Inhalers should always be used with a spacer, or aerosol-holding chamber. Learn how to use and administer a metered-dose inhaler with a spacer.
Key points
A metered-dose inhaler (MDI) should always be used with a spacer, to ensure your child’s dose of medicine gets directly into their lungs.
Young children will need help using an MDI properly.
Younger children, or children who are ill, may need to use a spacer with a mask. When they are able to effectively use a mouthpiece with a spacer, they should switch. Spacers with mouthpieces deliver medicine more effectively.
Introduction
Metered-dose inhaler
What is a metered-dose inhaler?
Many asthma medicines are given using a metered-dose inhaler (MDI). An MDI is made up of a metal canister inserted into a plastic holder. The metal canister contains the asthma medicine. When the canister is pushed down, it sprays a puff of medicine out. Young children cannot use an MDI properly by themselves. You will need to help your child.
Spacer with mask
What is a spacer?
A spacer, also called an aerosol-holding chamber, is a device that attaches to the MDI. It slows down the medicine delivered and allows your child to breathe it directly into their lungs. Without a spacer, the medicine would spray into your child’s mouth and throat, with less of it reaching the lungs. AeroChamber® and OptiChamber® are examples of spacers.
You should always use a spacer when giving your child their MDI asthma medicine.
Each child should have their own spacer. Do not share spacers with other children.
Spacers can be used with a mouthpiece or a mask
Depending on your child, you may give their asthma medicine using a spacer with a mouthpiece or with a mask. Younger children need to use a spacer with a mask until they can follow instructions to seal their lips together when using a mouthpiece and are able to hold their breath when the medication is administered. If your child is able to effectively use a mouthpiece, they can switch over to a spacer with a mouthpiece. However, when some children are very unwell, they may find it difficult to use the mouthpiece and may receive their asthma medication using a spacer with a mask.
Helping your child
How to use a spacer
Watch the video below to give your child asthma medicine using a spacer.
How to take your puffer with a mouthpiece spacer
Watch the video below to recognize the sound of using a spacer incorrectly.
Puffer + mouthpiece spacer - making the wrong sound
How to use a spacer with a mask
Watch the video or follow the illustrated steps below to give your child asthma medicine using a spacer with a mask.
How to take your puffer with a spacer and mask
Gather the MDI and spacer
Gather the spacer and the MDI.
Insert the canister into the plastic holder if they are not already put together.
Take the plastic cap off the MDI.
Prepare the MDI
With the plastic cap off, shake the MDI five times.
Connect the MDI and spacer
Put the MDI upright into the rubber hole of the spacer. The MDI should fit tightly into the hole.
Prepare your child by having them sit up or stand in a comfortable position.
Hold the mask to your child’s face
Older children can sit or stand in a comfortable position to receive their medication.
Younger children should be held on a parent’s lap. You can use the “one-person approach” or “two-person approach” to give medicine to a younger child.
One-person approachSit in a chair and place your child on your lap. Hug the child tightly with one arm and, with your other hand, press the top of the puffer firmly to release a puff of medicine.Two-person approachCross your leg over your child’s legs, hold their arms with your own arm and hold their forehead against your chest. Another adult will hold your child’s chin, place the mask firmly over your child’s nose and mouth, and press the top of the puffer firmly to release a puff of medicine.
Give the medicine
Hold the mask over your child’s face with one hand. Hold the spacer with the other hand and press the MDI down firmly with your thumb. This will release one puff into the spacer.
Hold the mask over your child’s nose and mouth for 10 to 15 seconds. This should allow your child to take about six breaths. You can also watch a valve move inside the spacer to count the breaths. Make sure your child takes deep breaths.
If your child needs to take more than one puff of the medicine, remove the MDI from the spacer and repeat steps 2 to 5.
Have your child rinse their mouth
Take the mask off your child’s face.
Wipe your child’s face. Let your child drink or rinse their mouth with water afterwards. This will help remove any medicine left in the mouth.
How to care for your child’s metered-dose inhaler
Your child's MDI and spacer need proper care and cleaning in order to dispense medicine effectively. This is a simple process that involves a few steps.
Make sure the cap is on the MDI when your child is not using it.
Make sure the hole where the medicine comes out is not plugged. Use a dry cloth or tissue to wipe off any powder around the hole or in it.
Store the MDI at room temperature. Do not let it get cold or hot. If it gets cold, warm it to room temperature with your hands.
Always check the expiry date of the MDI before use.
Write on the metal canister the date when the MDI is first used.
Your child’s MDI contains only a certain number of medication doses (puffs). It is difficult to tell when an MDI is empty by feel or sound alone. You can keep track of the number of doses remaining in your child’s MDI by using a counter tool. This will help you know when your child’s medication is running low and needs to be replaced.
How to care for your child’s spacer
Washing your child’s spacer is very simple. Try to do it before using it for the first time, and then every week after that.
Take the MDI adapter (the rubber back piece that lets the MDI fit in) off the spacer. Do not take off the mask or mouthpiece.
Soak the adapter and the spacer in lukewarm water with mild dish detergent.
Gently shake both parts so soapy water can get into all the parts.
Rinse both parts in clean water.
Shake off excess water. Do not use a towel.
Stand the spacer up in an upright position and let it air dry.
Put the adapter back onto the spacer when both parts are completely dry.
Do not wash your child’s spacer in a dishwasher.
Most spacers last about a year before you need to replace them. Ask your child’s health-care provider for a spacer prescription when it is time to replace your child’s spacer.
If you think there might be a problem with your child’s spacer, or if you have been using it for one year, have a health-care provider check it. They can tell you if the spacer is working properly.
