Childhood Asthma: Metered Dose Inhalers and Spacers

What is a metered dose inhaler?

A metered-dose inhaler (MDI) is a device that helps deliver a specific amount of medication to your lungs. It is commonly used to treat asthma. A MDI is a great way to take your asthma medicine. Side effects are usually minimal because the medicine goes directly to your lungs.

What is a spacer?

A spacer is a holding chamber that attaches on to your MDI. It can help increase the amount of medicine that gets to your lungs.

To use an inhaler with spacer, follow these steps:

An inhaler may look easy to use, but it may take some practice to use it correctly.

1. Remove the cap on the inhaler.
2. Shake the canister to mix up the medicine. Attach the inhaler to the spacer.
3. Have your child stand up straight and hold his head tilted back slightly.
4. Your child should then blow her breath out all the way, slowly, before using the inhaler.
5. Press down on the inhaler. This will put one puff of the medicine into the holding chamber.
6. Immediately place the mouthpiece of the spacer in your child's mouth and have him form a tight seal. Tell him to inhale slowly.
7. Tell your child to hold her breath for 10 seconds to allow the medicine to reach far into the lungs. You may hold the child's nose closed to be sure the medication goes into her lungs.
8. If the prescribed dose is more than one puff, wait one minute between puffs and repeat the above steps. Shake the inhaler well before each puff.
9. When finished, remove the inhaler from the spacer and replace the protective cap.
10. Have your child rinse her mouth with water and spit out (not swallow) the water. This helps prevent dry throat and mouth, and relieves the unpleasant aftertaste.

Cleaning the spacer

It is important to rinse your inhaler mouthpiece, cap and spacer once a day with warm water to prevent it from clogging and not working well. After rinsing, air dry the spacer. Do not use a towel that will leave lint in the spacer.

What types of spacers are used with children?

Aerochamber with mask: Used for children under 5 years old who cannot take a deep breath on command.

• Ensure the mask makes a tight seal on your child's face.
• When using the mask, have your child breath six normal breaths (in and out is one full breath) with each puff.
• Follow the above instruction steps.

Inspirease: Used for children older than 5 to 6 years old, who are able to take a deep breath on command. Good for parents and children who benefit from visual cues that they are using the spacer correctly.

• Connect the mouth piece to the reservoir bag.
• Remove the MDI canister, shake and place on the mouthpiece.
• Instruct your child to blow out until the bag is full.
• Press down on the inhaler to deliver one puff of the medicine.
• Instruct your child to slowly inhale, without causing bag to whistle, until the bag is collapsed.
• Instruct your child to hold her breath for five seconds.
• Instruct your child to repeat exhaling into the bag, inhaling, and holding his breath for five seconds.
• Repeat the above directions for each puff your doctor orders.

Aerochamber: Used for children 8 years old and older who are able to take a deep breath.

• Place mouthpiece in your child's mouth, making a tight seal with lips.
• Instruct your child to inhale slowly and completely without making the whistle sound.
• Repeat the above instruction steps.