A spacer is a tube-like device, sometimes called a valved holding chamber, designed to attach to a Metered-Dose Inhaler (MDI) to improve medication delivery. The spacer acts as a holding chamber that temporarily traps the medication spray released from the inhaler canister. This device addresses the difficulty of coordinating inhaler actuation with a deep breath, often called “hand-lung coordination.” By slowing the medication’s high-speed release, the spacer ensures more of the drug reaches the smaller airways in the lungs instead of depositing on the back of the throat. This enhanced delivery is important for children, older adults, and those using corticosteroid inhalers, as it reduces side effects like oral thrush.
Readying the Inhaler and Spacer
Preparing your device correctly ensures that the maximum dose of medication is available for inhalation. Remove the caps from both the MDI mouthpiece and the spacer. Hold the MDI upright and shake it vigorously for 10 to 15 seconds before each use to properly mix the medication and its propellant.
If the inhaler is new or has not been used for a few days, you must “prime” it by releasing a set number of puffs into the air, typically two to four, to ensure the dose is accurate; consult your specific instructions for the exact number. Once primed, insert the metal canister’s mouthpiece firmly into the rubber ring at the back of the spacer. A tight, secure seal is necessary to prevent medication from escaping the chamber.
The Proper Inhalation Technique
The breathing mechanics used with a spacer are important for effective treatment. Before pressing the inhaler, exhale fully and gently to empty your lungs of residual air, but do not exhale into the spacer itself. Seal your lips tightly around the spacer’s mouthpiece, or ensure the face mask creates a secure seal over your nose and mouth.
Press down firmly on the inhaler canister once to release a single puff of medication into the chamber. Immediately begin to inhale slowly and deeply through your mouth, aiming for an inhalation lasting three to five seconds. If the spacer has a whistle, inhaling too quickly will cause it to sound, indicating you need to slow your breath down to allow the medication to deposit deeper into the lungs.
After taking a full, deep breath, remove the spacer from your mouth and hold your breath for five to ten seconds. This breath-holding period allows the small, suspended medication particles sufficient time to settle in the airways. Finally, exhale slowly and gently. If more than one puff is prescribed, wait 30 seconds to one minute, then repeat the entire sequence, starting with a shake of the inhaler and a full exhalation.
Maintaining Your Spacer Device
Regular cleaning is necessary to prevent medication residue from building up inside the chamber, which can reduce the effectiveness of the device. You should typically clean your spacer at least once a week, though some manufacturers may recommend a different frequency.
To clean it, separate the plastic components and soak them in warm water mixed with a mild liquid dishwashing detergent for about 15 minutes. Avoid scrubbing the inside of the chamber, as this can create static electricity on the plastic surface. A static charge causes the medication to stick to the walls instead of being inhaled.
After soaking, rinse the parts thoroughly under clean water, or leave a slight detergent film if your spacer is designed for that purpose, as some coatings help prevent static buildup. Shake off excess water and allow all pieces to air-dry completely in a vertical position without wiping them with a cloth or paper towel. Once fully dry, reassemble the spacer and store it in a clean, dry place.