Spacers (apart from the new Aerochamber) usually come in two clear plastic halves, which click together to form a chamber. When the device is assembled, it has a mask for the child at one end and a hole for the inhaler at the other. The parent then squirts the aerosol into the spacer, one puff at a time, allowing the child to take five to ten breaths between puffs. The child breathes through the spacer mask, inhaling the drug from the chamber.
Spacers deliver the aerosol with less force than a standard puffer, so that the drug is less likely to be deposited at the back of the throat and swallowed. Unlike the standard aerosols, the child does not have to co-ordinate breathing in with the activation of the aerosol.
Spacers are more efficient than inhalers alone and get the medicines into the child’s lungs effectively and safely. They are particularly good for giving inhaled medicines to small children for whom just an inhaler is no good.
If the spacer is forgotten, an emergency spacer can be made by making a hole in the base of a paper cup for the puffer. The wide end of the cup is placed over the child’s nose and mouth, and the aerosol is activated.
If your baby will not tolerate anything held against the mouth, you can hold the mask near and just below the face. However, you may need to tip the spacer to keep the valve open. The infant will still breathe in the medication, even though some is lost.
You may need a lot of reassurance while you are learning to deal with your child’s asthma. Your doctor will understand how worrying it can be to try to get medication into a wheezing child, and should not object to being contacted out-of-hours if you are experiencing problems with this.