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. It contains a gas that helps the medicine get into your child’s lungs. The Inhaler helps send the medicine directly to your child’s lungs as he takes a deep breath.

A device called a collapsible bag spacer, or reservoir bag, can be used with the inhaler. It can help if it’s hard to press the inhaler at the same time that your child breathes in the medicine. The spacer holds medicine in the bag and:

• Allows your child to breathe in the medicine at his own pace
• Helps more medicine reach your child’s lungs

Some spacers are made for just 1 type of inhaler. Talk to your healthcare provider about this. Spacers may be used with or without a mask.

To attach the spacer to the MDI:

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

To use the MDI with the spacer and a mask:

1. Choose a mask that is the right size for your child (small, medium, or large) and attach it to the mouthpiece.
2. Have your child stand or sit up straight.
3. Put the mask against 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 your 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. You will hear a whistling 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.
9. If your provider prescribes additional puffs, wait 1 minute and repeat.

To use the MDI with the spacer and mouthpiece:

1. Put the mouthpiece between the teeth and seal the lips around it.
2. Press the inhaler down once so it releases a spray of medicine into the bag spacer.
3. Breathe in slowly over 3 to 5 seconds. (The bag will collapse as you inhale. You will hear a whistling sound if your breath is too fast.)
4. Hold your breath for 5 to 10 seconds.
5. Breathe out slowly back into the bag spacer.
6. Still using the bag, breathe in and out slowly once or twice more.
7. If your provider prescribes additional puffs, wait 1 minute and repeat.
8. If your child is taking an inhaled steroid medicine, he should rinse his 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 bag spacer. The bag should be replaced when it wears out, or once every month.