Children's spacers for the treatment of asthma: Top 10 tips

The purpose of the spacer device is to act as an intermediary chamber into which a pressurised metered dose inhaler (pMDI) can discharge the drug. This slows down the drug, which is propelled at force as an aerosol, allowing evaporation. This increases the respirable particle fraction leading to better lung deposition (National Institute for Health and Care Excellence (NICE), 2000). For this reason, a pMDI should always be used with a spacer device in young children and is recommended in adults who may have poor manual dexterity and/or learning difficulties (Vincken et al, 2018).

Using a metered dose inhaler without a spacer is difficult. All metered dose inhaler systems (MDI) require co-ordination of activation and inhalation and may be difficult to use, particularly for younger children. In addition, inhaler technique by many health professionals, who may be teaching technique to parents and children, is poor. In a questionnaire of health professionals in Ghana, only nine of the 75 (12%) participants, all of whom were doctors, knew at least three essential steps of the techniques in using a pMDI correctly. None of the participants got all the steps totally correct (Adeniyi et al, 2018).