All About Spacers

Instructions on using Spacer Devices

What is a spacer?

A spacer is a specially designed plastic tube for use with a puffer inhaler.

Why use a spacer?

A spacer used with a puffer delivers more medication into the lungs than using a puffer on its’ own.

When used with preventer medication the spacer helps to prevent thrush of the throat and mouth, by reducing the amount of medication that comes in contact with the back of the throat.

Using a spacer makes co-ordination easier.
Spacers can also be very helpful during an acute asthma episode as they are just as effective as a nebulizer.

Instructions on priming and maintaining a spacer

Because spacers are made of plastic, when they are new they hold a lot of static. So before using for the first time it is necessary to prime a spacer. First take it apart & wash in warm soapy water (using washing up liquid). Washing up liquid has been shown to be an effective agent in reducing static.

Instructions for use

  • Shake the puffer/inhaler several times, this mixes the propellant & medication together, ensuring a correct dose of medication is given. Fit the puffer/inhaler into the portal end of the spacer. (Not the mouthpiece end)
  • Ensure there is a firm seal of the lips around mouthpiece, or a snug fit of the mask over the nose and mouth. This prevents the medication from escaping into the air and allows it to be inhaled into the lungs.
  • Keep the spacer still whilst being used, press the puffer/inhaler once. Pressing more than one puff at a time will result in the particles of medication clumping together, reducing the amount of medication which reaches the lungs.
  • Slowly, breathe in and out through the mouth, six times. Slow, ‘tummy’ breathing will get the medication further down into the lungs.

Repeat 1-4 for each further puff required.

Remember to:
  • Always rinse, gargle and spit after using the preventer puffer/inhaler to reduce the chance of developing oral thrush. Encourage your child to perform this task as well.
  • Press and inhale only one puff at a time from the spacer, breathe in and out through the mouth, six times, using slow ‘tummy breathing.
  • When using a mask wipe your child’s face after giving preventer medication to help avoid irritating the skin around your child’s mouth.
Asthma New Zealand - Medication distribution with and without using a spacer

To purchase a spacer and/or spacer mask, click here >

Asthma New ZEaland - All About Spacers


Did you know?

A spacer is an effective way of getting reliever medicine into the breathing tubes when someone is having an acute asthma episode. If you have difficulty pressing the inhaler hard enough to release a dose of medication, ask your Practice Nurse, GP, or Pharmacist about a Haleraid. This device is available free of charge.

Both children and adults benefit from using a spacer when taking their puffer inhaler.

Using spacer devices with pre-school age children

Show your child how the puffer and spacer work before putting it near his/her face.

Demonstrate on yourself (without pressing the puffer). Do not use one of your child’s toys as the child may worry that the toy is sick. Plan medication times as part of the normal routine, fitting in with regular activities such as meal times.

At medication time, make sure inhaler and spacer are ready to use. Tell your child that it is time for the puffer. They should not be given a choice about having it. However, providing a choice as to where they can sit, or whether they want to hold the spacer etc, will give the child a feeling of control over the situation, and so aid co-operation. When using the spacer, count out loud as the child breathes and breathe with them to encourage breathing control.

Remember that arguing with a pre-schooler is tiring, frustrating, and pointless! If your child is not co-operating, then ignore the behaviour and abandon the task, without a word. Wait until all is calm and your child is occupied with other things, then try again. Reward co-operative behaviour with praise and cuddles. Some children respond well to sticker or star charts when trying to establish a new behaviour (avoid getting into the habit of handing out sweets, chocolates and new toys as rewards – children come to expect this and will not co-operate without them.)

If all else fails, the child will get some benefit from being given the medication whilst asleep!