Spacer Device for Inhalers
Essential tool for proper inhaler medication delivery in children and adults
A spacer device, also called a valved holding chamber, is a medical attachment used with metered dose inhalers (MDI) to improve medicine delivery to the lungs. This simple plastic chamber holds the medication mist, making it easier to inhale the full dose, especially for children, elderly patients, and anyone who has difficulty coordinating inhaler use.
What is a Spacer Device
A spacer is a hollow plastic tube or chamber that attaches to a metered dose inhaler on one end and has a mouthpiece or mask on the other end. When medication is sprayed into the spacer, it creates a holding area where the medicine stays suspended long enough for the user to breathe it in slowly and completely.
The device typically measures 10-20 cm in length and has a volume of 140-750 ml depending on the type and brand.
Purpose and Benefits
- Increases medication delivery to lungs by 2-3 times compared to inhaler alone
- Reduces medication deposit in mouth and throat
- Eliminates need for perfect timing between pressing inhaler and breathing in
- Decreases side effects like oral thrush and hoarse voice
- Makes inhaler use possible for young children, infants, and elderly patients
- Helps during acute asthma episodes when breathing is difficult
Where Spacers are Used
- Home management of asthma and chronic obstructive pulmonary disease (COPD)
- Hospital emergency departments for acute respiratory distress
- Pediatric clinics and general practice offices
- Schools and daycare centers for children with asthma
- Nursing homes and care facilities
- Ambulances and emergency medical services
Types of Spacer Devices
| Type | Description | Best For |
|---|---|---|
| Non-valved Spacer | Simple tube without valve mechanism | Older children and adults who can breathe immediately after actuation |
| Valved Holding Chamber | Has one-way valve that opens with inhalation | All ages, especially children and those with coordination difficulties |
| Small Volume Spacer | 140-250 ml chamber volume | Portable use, travel, older children and adults |
| Large Volume Spacer | 500-750 ml chamber volume | Young children, infants, severe asthma cases |
| Spacer with Face Mask | Soft mask attachment instead of mouthpiece | Infants, toddlers under 3 years, patients unable to use mouthpiece |
| Collapsible Spacer | Foldable design for portability | Travel, school, work environments |
Common Brand Examples
Popular spacer brands available internationally include AeroChamber, Volumatic, Able Spacer, OptiChamber, and InspirEase. Choice depends on availability, patient age, and inhaler compatibility.
How to Use a Spacer Device - Step by Step Guide
For Adults and Children Over 5 Years (with Mouthpiece)
- Remove the cap from the inhaler and shake it well for 5 seconds
- Check that the spacer is clean and assembled correctly
- Insert the inhaler mouthpiece into the circular opening at the end of the spacer
- Breathe out normally, away from the spacer
- Place the spacer mouthpiece between teeth and seal lips tightly around it
- Press down on the inhaler once to release one puff of medication into the spacer
- Breathe in slowly and deeply through the mouth. You should hear the valve click
- Hold breath for 10 seconds, or as long as comfortable
- Breathe out slowly through the mouth, still keeping lips sealed on mouthpiece
- If prescribed multiple puffs, wait 30-60 seconds between each puff and repeat steps 4-9
- Remove spacer, replace inhaler cap, and rinse mouth with water if using corticosteroid medication
For Infants and Young Children (with Face Mask)
- Shake the inhaler well for 5 seconds
- Attach the inhaler to the spacer device
- Attach the appropriate size face mask to the spacer
- Hold the child in a comfortable position (sitting or semi-upright)
- Place the mask gently but firmly over the child's nose and mouth to create a seal
- Press the inhaler once to release medication into the spacer
- Keep the mask in place and allow the child to breathe normally for 5-10 breaths (you will hear the valve clicking with each breath)
- Keep the mask in place throughout to prevent medication loss
- Remove the mask after 5-10 breaths
- For multiple puffs, wait 30-60 seconds and repeat the process
- Wipe the child's face after use if using corticosteroid medication
- Pressing the inhaler more than once before breathing in
- Breathing too quickly or forcefully
- Removing the spacer from mouth between breaths
- Not waiting between puffs
- Not creating a good seal with mouthpiece or mask
- Using the spacer upside down or incorrectly oriented
Precautions and Safety Information
General Precautions
- Always check that the spacer is compatible with your specific inhaler brand and model
- Inspect the spacer for cracks, damage, or worn valves before each use
- Do not use a damaged or broken spacer as it will not deliver medication properly
- Never share spacers between different people due to infection risk
- Keep the spacer away from heat sources and direct sunlight
- Do not modify or alter the spacer device in any way
- Replace the spacer every 6-12 months or as recommended by manufacturer
- Store in a clean, dry place when not in use
For Young Children
- Never force the mask onto a crying or struggling child as this reduces medication delivery
- Ensure mask size is appropriate for the child's age and face size
- Check that the mask seal is complete without gaps
- Always supervise children during spacer use
- Keep spacers out of reach of children when not in use
Potential Issues
- Symptoms do not improve despite regular medication use
- Increased frequency of inhaler use is needed
- You hear less or no clicking sound from the valve
- Unusual side effects develop such as rapid heart rate, tremors, or severe throat irritation
- Child refuses to use the spacer consistently
Electrostatic Charge Issue
Plastic spacers can develop static electricity that attracts medication particles to the walls, reducing the amount reaching the lungs. To minimize this:
- Wash new spacers before first use
- Do not dry or wipe the inside after washing - let it air dry
- Some manufacturers recommend priming new spacers by firing 10-20 puffs through them before first use
- Use antistatic spacers if available
Cleaning and Maintenance
Step by Step Cleaning Instructions
- Disassemble the spacer by separating the two halves and removing the mask or mouthpiece
- Prepare warm water with mild liquid dish soap
- Soak all parts in the soapy water for 10-15 minutes
- Gently clean all surfaces with a soft cloth or sponge - do not scrub vigorously
- Rinse thoroughly under running water to remove all soap
- Shake off excess water and place parts on a clean towel
- Allow to air dry completely - do not wipe or dry with cloth as this creates static
- Once completely dry, reassemble the spacer
- Store in a clean, dry place or protective case
What NOT to Do
- Do not use hot water or put spacer in dishwasher unless specified by manufacturer
- Do not use abrasive cleaners or brushes
- Do not use alcohol, bleach, or harsh chemicals
- Do not dry the inside with towels or paper as this creates static electricity
- Do not reassemble until completely dry to prevent mold growth
When to Replace
Replace your spacer device if you notice:
- Cracks or damage to the chamber or valve
- Valve becomes stiff or does not move freely
- Discoloration or cloudiness that does not clean off
- Mouthpiece or mask becomes worn or damaged
- Device has been used for 6-12 months (even if looks fine)
Storage and Care Tips
- Store spacer in original case or clean plastic bag to keep dust-free
- Keep in a cool, dry location away from direct sunlight
- Avoid storing in humid environments like bathrooms
- Do not store with inhaler attached to prevent accidental discharge
- Keep valve-end facing upward to prevent dust accumulation
- Label spacers if multiple family members use different ones
- Carry a portable spacer when traveling or for school/work use
- Keep spacer easily accessible for emergency use
- Check valve function periodically by inhaling through mouthpiece - should hear clicking
Spacer Selection Guide
| Age Group | Recommended Type | Volume |
|---|---|---|
| 0-18 months | Valved spacer with small infant mask | 140-250 ml |
| 18 months - 3 years | Valved spacer with toddler mask | 250-350 ml |
| 3-5 years | Valved spacer with mask or mouthpiece (based on ability) | 350-500 ml |
| 5 years and older | Valved spacer with mouthpiece | 350-750 ml |
| Adults | Valved or non-valved spacer with mouthpiece | 350-750 ml |
Consult with your healthcare provider or pharmacist to select the most appropriate spacer for your specific needs and inhaler type.
Frequently Asked Questions
Do all inhalers need a spacer?
Spacers are used only with metered dose inhalers (MDI), not with dry powder inhalers. Most people, especially children under 5 years, benefit from using a spacer with their MDI.
Can I use any spacer with my inhaler?
No. Check that the spacer is compatible with your specific inhaler brand and model. The inhaler must fit securely into the spacer opening.
How long does a spacer last?
Typically 6-12 months with proper care and cleaning. Replace sooner if damaged, cracked, or if the valve becomes stiff.
Why does my child need a spacer?
Children cannot coordinate pressing the inhaler and breathing in at the same time. A spacer holds the medication so they can breathe it in at their own pace, ensuring proper medication delivery.
Can I use a spacer for emergency medication?
Yes. Spacers are effective for both maintenance and rescue medications. They often improve delivery during acute episodes when breathing is difficult.
How many puffs can I give through a spacer at once?
Give only ONE puff at a time into the spacer, then breathe in completely before giving the next puff. Multiple puffs at once reduce effectiveness.
Is expensive spacer better than cheap one?
Not necessarily. The most important factors are correct size for the user, compatibility with the inhaler, presence of a valve, and proper use. Consult your healthcare provider for recommendations.
Why is there white powder in my spacer?
This is medication residue. It indicates the spacer needs cleaning. Regular cleaning prevents buildup that can harbor bacteria and reduce medication delivery.
Can spacers be used with oxygen?
Standard spacers are not designed for oxygen delivery. If you need both inhaled medication and oxygen, consult your healthcare provider for proper administration sequence.
Will insurance cover spacer cost?
Coverage varies by country and insurance plan. In many regions, spacers are covered when prescribed by a physician. Check with your insurance provider or healthcare system.
My baby cries when I use the spacer. What should I do?
Crying reduces medication delivery. Try timing medication when baby is calm or slightly drowsy. Use gentle but firm mask seal. Distraction with toys or songs may help. Consult your pediatrician if problems persist.
Should I hear a sound when using the spacer?
Yes. Valved spacers produce a clicking sound when you breathe in and out through them. This confirms the valve is working and you are breathing correctly.
Additional Tips for Success
- Practice the technique with your healthcare provider until you feel confident
- Have your technique checked regularly, especially for children
- Keep a spare spacer at school or daycare if your child uses medication regularly
- Teach older children to use the spacer independently while supervised
- Use reward systems for young children to encourage cooperation
- Consider spacers with fun designs or characters for young children
- Keep the device visible as a reminder to take medication as prescribed
- Record medication timing and doses to track adherence
Environmental Considerations
Spacer devices are reusable medical devices that reduce waste compared to single-use alternatives. When disposal is necessary:
- Check local regulations for medical device disposal
- Clean thoroughly before recycling if your area accepts medical plastics
- Some manufacturers offer take-back or recycling programs
- Consider donating gently used spacers to clinics in low-resource settings if permitted
The information provided on this page is for educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, pediatrician, or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment. Never disregard professional medical advice or delay seeking it because of information you have read on this website. The use of spacer devices should be under the guidance of a healthcare professional who can provide personalized instructions based on the patient's specific condition, age, and medication requirements. In case of emergency or severe breathing difficulty, seek immediate medical attention. PediaDevices does not recommend or endorse any specific products, tests, physicians, or procedures mentioned on this page.
Labels: Respiratory-System