Expert Answers: What is a Spacer and How Do I Use One?

There is so much to get used to when it comes to treating and managing COPD. One question that seems to come up in COPD circles quite often is:

"What is a spacer, and how do I use one?"

So, we asked our experts this question! Read on for their helpful answers...

Response from John

A spacer is a hollow device that attaches to the mouthpiece of a metered dose inhaler (MDI), such as an albuterol inhaler. There are couple correct ways of using one, although I find the following to be the most effective for people with COPD.

What you do is you shake the inhaler as normal, and then insert it into the back end of the spacer. (Some people like to keep the inhaler in the spacer, and just shake the whole unit when it's needed. This is fine too). Squirt the inhaler into the spacer. As you normally would when using any inhaler, you exhale fully. You then place your mouth around the mouthpiece of the spacer. You then inhale as deep as you can using a slow, smooth flow. (Some spacers whistle when you inhale too fast, a reminder to slow down next time.) Hold your breath at least 2-3 seconds.

Spacers trap large particles, preventing them from impacting in your upper airways. When medicine impacts your upper airways, it can be swallowed and increases your risk for side effects. Spacers also assure only optimal medicine particles are inhaled so they can make the twists and turns to your lower airways where they bind with cells and work their magic.

In this way, spacers have been shown over and over and over again to improve patient/ inhaler coordination, assure ideal medicine distribution throughout your lungs, and reduce the risk for side effects.

If you have an MDI, you should definitely use a spacer. If you do not have one already, you should talk to your doctor about writing a prescription for one. It's the best way of getting the most out of your metered dose inhaler.

Response from Lyn

A spacer is a long tube that you attach your metered dose inhaler (MDI) to. One side attaches to the MDI and the other has an opening for your mouth. Some can even be fitted with a mask for persons that have disabilities that may hinder their use of the mouthpiece. It slows the delivery of the medication allowing more of it to reach your lungs and less of it to hit the back of your throat. In fact, some spacers come equipped with a whistle that indicates you need to slow down the breath to get optimum delivery of medication.

The other advantage to using a spacer is that it makes it easier to coordinate breathing and medication delivery. Often people find that they have trouble breathing in at the same time they actuate the inhaler – therefore delivering most of the medication to the back of their throat. This can be especially true if a person is having trouble breathing and needs to take their inhaler quickly...

Your hands may be shaking, you’re breathing too quickly, and you’re nervous because you just need to get that medication into your lungs as quickly as possible.

I’m sure you know the feeling well!

There are a few things to keep in mind when using a spacer:

1. They aren’t meant to be used with dry-powder inhalers – only high pressure ones.
2. Don’t share! It seems obvious, but never let anyone else use your spacer.
3. Keep it clean. At least a few times a week, take it apart and wash it with warm, soapy water and let it air-dry.

If you need any assistance using the device, try Youtube and search “MDI or Using a spacer for an inhaler”. There are a number of great videos that illustrate the proper technique for using one.

What about your experience with spacers? Share with us in the comments!