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Asthma: tips for using a spacer device

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A spacer is a holding chamber that connects to your inhaler to make it easier for your medicines to reach your lungs.

The spacer allows you to inhale normally while using your inhaler, without having to worry about coordinating pressing the pump at the same time as starting to breathe in. It also ensures that less medicine gets deposited in your mouth and throat, where it can lead to irritation and thrush.

Some spacers are bulky to carry. Fortunately, it may not be necessary to carry it with you. Most steroid inhalers are used twice daily, so the spacer can be left at home for morning and evening use only.

Spacer devices are very valuable during an emergency. Spray 4-10 puffs of your reliever and controller pumps into the spacer device every 20 minutes for an hour, and inhale deeply through your mouth from the spacer. This may prevent unnecessary nebulisation.

How to use a spacer in 8 steps:

  • Shake the inhaler well before use (give it 3-4 shakes).
  • Remove the cap from your inhaler and spacer (if it has one).
  • Put the inhaler into the spacer.
  • Breathe out, away from the spacer.
  • Bring the spacer to your mouth, put the mouthpiece between your teeth and close your lips around it.
  • Press the top of your inhaler once.
  • Breathe in very slowly until you’ve taken a full breath. If your spacer has a whistle and you hear a whistling sound, you’re breathing in too fast.
  • Hold your breath for about ten seconds; then breathe out.

Cleaning your spacer

To clean your spacer, follow the instructions that come with it. In most cases, the manufacturers will advise you to:

  • Take the spacer apart.
  • Gently move the parts back and forth in warm water, using mild soap. Never use high-pressure or boiling hot water, and don’t rub your spacer with alcohol or disinfectant.
  • Rinse the parts well in clean water.
  • Don’t dry the inside of the spacer with a cloth as it will cause static to develop. Instead, allow the parts to air dry.
  • Put the spacer back together.

Important reminders about spacers

Always follow the instructions that come with your spacer. The following are useful tips:

  • Only use your spacer with a pressurised inhaler, and not with a dry-powder inhaler.
  • Spray only one puff into a spacer at a time.
  • Use your spacer as soon as you’ve sprayed a puff into it.
  • Never let anyone else use your spacer.
  • Keep your spacer away from heat sources.
  • If your spacer has a valve that’s damaged, or if any other part of the spacer is damaged, don’t use it. The spacer will have to be replaced.

Reviewed by independent healthcare consultant Prof Praneet Valodia and pulmonologist Prof Elvis Irusen, Head of the Division of Pulmonology at the Faculty of Medicine and Health Sciences, Stellenbosch University. October 2018.

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