A spacer is a device used with a metered-dose inhaler (MDI) to help deliver medication more effectively into the lungs. It is a tube or chamber that connects to the inhaler, creating a holding space for the medicine after it is sprayed. Most spacers include a one-way valve, allowing for normal breathing while ensuring the medication remains within the chamber until inhaled. These devices are often referred to as valved holding chambers (VHCs).
Purpose of a Spacer
Spacers optimize inhaled medication delivery. They address common challenges associated with using metered-dose inhalers directly, such as coordinating the spray with inhalation. By providing a chamber, the spacer slows down the aerosolized medication, allowing the user more time to inhale the medicine effectively. This controlled delivery means that a greater concentration of medication reaches the lungs, where it is most needed, rather than settling in the mouth or throat.
Spacers also reduce potential side effects. Medication depositing in the mouth, especially with corticosteroid inhalers, can lead to oral thrush or irritation. The spacer minimizes this by reducing the amount of medication that impacts the mouth and throat. Ultimately, the spacer helps ensure that the prescribed amount of medication reaches the airways, improving treatment effectiveness.
Step-by-Step Guide
Remove the caps from your metered-dose inhaler and the spacer. If your inhaler is new, hasn’t been used in a while, or has been dropped, it may need to be primed by spraying a few puffs into the air according to the manufacturer’s instructions. Shake the inhaler well for 5 to 10 seconds before each use.
Insert the inhaler’s mouthpiece firmly into the spacer’s open end, pointing upwards. If using a spacer with a mouthpiece, place it between your teeth without biting down and seal your lips tightly around it to prevent medicine from escaping. For children under four years old or individuals unable to create a tight seal, a mask attachment that covers both the mouth and nose should be used, ensuring a snug fit.
Before administering, breathe out gently and completely, emptying your lungs. Press the inhaler once to release a single puff into the spacer. Immediately after pressing the inhaler, begin to breathe in slowly and deeply through your mouth. Continue inhaling for 3 to 5 seconds, aiming for a slow, steady breath; a whistling sound from some spacers indicates breathing in too quickly.
Remove the spacer and hold your breath for up to 10 seconds to allow medicine to reach deep into your lungs. Then, breathe out slowly. If a second puff is prescribed, wait about 30 seconds to one minute, shake the inhaler again, and repeat the entire process starting from shaking the inhaler. After using a corticosteroid inhaler, rinse your mouth with water and spit it out to prevent side effects like oral thrush.
Maintenance and Troubleshooting
Clean your spacer regularly, typically weekly, or more frequently after a cold or respiratory infection. To clean, take the spacer apart if possible and wash all components in warm water with a mild liquid dishwashing detergent. Allow the parts to air dry completely without rinsing or wiping with a towel, as this can create static electricity that causes medication to stick to the sides.
Reassemble the spacer once dry. If you hear a whistling sound during inhalation, you are breathing too fast; adjust to a slower, steadier breath. Spacers should be replaced approximately every 6 to 12 months, or sooner if they show signs of cracking or damage, or if the one-way valve is not functioning correctly. Regular checks by a healthcare professional every 6 to 12 months can confirm the spacer’s integrity.