How to Use an MDI With a Spacer

By Adem Lewis / in , , , , , , , , , , , , , , , /

A lot of medicines come in a
metered dose inhaler, also called an MDI. Always use these
medications with a valved holding chamber called a spacer.
There are different types of spacers. Follow the instructions
provided with your spacer. Remove caps from the spacer and
metered dose inhaler. Shake the MDI for three to five seconds
before using. Spray the MDI no more than four times before
using it for the first time, if you haven’t used it in a while,
or if you dropped it. This is called priming the MDI. Insert
the opening of the MDI into the rubber sealed end of the spacer.
Stand or sit up straight. Breathe out completely. Put the
mouthpiece between your teeth and make a tight seal with your
lips. Make sure your teeth and tongue are not blocking the
mouthpiece. Press the top of the MDI so it sprays into the
chamber. After spraying the MDI into the valved holding chamber,
breathe in slowly and deeply. Hold your breath for 10 seconds
and then breathe out normally. Only press one time. Wait one
minute and repeat as prescribed for a minimum of two puffs. If
you hear a whistle, you are breathing in too fast. If the
medicine is an inhaled steroid, have your child rinse his or her
mouth and brush his or her teeth after each treatment. Make sure
you rinse and spit, and don’t swallow. Clean the spacer and
mask once a week. Take apart the spacer before cleaning. Wash the
spacer in hot, soapy water. Do not place in the dishwasher.
Remove it and rinse with clean water. Allow it air dry on a
clean paper towel. Each week, clean the small hole inside the
MDI with a wet Q-tip. This will prevent the hole from getting
clogged with medicine. Before using the MDI for the first
time, read the package insert to see how many doses there are in
the MDI. Many new MDIs track doses with counters. If your MDI
does not have a counter, mark each dose on the plastic cover.
When the counter reads zero, get a new MDI of medicine from the
pharmacy. The MDI will still spray, but no medicine will be

3 thoughts on “How to Use an MDI With a Spacer

  1. Great video–best I've seen on how to use a spacer with MDI (I'm a pediatrician). BUT a question on cleaning: vid says to rinse the spacer. What I've read is you should use dilute solution of dish soap and water (3-4 drops soap to gallon water) and NOT rinse it. The rationale is a small amount of remaining soap reduces the electromagnetic charge in the spacer and prevents the medicine from sticking to the sides of a plastic spacer–doing it via this method increases drug delivery by up to four fold (information from uptodate). Please clarify and correct the video as necessary. Thank you for this high quality video.

  2. Shouldn't the patient take several breaths from the spacer through his mouth, instead of one long breath and holding?

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