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How To Use An Asthma Inhaler With A Spacer

How Steroid Inhalers Work

Asthma how-to: How to use an inhaler with a spacer and mouthpiece

Steroids are a man-made version of hormones normally produced by the adrenal glands, which are 2 small glands found above the kidneys.

When theyre inhaled, steroids reduce swelling in your airways.

This can help reduce symptoms of asthma and COPD, such as wheezing and shortness of breath.

Steroid inhalers are different to the anabolic steroids that some people use illegally to increase their muscle mass.

Page last reviewed: 15 January 2020 Next review due: 15 January 2023

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How Does A Spacer Help

Advantages of using a spacer
  • Many adults and children are unable to use their metered dose inhaler effectively. The spacer reduces the need for perfect technique.
  • Spacers are designed to deliver up to twice the medication of an inhaler alone. 50% more medicine enters the lungs when a spacer is used.
  • Less medicine gets left in the mouth and throat, which reduces the side effects of hoarseness or thrush in your mouth from preventer medicine.
  • A spacer can help when you are short of breath and an inhaler by itself is difficult to use.
  • A spacer is a smaller, convenient alternative to a nebuliser.
  • Studies on adults and children show spacers work just as well as nebulisers in acute asthma.
  • Spacers with masks can help very young children inhale their medicine.

If you are unsure about how to use your spacer, ask your doctor, pharmacist or nurse. The following steps are a guide.

  • Remove the cap and shake the inhaler. Fit the inhaler into spacer opening .
  • Put the spacer into your mouth ensuring that there are no gaps around the mouthpiece. Press the inhaler once only one puff at a time into the spacer.
  • Breathe in slowly and deeply through the spacer mouthpiece and hold your breath for 5-10 seconds OR take 2-6 normal breaths keeping the spacer in your mouth all of the time You can breathe in and out with the spacer still in your mouth as most spacers have small vents to allow your breath to escape rather than going into the spacer.
  • Friends Family And Co

    One of the best ways to learn about helpful and reliable asthma doctors is through personal recommendations from people you know and trust not only are they more likely to be located in the area in which you live, but you can also approach them with the confidence of someone whose parent, friend or colleague received beneficial care and treatment with that doctor. You can ask around your social and family circles for advice, but also be prepared with several criteria to specify what you are looking for: for example, let people know that you want a doctor who specializes in working with kids, for example.

    So what goes into knowing how to find a doctor for your asthma? First, there are some factors that you need to consider.

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    What To Remember When Using Your Inhaler

    • Stand or sit upright when using your inhaler
    • Remove the mouthpiece cover, check inside to ensure its clean and give it a shake
    • Hold the inhaler upright with your thumb on the base and fingers on the top of the canister your hand should make a C shape
    • Breathe out as far as is comfortable and place the mouthpiece in your mouth, between your teeth. Close your lips around it and dont bite
    • Breathe in through your mouth just after you start to breathe in, press down on the top of the canister to release a puff of medicine. Continue breathing in steadily and deeply
    • Take the inhaler out of your mouth and hold your breath for about ten seconds .
    • If you need another dose of medicine, wait for about 30 seconds before taking the second dose.

    The above steps are for those using metered dose inhalers , which are the most popular type of inhaler. If you use an alternative type of inhaler, please visit our asthma page so we can help you ensure you are using this correctly.

    We offer inhalers through our online servicemeaning you dont have to visit a doctor every time you need an inhaler.

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    Aerosol Inhalers/metered Dose Inhalers


    These are likely the one you are most familiar with: Also known as a puffer, this inhaler, or pressurized metered dose inhaler , is a canister filled with asthma medication suspended in a propellant. When the canister is pushed down, a measured dose of the medication is pushed out as you breathe it in. Examples of MDIs are: Ventolin, Flovent, Advair, Alvesco, Airomir, and QVar.

    This medication should be used with a spacer for increased delivery to the airways. When your inhaler is used alone, medicine often ends up in your mouth, throat, stomach and lungs. Medicine left in your mouth, throat and stomach may cause unpleasant taste and side effects. When you use a drug delivery system with your inhaler, more medicine is delivered to your lungs.

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    How To Make Your Own Essential Oil Inhalers

    Inhalers are really easy to make.

    Just purchase these and add the essential oils to the cotton piece in the nasal tube.

    Add 2-10 drops of oil to the tube depending on the strength you want.

    The great thing about making these inhalers is thatyou can refresh them at any time.

    Simply open the tube and add more oils.

    Controller And Reliever Medicines Work Together

    There are two main kinds of asthma medicines: preventer medicine and rescue medicine. Each medicine is important, and each medicine does a different thing for your lungs.For most people with asthma, the doctor will prescribe both kinds of medicine:

  • Asthma preventer medicine : You take your preventer medicine every day, even if you have no symptoms, to make sure your airways stay clear and to prevent redness, mucus and swelling.
  • Asthma Rescue medicine: Most people with asthma will be given a reliever inhaler. These are usually blue.

    You use a reliever inhaler to treat your symptoms when they occur. They should relieve your symptoms within a few minutes.

  • Some people think they can skip the preventer medicine and only use the rescue medicine. This is dangerous. If youve been prescribed a preventer medicine, use it. The rescue medicine by itself will not control your asthma over the long term. To make sure you get all your medicine into your lungs, be sure you know how to use your inhalation device.

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    Alternative To An Inhaler: Nebulizer

    A nebulizer is a machine that turns the asthma medication into a fine mist. A nebulizer can be used for rescue medications and control medications.2 Nebulizing can be expensive and time-consuming.2 The machines are bulky. For these reasons, nebulized medication is mainly used for people who cannot use a metered-dose inhaler with a valve holding chamber and face mask.2 The advantage of using a nebulizer is that the person can breathe in and out like normal. The nebulizer can be used with a mouthpiece or snug-fitting face mask.2

    General guidelines for using a nebulizer are:3

  • Wash your hands before you start.
  • Assemble the machine, tubing, medicine cup, and mouthpiece or mask.
  • Pour the medication into the medication cup.
  • Place your mouth around the mouthpiece.
  • Turn on the machine.
  • Take normal breaths through your mouth.
  • Continue for about 10 minutes, until the medicine cup is empty or the mist stops.
  • Rinse out your mouth with water and spit it out, especially if you are taking an inhaled corticosteroid. Rinsing helps to prevent thrush . It also reduces the amount of medication you swallow.
  • What type of asthma inhaler do you use? Do you use a spacer or valved holding chamber with it? Let us know in the comments below!

    Criteria For Considering Studies For This Review

    Using Your Asthma Inhaler Spacer

    Types of studies

    Randomised clinical trials including open and blinded study designs.

    Types of participants

    Children under 18 years with acute exacerbations of wheezing or asthma presenting to an ED or equivalent care setting.

    Types of interventions

    Intervention: Rapid acting beta 2agonists via MDI given attached to homemade spacers. Combination treatment with anticholinergic agents was permitted. Controls: The same bronchodilator therapy delivered with commercially produced spacers. Combination treatment with anticholinergic agents was permitted.

    Types of outcome measures

    The primary outcome measure was the need for hospital admission.

    Secondary outcomes

    Secondary outcomes measures were changes from baseline in peak expiratory flow rate , forced expiratory volume in one second , oxygen saturation , respiratory rate , clinical scores, and physical signs, such as dyspnea, accessory muscle use, and wheezing. Other secondary outcomes measures were intensive care unit admission rates, emergency department length of stay, need for additional treatment upon completion of the intervention protocol, and adverse effects such as heart rate , dysrhythmia, tremor, and nausea.

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    How To Make A Steam Inhaler Jar To Beat Congestion

    Get fast relief from congestion.

    Has anyone elses family been experiencing a seemingly never-ending cycle of colds? It seems like every time one of us starts feeling better after a head cold, another person starts sniffling and sneezing. But when your main symptom is a stuffy nose, it can seem like overkill to take cold medicine So I set out to find a more natural solution to help ease all of the stuffy noses around here. And I managed to find just the thing!

    More Ideas Youll Love

    This steam inhaler gives you the benefits and relief of a humidifier and a diffuser, all contained in one little mason jar. The steam, much like in a warm-air humidifier, helps to loosen mucus and phlegm. It also helps reintroduce moisture into your nose and throat, which helps your body fight off germs and bacteria more effectively.

    In addition to the steam, this handy little jar also contains beneficial essential oils. These four essential oils have a combination of antibacterial and anti-inflammatory properties that can help open your airways and get you breathing easier.

    Heres how you can make your own steam inhaler jar at home!

    Contact Doctor During Office Hours

    • Dont have written asthma action plan from your doctor
    • Use an inhaler, but dont have a spacer
    • Miss more than 1 day of school per month for asthma
    • Asthma limits exercise or sports
    • Asthma attacks wake child up from sleep
    • Use more than 1 inhaler per month
    • No asthma check-up in more than 1 year
    • You have other questions or concerns

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    Choosing An Asthma Specialist: Points To Consider

    When considering an asthma specialist, you should think about which types of asthma specialists have the skills and experience that best fits your needs, including your age, type of asthma, and medical history.

    In some cases, you may need more than one specialist to manage your asthma. For example, if trigger your childs asthma symptoms, you may want your child to see a pediatrician and an .

    Caring For Your Spacer

    How to use an inhaler with a spacer

    The most important aspect of inhaler spacer care is keeping it clean. You can do this with clean, warm water and liquid dishwashing detergent.

    Allow the spacer to air dry, rather than drying it with a towel or paper towel. Static can build up inside the spacer, which makes the medication stick to the sides of the tube. Towel strands may also be left behind in the spacer. You dont want to inhale those. You may use a towel on the mouthpiece if you wish.

    You should also clean your spacer before using it the first time. Once or twice a year, have your doctor check your spacer for cracks and to make sure its working properly with your inhaler.

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    How To Use An Inhaler With A Spacer And Mouthpiece

    Learning how to properly use an inhaler with a spacer and mouthpiece for asthma ensures the medicine gets deposited into the lungs. Incorrect technique can leave some of the particles from the medicine on your tongue or throat, where it is useless. Inhalers spray the medicine out so that you can breathe it deep into the lungs. A spacer, or holding chamber, is an attachment that should always be used with your inhaler. The spacer holds the medicine in place so you can breathe it in easier. If you have any further questions about inhalers, spacers or mouthpieces contact your doctor’s office, asthma care team or pharmacy.

    How Do I Know If I Need To See The Allergist Or Ent

    ENTs are highly proficient surgeons who specialize in structural disorders of the ears, nose, and throat such as head and neck tumors, facial reconstruction and plastic surgery, chronic sinusitis, deviated septum, hearing impairment, and dizziness/balance problems. Board-certified Allergists optimize control of nasal and sinus problems though nonsurgical means. ENTs and Allergists commonly work together to treat conditions where allergies are causing problems in the ears, nose, sinuses and throat regions. ENTs often refer patients to Allergists when surgery is not indicated. Likewise, Allergists will refer patients to ENTs for surgical options when medications and allergen avoidance are not adequately controlling symptoms.

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    How Do I Use A Spacer

    • Shake the inhaler.
    • Fit the inhaler into spacer opening and put the spacer into your mouth ensuring that there are no gaps around the mouthpiece OR place the mask on your childs face, covering the mouth and nose ensuring there are no gaps. Most children should be able to use the spacer without a mask by the age of four years.
    • Press the inhaler once only one puff at a time into the spacer.
    • Breathe in slowly and deeply through the spacer mouthpiece and hold your breath for 5-10 seconds OR take 2-6 normal breaths, keeping the spacer in your mouth all of the time.You can breathe in and out with the spacer still in your mouth as most spacers have small vents to allow your breath to escape rather than going into the spacer.
    • If you need more than one dose of medication, wait one minute and then repeat these steps for further doses, making sure that you shake your inhaler between doses.
    • If using a mask with preventer medication, wash the childs face after use.
    • Wash your spacer once a week and before using it for the first time with warm water and dishwashing liquid. Dont rinse. Drip dry. This reduces the electrostatic charge so that the medicine does not stick to the sides of the spacer.
    • Check for any cracks. If used regularly your spacer may need to replaced every 12-24 months.

    Interface With The Patient

    Using an Inhaler with a Spacer Mask

    Spacers/VHCs with a facemask rather than a mouthpiece may be preferable for children < 3years of age and for all patients incapable, for any reason, of making a slow, measured inspiratory effort while holding a mouthpiece between the teeth. Children over the age of 3years often continue to use facemasks and, if so, technique should always be checked as spacers/VHCs with facemasks designed for use with small children may provide a poor seal with the face, resulting in impaired or variable dosage delivery . A tight mask-to-face seal using sufficient force is important but may be difficult to achieve in young or uncooperative patients . When using a facemask, the dead space between the mouth and valve of the spacer/VHC should be minimised. Besides facial seal and dead space, other design considerations for an optimal mask for young children and infants include contour, flexibility, transparency, weight and cost .

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    An Inhalation Technique For Each Inhaler

    Asthma inhalers include two main parts the medication and the delivery device. There are many types of delivery devices, MDIs, Diskus, Respiclick, Flexhaler, Ellipta, and Respimat. The goal of creating new delivery devices is to make inhaling the medication easier. Some inhalers require a slow, steady inhalation for 5 7 seconds. Others, such as dry powder inhalers require a deep, fast inhalation for 3 seconds.

    The truth is, not everyone can master the different inhalation techniques, and a spacer doesnt always help. In fact, a recent study published in The Journal of Allergy and Clinical Immunology: In Practice, found no evidence that spacer use led to an improved effectiveness of inhaled corticosteroids delivered using a metered-dose inhaler. The authors called for additional research to better understand and confirm their findings. They emphasized the importance of patient education on inhaler technique, whether or not a spacer is prescribed.1

    The spacer does not necessarily ensure we will use our inhalers correctly, and education on inhaler technique is important. So, how do you learn and measure the correct inhalation technique?

    Homemade Asthma Nebulizer: A New Use For Recycled Water Bottles

    My wife and I recycle nearly everything: cans, glass, aluminum, plastic, and paper/cardboard. We have a huge compost pile for leaves, lawn trimmings, twigs, and pine needles. Of course it is highly-enriched when we clean the chicken coop.

    We are on well water and fortunately, our deep well produces an adequate amount of cold, fresh, and untreated water. My only guilt is that I love ice-cold bottled water in those plastic bottles. I find them perfect to partially freeze and find them convenient when traveling. Since my bout with kidney stones, I am forced to drink a gallon or so of water per day. Working outside, I find it easier to grab a few cold bottles from the fridge and bring them with me to the garden. I cant drink out of the hose, since this is untreated, irrigation water.

    We dont throw away the plastic water bottles. I envision a time when I will refill them from our well water , and just use them over and over. At this time, most of these bottles just go in the plastic recycling bins.

    I have a lot of asthmatic patients mostly children. In order for kids to use a hand-held MDI for albuterol or inhaled corticosteroids, they must have a spacer a chamber-like device where the medicine is sprays, and the child can easily inhale it without having the coordination to time their inhalations with the spray.

    Supplies Needed:

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