Knowing how to use a spacer properly can decide how much of each puff actually reaches the lungs. Many people were shown once, years ago, and small habits have crept in since. This guide follows National Asthma Council Australia advice step by step, and it sits alongside the asthma management support available at Abermain Chemist, where a pharmacist can watch your technique in person and suggest changes.
Key Takeaways
- Fire a single puff, breathe it in fully, then repeat for the next.
- Children under 4, and people who struggle to form a lip seal, need a small spacer fitted with a face mask.
- Air dry a washed spacer rather than towelling it, so medicine does not cling to static.
- An asthma emergency is a 000 call.
What a spacer does
Think of a spacer as a chamber or tube that clips onto a puffer, which is the everyday name for a metered dose inhaler. The Council explains that it gives the medicine room to slow down, so you can breathe it in slowly and deeply. Less medication lands in the mouth and throat, where it can lead to irritation, hoarseness or infections. A spacer also makes it easier to time the puff with your breath.
The Council recommends a spacer for these groups:
- all children aged 4 years and under
- anyone using a corticosteroid preventer through a puffer
- anyone who finds the press-and-breathe timing hard
- anyone taking a reliever puffer for asthma symptoms
Before the first puff
A few checks come before the medicine goes anywhere near the spacer. The Council’s checklist for adults starts with them:
- Look at the dose counter, if your puffer has one, and the expiry date. Never use medication past that date.
- Take the caps off the inhaler and the spacer mouthpiece.
- Shake the puffer well while holding it upright, unless your device says it does not need shaking.
- Prime a new puffer, or one that has not been used for a while, following the instructions in its packet.
Using a spacer, step by step
- Push the puffer, held upright, into the end of the spacer.
- Put the mouthpiece between your teeth (do not bite down) and seal your lips around it.
- Keeping the spacer horizontal, breathe out gently into it.
- Press the canister firmly, once only.
- Right after pressing, take 4 normal breaths in and out through the spacer. The Council also describes an alternative: one slow, deep breath over 3 to 5 seconds, then holding it for 5 to 10 seconds.
- Take the puffer out of the spacer and replace the covers.
The most important habit is one puff at a time. The Council’s video notes that putting several puffs into the spacer at once is a common error. If your plan calls for more than one dose, go back through every step for each one. People using a corticosteroid inhaler should rinse their mouth afterwards.
These are general steps. The Council notes that the instructions are different for each type of inhaler device, so check the packet that came with yours as well.
Want someone to watch your technique? Bring your puffer and spacer into Abermain Chemist and ask a pharmacist to check how you use them.
Masks for babies and young children
Babies and toddlers may not be able to close their lips around a mouthpiece, so the Council’s spacer fact sheet advises a small volume spacer with a tightly fitting mask for children younger than 4, and for people unable to form a tight seal with their lips. Its children’s checklist adds a few points for this technique:
- Sit the child upright.
- Place the mask over both nose and mouth, with no gaps between mask and skin.
- Hold the spacer level while you press the canister once.
- Let the child breathe normally for 4 breaths, keeping the mask on the face the whole time.
Keeping your spacer in working order
Cleaning affects how well a spacer works. The same fact sheet sets out this routine:
- Take the spacer apart, if it comes apart.
- Wash the parts in clean warm water with dishwashing liquid.
- Leave them to air dry without rinsing. A cloth or paper towel builds up static inside, which makes the medicine stick to the walls.
- Wipe any detergent off the mouthpiece, then put it back together once completely dry.
It recommends cleaning weekly and after you recover from a cold or chest infection. Replace the spacer after 12 months of use, or as the manufacturer directs, and have a pharmacist, nurse or asthma educator look it over every 6 to 12 months for cracks and a working valve.
When it is more than technique
Good technique does not replace medical care. The Council lists the signs of an asthma emergency: symptoms getting worse very quickly, severe shortness of breath, being unable to speak comfortably, blue lips, or little or no relief from the reliever. In any of those situations, call 000 and say it is an asthma emergency. For advice that is not urgent, the Healthdirect helpline on 1800 022 222 has a registered nurse available around the clock. For an asthma review, or before any change to your medicines, see your GP.
Frequently asked questions
Why does my spacer whistle?
On spacers that have one, a whistle means you are breathing in too quickly. The Council’s adult checklist says to slow down your inhalation when you hear it.
My spacer has gone cloudy. Is it still safe?
Some cloudiness over time is normal. According to the Council’s care guide, a spacer should never be mouldy or brown, so replace one that is.
Which spacer should I buy?
There are plastic chamber, collapsible and disposable cardboard types in many sizes. The Council suggests getting advice from a health professional, such as your pharmacist or asthma educator, on which suits you or your child, and choosing one that is easy to put together and convenient to carry.
What if there is no spacer during an asthma attack?
Call 000 first. The Council’s first aid page also shows how to make a makeshift spacer from a plastic drink bottle or a rolled-up piece of paper.
Pop into 193 Cessnock Rd with both devices, so a pharmacist can check a practice puff with you.