Key points about spacers
- your child needs to use a spacer with a metered dose inhaler (MDI)
- spacers help make sure asthma inhaler medicine gets into the lungs
- a spacer helps prevent the medicine from hitting the mouth and throat where it can cause side effects
What is a spacer?
A spacer is a clear plastic tube. The asthma inhaler fits in one end of the spacer, and at the other end is a mouthpiece. It's easier for tamariki 4 years and under to use a mask attached to their spacer. The medicine that is released into the spacer goes directly into your child's lungs when they breathe in through the spacer. Spacers help make sure the medicine gets to the right place.
How spacers work
Using a spacer helps direct the medicine into your child's lungs, where it can work best. If your child uses an inhaler without a spacer, very little medicine may actually get into the lungs.
Without a spacer, the medicine from the inhaler may just hit the back of your child's mouth and throat. A spacer helps prevent the medicine from sitting in the mouth and throat. This can cause side effects such as:
- sore throat
- hoarse voice
- fungal throat and mouth infections
Your child should still always rinse their mouth out after using preventer medicine to avoid these side effects.
How to use an inhaler with a spacer
See the 5 steps for using an MDI with a spacer.
Younger tamariki will need help to follow the steps. As tamariki get older, they will be able to use the spacer themselves.
Hold the inhaler upright and give it a good shake.
Fit the inhaler into the opening at the end of the spacer.
Seal the lips firmly around the mouth piece - press the inhaler once only.
Take 6 slow breaths in and out through your mouth. Don't remove the spacer from your mouth between breaths.
Remove the spacer from your mouth. Repeat steps 1 to 4 for further doses.
A video on how to use a spacer
In this video, Lachlan is showing how to use an MDI inhaler with a spacer.
Source: Asthma Waikato
transcribeTranscript
[Music]
[Health professional]
Hi everyone, this is Lachlan and he is my asthma star today and he's going to show us how to use the MDI inhaler with the spacer correctly.
Right Lachlan, first of all we're going to take off the lid of the inhaler.
We're going to shake the inhaler - mix the medicine and aerosol together. We're going to place the inhaler into the spacer and place the spacer mouthpiece into the mouth forming a good seal.
Now one puff with 6 breaths.
Using the spacer delivers 50% more medicine.
Well done Lachlan.
To have another dose, we need to shake the inhaler again, place the inhaler into the spacer and repeat the sequence.
Remember everyone, it's one puff with 6 breaths.
The spacer's washed once a week with warm soapy water and allowed to drip-dry.
Place the lid back onto the inhaler.
Children aged 0 to 4 years are recommended to use a mask with the spacer.
Between the ages of 2 and 4, start weaning off the mask.
Using the spacer without the mask delivers ⅔ more medicine to the lungs than using the mask. However, during an acute flare-up, a good seal with the mouthpiece may not be achievable. So using a mask might be required.
Well done Lachlan and thank you for showing us how to use the MDI inhaler with the spacer correctly.
When to use a mask with a spacer
A spacer with a mask can help young tamariki who have difficulty breathing properly with a regular spacer. If you use a mask and spacer for your child, make sure the mask covers their mouth and nose completely, without any openings. Masks are often used for babies and infants who can't close their lips around the spacer's mouthpiece. Most tamariki should be able to use a spacer without a mask by the time they are 4 years old. If you use a mask with preventor medicine, wash your child's face after each use.
Caring for spacers
It's important to look after your child's spacer and inhaler. Wash the spacer once a week with a mild dishwashing detergent. Then leave it to air dry. This will stop the medicine from sticking to the spacer and blocking the valve at the mouthpiece. Your child needs a new spacer every year. You can get this at the same time as you see your health professional about your child's asthma action plan.
Where to get a spacer from
You can get a spacer for free from your health professional or asthma educator. Your child needs a new spacer every year.
Asthma action plan
Ask your child's health professional for an asthma action plan. The best way to manage your child’s asthma symptoms is to follow their asthma action plan.
Having an asthma action plan gives guidance on what medicines to use and when. This is for interval symptoms and asthma attacks. It’s a good idea to review the asthma action plan every year.
Take a look at the Cardiac + Respiratory Foundation NZ website for an example of what a blank asthma plan looks like. It's available in English, te reo Māori, Samoan and Tongan.
Good management can stop asthma from interfering with your child's life, including enjoyment of sports and play.
More information and support
Asthma Interval Symptoms In Children
Read a booklet about managing your child's asthma in English, te reo Māori or Samoan.
Cardiac + Respiratory Foundation NZ brings together the Asthma and Respiratory Foundation NZ, Kia Manawanui Trust – The Heart of Aotearoa, Lung Foundation NZ, and the Bronchiectasis Foundation NZ. Check out their website for information and resources on asthma and other respiratory conditions.
Asthma New Zealand provides information. They also offer free appointments to people with asthma in some regions, or nationally through telehealth. You can self-refer or a health professional can refer you.
Acknowledgements
The photos of the child using the spacer are from Asthma + Respiratory Foundation NZ.
