Kids Health Info

Asthma - Use of spacers

  • Inhalation is the best way to take most asthma medications. We now know that asthma medication given through a puffer and spacer relieves asthma symptoms just as well as a nebuliser.

    The benefits of using a puffer and spacer are that they are:

    • easy to use;
    • inexpensive;
    • portable;
    • easy to care for.

    It is important to remember the following when using a puffer and spacer:

    • A puffer and spacer are better than using a puffer alone as more medication gets to the lungs where it is needed.
    • The number of puffs given in hospital is usually more than is given at home.
    • You and your child need to know how to use the puffer and spacer properly for the medication to work as well as it can.
    • You and your child need to know how to care for the spacer.

    Large Volume Spacers

    (eg Volumatic)

    Large spacer

    How to use your Large Volume Spacer

    1. Put together the spacer following the instructions that came with it.
    2. Remove the protective cap from the puffer.
    3. Shake the puffer well and insert (place) it firmly into the end of the spacer.
    4. Place the mouth piece of the spacer in your mouth and put it between your teeth. Now, close your lips around the spacer mouth piece. Make sure your lips cover the entire mouth piece so there are no gaps. Hold the spacer level so that it does not tilt up or hang down.
    5. Breathe out gently.
    6. Press the puffer ONCE to release a dose of the medicine into the spacer. Do not remove the puffer.
    7. Breathe in very slowly until you have taken a deep breath. You will hear a whistle sound if you are breathing in too fast. Hold your breath for a few seconds, then breathe out slowly and deeply through your mouth. Breathe in and out 4 or 5 times (do not remove your mouth from the mouthpiece in between each breath - there is a 2 way valve system which will prevent any of the medication from escaping from the chamber).

    If a second dose is needed, shake the puffer again and repeat steps 4-7. You can shake the puffer while it is still attached/connected to the spacer.

    Make sure you have been shown how to use the spacer and that you have practiced and understand it before you leave the hospital.

    How to care for your spacer

    • The spacer should be cleaned once a week.
    • Take the spacer apart and wash it in warm water containing a little dishwashing detergent or mild soap.
    • DO NOT RINSE.
    • Allow the spacer to drip dry. Do not wipe the spacer dry with a tea towel or kitchen paper but allow it to air dry. This can be done overnight.
    • Put the spacer back together.
    • Do not allow anyone else to use your spacer.

    Small Volume Spacer

    (eg Aerochamber or Space Chamber or e-chamber La Petite Spacer)

    Small spacer

    How to use your Small Volume Spacer

    1. Put the spacer together following the instructions that came with it.
    2. Remove the protective cap from the puffer.
    3. Shake the puffer well and insert it firmly into the end of the spacer.
    4. Place the mask over your child's face, making sure that it covers the mouth and nose. Try to get a good seal on the skin so that no air can get in. In older children you may wish to use the mouthpiece on the spacer, rather than the mask.
    5. Ask your child to breathe out gently.
    6. Press the puffer once to release a dose of the medicine into the spacer. Do not remove the puffer.
    7. Allow your child to breath in and out 4 or 5 times. This usually means leaving the spacer in position for about 15-20 seconds (do not remove the mask in between each breath - there is a 2 way valve system which will prevent any of the medication from escaping from the chamber).

    If further puffs are needed, shake the puffer again and repeat steps 4-7.

    How to care for your spacer

    • The spacer should be cleaned once a week.
    • Take the spacer apart and wash it in warm water containing a little dishwashing detergent or mild soap.
    • DO NOT RINSE. 
    • Allow the spacer to drip dry. Do not wipe the spacer dry with a tea towel or kitchen paper but allow it to air dry. This can be done overnight.
    • Put the spacer back together.
    • Do not allow anyone else to use your spacer.

    For spacers with removable valves (eg Breath-A-Tech): ensure the 4 holes in the valve fit over the location pegs. Spare valves can be purchased from your local chemist. 

    More information on asthma

      Developed in consultation with the RCH department of General Medicine.  First published 2000. Updated October 2013.

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    Disclaimer 
    This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.