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Metered-Dose Inhaler, How to Use with a Collapsible Bag Spacer

What is a metered-dose inhaler with a spacer?

A metered-dose inhaler (MDI) is a hand-held device that releases a mist of medicine. Metered dose inhalers contain a gas that helps the medicine get into your child’s lungs. Inhalers help send the medicine directly to your child’s lungs as he takes a deep breath.

A device called a spacer can be used with the inhaler. Spacers help when it is hard to press the inhaler at the same time that your child breathes in the medicine. The spacer holds medicine in the bag or tube and:

  • Helps your child to breathe at his own pace
  • Helps more medicine to reach your child’s lungs
  • Keeps medicine from just going into the air

Some spacers are made for just one type of inhaler. Talk to your healthcare provider about this. Spacers can be used with or without a mask.

To attach the spacer to the MDI:

  1. Attach the inhaler mouthpiece to the reservoir bag by matching the tabs in the reservoir bag.
  2. Push in, twist, and lock.
  3. Pull the reservoir bag all the way open so there are no wrinkles.
  4. Remove the inhaler canister from the plastic case and shake it vigorously.
  5. Attach the canister to the inhaler mouthpiece.

To use the MDI with the spacer and mask:

  1. Select the proper size mask for your child (small, medium, or large) and attach to the mouthpiece end.
  2. Have your child stand or sit up straight.
  3. Put the mask to your child's face, covering both the nose and mouth. The mask must be pressed to your child's face to make sure that the medicine can get to the child's lungs.
  4. Depress the MDI once. The medicine will be trapped in the reservoir bag.
  5. Have your child breathe in slowly over 3 to 5 seconds. (The reservoir will collapse as your child inhales. A whistling noise will sound if the breath is too fast.)
  6. Have your child hold his breath for 5 to 10 seconds.
  7. Have your child breathe out slowly back into the reservoir bag.
  8. Still using the bag, have your child breathe in and out slowly once or twice more.

To use the MDI with the spacer and mouthpiece:

  1. Put the mouthpiece between the teeth and seal the lips around it.
  2. Depress the metered-dose inhaler. The medicine will be trapped in the reservoir bag.
  3. Breathe in slowly over 3 to 5 seconds. (The reservoir will collapse as you inhale. A whistling noise will sound if the breath is too fast.)
  4. Hold your breath for 5 to 10 seconds.
  5. Breathe out slowly back into the reservoir bag.
  6. Still using the bag, breathe in and out slowly once or twice more.
  7. If you are taking an inhaled steroid medicine, rinse your mouth and spit out the water after the last dose.

Cleaning the equipment

The mouthpiece should be washed daily with warm water and dried. (Do not put it in the dishwasher.) The manufacturer does not recommend washing the reservoir bag. The bag should be replaced when it wears out, or once every month.

Developed by RelayHealth.
Pediatric Advisor 2013.2 published by RelayHealth.
Last modified: 2013-06-12
Last reviewed: 2012-03-05
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2013 RelayHealth and/or its affiliates. All rights reserved.
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