Puffers and spacers

What is a puffer?

A puffer (or inhaler) is medication that is used to treat wheezing symptoms. They can be relievers or preventers.

What is a spacer?

A spacer is a cylinder-shaped device that connects to a puffer. You will usually get to take home the spacer (and mask where needed) that your child used in hospital. Replacements or spares can be purchased from your local pharmacy/chemist.

When to use a spacer

All children should use a spacer to inhale their puffer medication.

Why use a spacer?

A spacer reduces the amount of medicine that lands in the mouth, allowing more to go down into the lungs where it is needed.

Using a spacer

Using a spacer step 1
Step 1:

Remove cap from puffer (and spacer if there is one). Hold puffer upright and shake well.

Using a spacer step 2Step 2:

Attach puffer to the end of spacer.

Using a spacer step 3-4-5Step 3:

Place mouthpiece of spacer in child’s mouth and make sure he/she uses their lips to form a good seal.

Step 4:

Release one puff of medication into the spacer. Ask the child to breathe in and out normally for four breaths (keeping their mouth on the spacer).

Step 5:

Shake the puffer and spacer between each dose. Repeat to give the number of doses needed (as advised by doctor). Replace cap on puffer when done.

When should I use a mask with a spacer?

Children who are unable to form a reliable seal around the spacer with their lips should also use a mask. The type of mask will vary depending on the size of the child’s face.

Using a mask with a spacer

Using a mask with a spacer
Step 1:
Attach the mask to the mouthpiece of the spacer (with puffer attached).

Step 2:
Gently place the mask over mouth and nose so there are no gaps around the edges.

Step 3:
Release one puff of medication into the spacer. Hold spacer and mask in place while the child breathes in and out normally for four breaths.

Step 4:
Shake the puffer and spacer between each dose. Repeat to give the number of doses needed. Replace cap on puffer when done.

Cleaning a spacer

Wash the spacer in warm, soapy water before first use and every month after that. Do not rinse. Shake off excess water and leave it to air dry. Do not dry spacer with a cloth or paper towel. Your child’s nurse, GP, asthma educator or pharmacist should check the spacer every six to 12 months to make sure it is fit for use.

When should I see a doctor?

Follow the Action Plan prepared by your child’s doctor to manage your child’s wheeze.

Wheezing episodes can be life-threatening. Call 000 immediately if your child has any of the following:

  • a lot of trouble breathing or talking
  • blue lips
  • symptoms that get worse very quickly

Otherwise, contact your local doctor or visit the emergency department of your nearest hospital. For non-urgent medical advice, call 13 HEALTH (13 43 25 84) to speak to a registered nurse 24 hours a day, seven days a week for the cost of a local call.

Resource No: FS092 developed by Emergency, Queensland Children’s Hospital. Updated: August 2019 All information contained in this sheet has been supplied by qualified professionals as a guideline for care only. Seek medical advice, as appropriate, for concerns regarding your child’s health.

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