12 Aug Spacer Adventures with pMDIs!
- Blast from the Past
In the 1950s, the pMDI (pressurized metered-dose inhaler) changed the game—compact, portable, and effective! But here’s the catch: it’s tricky to use right. If you mistime the puff or breathe in too fast, most of the medicine just hits your throat or floats away. Even with perfect technique, only about 20% reaches the lungs!
- Why Not Just Puff and Go?
Great question! Here’s why going spacer-free isn’t ideal:
- Speed trap! pMDIs release medicine at lightning speed (~60 mph!). Without a spacer, it smashes into the back of your throat instead of floating gently into your lungs.
- Timing trouble. You have to synchronize inhalation perfectly with the spray. Mess it up? You waste your dose.
- Side effects galore. More drug in your mouth = higher risk of hoarseness, oral thrush, and swallowed meds affecting other organs.
- Short breath? No problem. Spacers let you breathe in slowly or even in tidal breaths (especially with a VHC), making it a game-changer for kids, elderly, or people having an asthma attack.
- Double duty during emergencies. Can’t coordinate your breath in a crisis? A spacer lets someone else deliver the dose while you just breathe.
Bottom line? A spacer bridges the gap between “spray and hope” and targeted lung delivery.
- Enter the Spacer (or VHC!)
It’s like a chill-out lounge for medication particles—giving them time to slow down and become easier to inhale deeply into your lungs. No need for Olympic-level timing skills anymore!
- Benefits Galore… Mostly
- Slows aerosol—better lung delivery, less throat gambling
- Helps sync poor coordination of inhaler fires with inhalations
- Filters out big particles—less throat side effects and swallowed drug
- Lets caregivers help during emergencies (bye-bye nebulisers!)
Yet, some hiccups: they need cleaning, can be bulky, may cost more—and plastic versions can rob your medication via static.
- How to Use It Like a Pro
- Sit/stand upright, chin slightly up
- Shake the inhaler (5x!) and spacer; check the valve
- Exhale, seal lips tight on spacer or mask
- Breathe in slowly, press the inhaler once
- Hold your breath for about 10 seconds
- Repeat properly for each dose (no double‑firing!)
- Rinse your mouth if using steroids… because extra care.
- Keep It Clean & Working
- Wash weekly (or monthly)—not in the dishwasher!
- Use lukewarm water + detergent; soak 15 minutes, air-dry—no towel rubbing!
- Plastic spacers benefit from this simple soap ritual—it reduces static and keeps bugs at bay.
- Metal or antistatic ones? Still clean them—they last 6–12 months, so plan for replacements.
- The Final Word
After decades of research, the verdict’s clear: spacers are low-risk, high-reward. Every patient with a pMDI should have one, know how to use it, and keep it spick and span. Education for both patients and caregivers is key. Let’s turn more inhalers into accurate breath‑saving tools!
Source: Vincken, W., Levy, M. L., Scullion, J., Usmani, O. S., Dekhuijzen, P. N. R., & Corrigan, C. J. (2018). Spacer devices for inhaled therapy: why use them, and how?. ERJ open research, 4(2), 00065-2018. https://doi.org/10.1183/23120541.00065-2018