Childen's Hospital Boston  300 Longwood Avenue
Boston, MA 02115
(617) 355-6000
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My Child Has:
Asthma: Metered Dose Inhaler (MDI) and Spacers
Programs that treat this condition or perform this procedure
 Allergy Program    Community Asthma Initiative  
 Center for Aero-Digestive Disorders (CADD)  
What is a metered dose inhaler (MDI)?
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 to your MDI. It can help increase the amount of medicine that gets to your lungs.
To use an inhaler with a spacer, follow these steps:
Inhalers look easy, but may take some practice before you can use them correctly.
  1. Remove the cap on the inhaler.
  2. Shake the canister to mix up the medicine before use. Attach the inhaler to the spacer.
  3. Have your child should stand up straight and hold his or her head tilted back slightly.
  4. Tell your child to blow out all the way, slowly, before using the inhaler.
  5. Press down on the inhaler. This will put one puff of the medicine in the holding chamber.
  6. Immediately place the mouthpiece of the spacer in your child's mouth and have him or her form a tight seal. Tell him or her to inhale slowly.
  7. Tell your child to hold his or her breath for 10 seconds to allow the medicine to reach far into the lungs. You may hold your child's nose closed to be sure that the medication goes into his or her throat.
  8. If the 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 his or her mouth with water and spit (not swallow). This helps prevent dry throat and mouth and relieve 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 age five who cannot take a deep breath on command.

Instructions:

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

Used for children over five to six years old who are able to take a deep breath on command. It is good for parents and children who benefit from visual cues that they are using the spacer correctly.

Instructions:

  • Connect the mouth piece to the reservoir bag.
  • Remove the MDI canister, shake, and place on proper 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 his or her breath for five seconds.
  • Instruct your child to repeat, exhaling into the bag, inhaling, and holding his or her breath for five seconds.
  • Repeat the above directions for each puff your doctor orders.
Aerochamber

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

Instructions:

  • Place mouthpiece in mouth, making a tight seal with lips.
  • Instruct your child to inhale slowly and completely without making the whistle sound.
  • Repeat above instruction steps.
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which can only be given to you by your personal health care professional.
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