Asthma – use of spacers

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    Inhalation (breathing in) is the best way to take most asthma medications. Giving a child their asthma medication through a puffer and spacer relieves asthma symptoms just as well as using nebulisers, which are the machines often used in hospitals or ambulances to deliver asthma medication.

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

    • A puffer and spacer used together is 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. Make sure you have been shown how to use the spacer and that you have practiced and understand it before you need it.
    • You and your child need to know how to care for the spacer.

    Spacers are used with mouthpieces, or with facemasks for younger children and babies.

    Using a spacer

    Asthma use of spacers

    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 prime it by pressing down a few times until a mist comes out.
    4. Insert the puffer firmly into the end of the spacer.
    5. 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.
      If your child is able to use a spacer without a mask, they should place the mouthpiece of the spacer in their mouth and put it between their teeth, then close their lips around the spacer mouthpiece. Make sure their lips cover the entire mouthpiece so there are no gaps. 
    6. Ask your child to sit upright and breathe out gently. Hold the spacer and puffer level so that they do not tilt up or hang down.
    7. Press the puffer once to release a dose of the medicine into the spacer. Do not remove the puffer.
    8. Allow your child to breathe in and out four 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 two-way valve system that will prevent any of the medication from escaping from the chamber.

    If further puffs are needed, shake the puffer again and repeat steps 4 to 7. You can shake the puffer while it is still attached to the spacer.

    Caring for your spacer

    • Spacers 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 the spacer. It is important to leave residual soap on the inside lining of the spacer, to minimise static electricity in the spacer. Static electricity causes the medicine to get trapped to the walls of the spacer, instead of entering the your child’s lungs.
    • Allow the spacer to drip dry. Do not wipe the spacer dry with a tea towel or kitchen paper – it should air dry. This can be done overnight.
    • Put the spacer back together.
    • Do not allow anyone else to use your child’s spacer.

    When putting back together spacers that have removable valves (such as Breath-A-Tech), ensure the four holes in the valve fit over the location pegs. Spare valves can be purchased from your local pharmacy.

    Key points to remember

    • You and your child need to know how to use the puffer and spacer properly for the medicine to work.
    • You and your child need to know how to care for the spacer. 
    • Spacers should be cleaned once a week. Spacers should not be rinsed or wiped dry.
    • Do not allow anyone else to use your child’s spacer.

    For more information

    Common questions our doctors are asked

    When should I buy a new spacer? 
    Replace your child’s spacer about once a year if they you use it every day. Buy a new one straight away if the spacer breaks or cracks.

    What should I do if my child needs to use the spacer again if it is still wet after washing? Should I dry it with a clean tea towel?

    You should never wipe a spacer dry – wiping the spacer creates static electricity inside the chamber, making the medicine stick to the side walls and not enter the lungs effectively. It is a good idea to always have a spare spacer and not wash both at the same time. Don't wash the spacer during an asthma attack so that it is readily available if needed. If a spacer is wet, do not use it. Use the puffer directly instead while waiting for the spacer to drip dry.

    Developed by The Royal Children's Hospital General Medicine department. We acknowledge the input of RCH consumers and carers.

    Reviewed May 2018.

    This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.

    Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit

  • Asthma – use of spacers


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