’re having an asthma attack.

Using a spacer may mean you can use less medicine

This is because a spacer slows the medicine down as it comes out of the inhaler, so more of it gets taken down into your lungs.

This makes your medicine more efficient, so you may need to use less of it.

Using a spacer reduces the risk of side effects

Spacers reduce the small risk of side effects if you’re taking preventer medicine.

Because more of the medicine gets down to your lungs, less medicine is absorbed into the rest of your body, lowering the risk of side effects.

This also reduces the risk of voice changes and oral thrush: 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 check your technique at your annual asthma review

Take a look at our videos on how to use a spacer.

How to get the correct inhaler technique using a spacer

There are two breathing techniques you can use with your spacer.

If your healthcare professional has advised you to use the ‘tidal or multiple breathing’ technique when you’re using a spacer:

  1. Take off the cap and hold your inhaler upright. Check there’s nothing inside the mouthpiece
  2. Shake the inhaler well
  3. Put the inhaler into the end of your spacer, with the indent for your nose pointing upwards
  4. Put the mouthpiece between your teeth and lips, making a seal so no medicine can escape
  5. Sit or stand up straight and slightly tilt your chin up as it helps the medicine reach your lungs
  6. Press the canister to put one puff of your medicine into the spacer
  7. Breathe in and out slowly and steadily five times through the mouthpiece
  8. Remove the mask from your face.

If your healthcare professional has recommended the ‘single breath and hold’ technique:

Carry out steps 1 to 3 as above, then:

  1. Breathe out gently and slowly away from the inhaler and spacer until your lungs feel empty and you feel ready to breathe in
  2. Put the mask on your face to make a seal over your nose and mouth
  3. Sit or stand up straight and slightly tilt your chin up as it helps the medicine reach your lungs
  4. Press the canister on the inhaler once and breathe in slowly and steadily until your lungs feel full
  5. Remove the mask from your face and, with your mouth closed, hold your breath for up to 10 seconds, or for as long as you comfortably can. Then breathe out gently.

Watch our video to help you master the ‘single breath and hold’ technique.

Whichever technique you use, if you need to take another dose, take the mask away from your face. Wait 30 seconds to a minute and shake the inhaler again. Then repeat the steps.

Some small volume spacers make a whistling sound if you’re breathing in too fast.

How to help your child use a spacer

Your child’s GP or asthma nurse should show you how to help them 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. 

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. 

How to prepare your child’s spacer

Sit your child on your lap either sideways or facing away from you. Older children usually prefer to sit or stand by themselves.

  1. To use the inhaler, hold it upright and take the cap off. Check there’s nothing inside the mouthpiece
  2. Ask your child to slightly tilt their chin up as it helps the medicine reach their lungs
  3. If the spacer has a valve, make sure the valve is facing upwards
  4. Shake the inhaler well
  5. Take the cap off the inhaler and put the inhaler into the hole at the back of the spacer.

Using your child’s spacer

There are two different breathing techniques a child can use with their spacer.

If their healthcare professional has recommended the ‘tidal breathing or multiple breath’ technique, here’s how to do it:

  1. Ask them to put their lips around the mouthpiece of the spacer to make a tight seal and begin breathing in and out
  2. Press the canister on the inhaler once, and encourage them to breathe in and out slowly and steadily into the spacer five times.

If their healthcare professional has recommended the ‘single breath and hold’ technique, here’s what they mean:

  1. Encourage your child to breathe out gently and slowly away from the inhaler and spacer until their lungs feel empty and they feel ready to breathe in
  2. Ask them to put their lips around the mouthpiece of the spacer to make a tight seal
  3. Press the canister on the inhaler once and have them breathe in slowly and steadily until their lungs feel full
  4. Take the mouthpiece of the spacer out of their mouth and, with their mouth closed, ask them to hold their breath for up to 10 seconds, or for as long as they comfortably can. Then get them to breathe out gently.

If your child has been prescribed a second puff, remove the spacer from their mouth. Wait 30 seconds to a minute and shake the inhaler again. Then repeat the steps.

When you’ve finished, take the inhaler out of the spacer and replace the caps on the inhaler and the spacer.

If your child has used an inhaler that contains steroids, make sure they rinse their mouth out with water or brush their teeth to help prevent side effects.

For more useful tips, take a look at our video 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 a young child, you’re not alone!

Spacers with facemasks can be used with babies or with younger children who find it hard to use an ordinary spacer with a mouthpiece.

You can always ask your 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, or message them on WhatsApp on 07378 606 728. 

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

Before you start

  • If you have a baby or young toddler, sit them on your lap facing you so you can keep eye contact. With very young babies, you might find it best to tilt them back slightly.
  • 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’re anxious.
  • Gently stroke your baby’s cheek with the mask so they get used to how it feels.
  • 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.

When you’re ready, follow these steps

  1. Hold the inhaler upright and take the cap off. Check there’s nothing inside the mouthpiece
  2. Shake the inhaler well
  3. Put the inhaler into the hole at the back of the spacer with the indent for the nose on the mask facing upwards
  4. Put the mask on your baby’s face to make a seal over their nose and mouth
  5. Slightly tilt their chin up as it helps the medicine reach their lungs
  6. Press the canister once so that one puff of medicine goes into the inhaler
  7. Count to 10 slowly (in your head, say ‘one, and two, and three’ etc to get the timing right)
  8. Remove the mask from their face.

Watch our video for more advice on using a spacer with a facemask on your baby or child.

  • If you need to give further doses, wait 30 seconds to one minute, shake the inhaler again, then repeat the steps above.
  • If your child has used an inhaler that contains steroids, rinse their mouth out with water or brush their teeth to avoid side effects. Wipe their face with a damp cloth.

“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, mum to Emelia, aged 9. 

Even if you’re finding it difficult using a spacer with your baby, it’s important to 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. Always follow the manufacturer’s instructions.

If it’s a new spacer, clean it before you use it for the first time, then once a month afterwards.

  • Gently clean it 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 reduce static (an electrical charge that builds up) and prevent the medicine sticking to the inside of the spacer
  • 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. 

How to clean and store your asthma spacer

Asthma UK expert nurse Caroline demonstrates how to properly take care of your asthma spacer.

Video: How to clean and store your asthma spacer

Asthma UK expert nurse Caroline demonstrates how to properly take care of your asthma spacer.

Storing your spacer

When you’re not using your spacer, storing it properly will help to keep it in good condition, helping you or your child to get the best from your asthma medicine.

  • Don’t put your spacer in a plastic bag as this will cause it to build up static and reduce 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 small bag so it doesn’t get scratched, and so small objects don’t get stuck inside it.
  • You may find it useful to give 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). You can also buy them from pharmacies.

If you’re concerned that the type of inhaler you have doesn’t fit properly on the spacer, don’t put up with this or try to manage without the spacer. Speak to your GP or asthma nurse for help. 

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.

You can also speak to an asthma nurse specialist by calling our Helpline on 0300 222 5800 (9am – 5pm; Mon - Fri), on WhatsApp, or by emailing our asthma nurses directly.

Last updated August 2019

Next review due August 2022