Payel Gupta, MD, on Using a Spacer With Your Metered-Dose Inhaler

In this video, Payel Gupta, MD, explains who should use a spacer with an inhaler, how to use the spacer, and how to use a steroid-based medication.

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Payel Gupta, MD, is a volunteer national spokesperson for the American Lung Association affiliated with Mount Sinai Hospital and SUNY Downstate Medical Center. 


Dr Payel Gupta:  A spacer is a device that allows the medication...It's a tube and it allows the medication to stay within that tube so that coordination of breathing in and pushing down on the inhaler doesn't have to be so perfect. For adults and kids, it's recommended that we use spacers.

A couple of things to remember if you are using a spacer is that number 1, you want to keep the spacer clean in addition to keeping your inhaler clean.

The technique is almost essentially the same for adults. You're using the mouthpiece of the spacer to breathe in deeply, and you're going to hold your breath and take your mouth off of the mouthpiece, and hold your breath for at least 10 seconds after you're done taking that nice, deep breath in.

When you're using a spacer, you're going to push down in the canister, release the dose into the spacer device. Then that allows you to have a little bit more time to get a nice, deep breath and get all of that medication into your airways. If at all possible, it's always recommended to use a spacer when you're using your inhaler.

With kids, depending on their age, they'll have a mask with the spacer. The mask needs to be snugly fit around their face. In that instance, you're going to watch the child take six breaths in and out through the spacer, through the mask for every time that you push down on the canister. For every dose, you watch them take six breaths in and out. That ensures that they're getting the medication from the inhaler.

Secondly, we also, depending on the medication that you're using your inhaler for, if it's a steroid based medication, it's also recommended that you rinse your mouth out after you use an inhaler.

The reason for that is we want to prevent the patient from getting any form of a fungal infection in their mouth or thrush. If the steroid medication stays in their mouth for too long, it can cause thrush to develop. In order to prevent that, we want to make sure that the patient is rinsing out their mouth after they use their inhaler.

Thank you so much for watching this video.