Spacer inhalation with children: Instructions & the suitable equipment

Paediatricians recommend using an inhalation chamber, known as a spacer or holding chamber, for spray inhalation for children up to the age of about eight. We show you how to use the spacer for inhalation with children and what you need to watch out for when selecting, using and cleaning inhalation chambers.

It is advisable to use a spacer up to the age of about eight years

“Basically, any child up to the age of six to eight years who has to use a metered-dose inhaler or a spray because of asthma, obstructive bronchitis, a hypersensitive bronchial system or similar chronic lung disease should use an inhalation chamber”, explains Dr Franziska Stieglitz in an interview. She has been working as a paediatric pneumologist for over fifteen years and guides parents and their children on the use of a spacer nearly every day.

Inhalation with a spacer is easier for children to coordinate

The experienced paediatrician considers a spacer to be important for children because “it is very difficult (...) to coordinate releasing the spray and at the same time taking a deep breath”. Children can overcome these coordination difficulties if they use an inhalation chamber.

Step-by-step instructions: Spacer inhalation for children using the VORTEX® holding chamber

In this quick guide we will show you how children should inhale properly using the VORTEX® spacer.

Please note:

  • The inhalation chamber should only be used by one child and should not be shared with others.
  • For hygiene reasons, the spacer must be dry for the inhalation (to avoid germs).
  • For hygiene reasons, it is also important to replace the inhalation chamber after a year of regular use.
  • If your child is using the VORTEX holding chamber for the first time, please carefully read through the VORTEX® instructions for use (PDF).

Step 1: Prepare the metered-dose inhaler

  • Remove the cap from the metered-dose inhaler.
  • Shake the spray rigorously.

Step 2: Fit the spray into the spacer

  • Fit the metered-dose inhaler into the blue connection ring on the inhalation chamber.

Step 3: Remove the protective cap from the mouthpiece of the inhalation chamber

  • Remove the protective cap from the mouthpiece and place the mask on the mouthpiece if necessary.

Step 4: Inhale with two to four breaths

  • Breathe out.
  • Inhalation with a mask: Gently place the mask on the child’s face or check if it is properly fitted, if your child is doing the inhalation himself or herself.
  • Inhalation with the mouthpiece: The child should firmly seal the mouthpiece of the spacer with their lips and hold the mouthpiece with their teeth.
  • Operate the spray, while the child breathes in slowly and deeply.
  • If possible, they should hold their breath briefly and then slowly breathe out into the mouthpiece or the mask.
  • The child should take one to three slow deep breaths in and out.

CAUTION: If the doctor has prescribed several puffs, spray and inhale again. Do not release all puffs at once at the start.

Step 5: Clean the spacer

For optimum hygiene, you should clean your child’s inhalation chamber regularly and disinfect if necessary. Please check out our blog for further information on cleaning and looking after the spacer.

Video: VORTEX in the application

Which children should inhale using a spacer?

  • All children up to the age of about six to eight
  • Children with delayed development
  • Children with poor lung function and reduced inhalation effort
  • Children who have coordination difficulties when using metered-dose inhalers

With these children there is a risk that they will not completely inhale the medication from the spray, and that some of it will remain in their mouth and throat where the spray inhalation can then cause undesirable side effects. The inhalation chamber ensures that all of the medication reaches the bronchial tubes where it can have its optimal effect.

The right inhalation chamber for every age

The “frog” model is suitable for children aged 2 to 4 years. Children from the age of four can inhale directly using the mouthpiece. Depending on your location, you can buy the VORTEX® holding chamber in pharmacies or online shops.

Switching from mask to mouthpiece

It makes sense to switch from a mask to a mouthpiece at about the age of four years. Here, parents and children sometimes make the mistake of leaving out the spacer altogether “(...) and the child inhales the spray without a holding chamber although they do not yet have the coordination to do so”, explains the paediatric pneumologist Dr Stieglitz from experience.

This not only gives rise to side effects in the mouth and throat region – there is also the risk that the patient’s health and lung function will deteriorate because too little of the medication is reaching the bronchial tubes. Consult your paediatrician or pneumologist before your child stops using the spacer for the inhalation.

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Note: The information in this blog post does not constitute a treatment recommendation. PARI recommends that patients always consult with their GP or specialist.

An article written by the PARI BLOG editorial team.

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