This short clip shows you how to use a standard metered dose inhaler (MDI), often called a puffer, with a spacer.

A standard puffer and spacer is used with many different medications. These include:

• Airomir (salbutamol)
• Alvesco (ciclesonide)
• Asmol (salbutamol)
• Combivent (ipratropium plus salbutamol)
• Epaq (salbutamol)
• Flixotide (fluticasone)
• Flixotide Junior (fluticasone)
• Intal (sodium cromoglycate)
• Intal Forte (sodium cromoglycate)
• Qvar (beclomethasone)
• Seretide (salmeterol plus fluticasone)
• Serevent (salmeterol)
• Tilade (nedocromil sodium)
• Ventolin (salbutamol)

Checklist of steps

1. Assemble spacer
2. Remove inhaler cap
3. Hold inhaler upright and shake well
4. Insert inhaler upright into spacer
5. Put mouthpiece between teeth without biting and close lips to form good seal
6. Breathe out gently
7. Hold spacer level and press down firmly on canister once
8. Breathe in and out normally for 3-4 breaths*
9. Remove spacer from mouth
10. Breathe out gently away from mouthpiece
11. Remove inhaler from spacer
12. If an extra dose is needed, wait 1 minute and then repeat steps 3 to 11
13. Replace cap and disassemble spacer

Your inhaler and spacer will come with instructions in the package. Always check the package insert for any specific instructions.

*Having several breaths may be easier for young children and/or during an asthma attack when a single deep breath is too difficult to manage.

Common problems

• Not breathing in soon enough after pressing the canister, so the medication falls to the bottom of the spacer
• Taking several puffs without waiting or shaking the inhaler in between

Tips

• Looking after your spacer properly helps the medication get to your lungs better, as it doesn't stick to the sides or get clogged in the valve
• Using a spacer can help reduce the chance of side-effects like hoarse throat and thrush
• Ask your pharmacist about a facemask if your child can't seal their lips around the spacer mouthpiece properly

Spacer care

• Clean your spacer before you use it for the first time and then about once a month
• It's normal for your spacer to look a bit cloudy
• Wash your spacer in warm water with kitchen detergent and allow to air dry without rinsing
• Drying with a cloth or paper towel can result in electrostatic charge (‘static') on the inside of the spacer, which make the medication stick to the sides
• Wipe the mouthpiece clean of detergent before use
• Spacers should be checked by your doctor, pharmacist or nurse every 6-12 months to check the structure is intact (e.g. no cracks) and the valve is working.

Getting the most out of your inhaler

Ask your doctor, pharmacist or asthma & respiratory educator to:

• Explain how your inhaler should be used
• Check you are using your inhaler properly
• Tell you where to find the expiry date on your inhaler
• Show you how to check if your inhaler is empty or nearly empty
• Discuss any unwanted effects from your medication
• Explain how to clean your inhaler and spacer (if you have one).