Use a spacer to put the squeeze on your child’s wheeze

Huffing and puffing was bad enough when the Big Bad Wolf blew down the homes of the Three Little Pigs, but when your child does it, the fairy tale is over.

Fortunately, spacers make it easier for patients to use inhalers correctly to control their asthma.

An asthma spacer is a 4-to-8-inch-long tube added onto your child’s inhaler to simplify the administration of aerosolized medication from a metered-dose inhaler (MDI).

By adding distance between your child’s mouth and the MDI, the aerosol is moving slower when it reaches your child’s mouth.

Without a spacer, the aerosol leaves the inhaler at about 50 MPH making it impossible for a child to inhale all the medication that quickly.

As a result, the child doesn’t receive the entire dose of medication, diminishing its effectiveness. The spacer also reduces the potential negative effects of residual corticosteroids left in the mouth.

Spacers work with all MDIs, but are available by prescription only. They can be found at pharmacies or durable medical equipment companies. Spacers must be used with a mask for children 5 years and younger. If size is a concern for older children, collapsible spacers are also available.

To properly use an MDI with a spacer, you should:

• Remove the cap from the mouthpiece, making sure the opening is not blocked.
• Attach the inhaler to the spacer and shake it for 15 seconds.
• If the inhaler is new, prime the inhaler by releasing 2 puffs into the air. If it’s a daily inhaler, you only need to prime it once. If it is a rescue inhaler, it will need re-primed if it hasn’t been used in 2 to 3 days.
• Stand up straight when using an inhaler. Exhale gently and completely through your mouth.
• Place the spacer comfortably in your mouth, with lips and teeth around the mouthpiece. Be sure not to block the mouthpiece with your tongue.
• Press down on the inhaler.
• Breathe in deeply and slowly for about 5 seconds to move the medicine into your lungs.
• With your mouth closed, hold your breath for 10 seconds or more. Then exhale.
• Repeat dose as prescribed, making sure to shake the inhaler before each puff or before pressing down on the inhaler.
• Wait 30 to 60 seconds between doses to give the medication time to work.
• Wait a minimum of 10 minutes between doses when using 2 or more types of inhalers. If your controller and rescue inhalers are due at the same time always use your rescue inhaler first.

Watch an instructional video on using an MDI with spacer.