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Metered-Dose Inhaler (MDI) Used with a Collapsible Bag Spacer

A metered-dose inhaler (MDI) is a pressurized canister of medicine that releases a medicated mist. The spacer is a device that traps medicine and increases the space between the metered-dose inhaler (MDI) and the mouth. This helps your child inhale more medicine into the lungs. It also decreases the amount of medicine deposited on the back of the throat. The use of a spacer or a valved holding device is recommended for all MDIs.

Inspirease and EZ Spacer are two brands of the collapsible bag type spacer. EZ Spacer can be used with a mask, but Inspirease cannot.

To attach the spacer to the MDI:

  1. Attach the inhaler mouthpiece to the blue reservoir bag by matching the tabs in the reservoir bag.
  2. Push in, twist, and lock.
  3. Pull the blue reservoir bag all the way open so there are no wrinkles.
  4. Remove the inhaler canister from the plastic case and shake it vigorously.
  5. Attach the canister to the inhaler mouthpiece.

To use the MDI with the spacer and mask:

  1. Select the appropriate size mask for the patient (small, medium, or large) and attach to the mouthpiece end.
  2. Have your child stand or sit up straight.
  3. Put the mask to your child's face, covering both the nose and mouth. The mask must be pressed to your child's face to make sure that the medicine can get to the child's lungs.
  4. Depress the MDI once. The medicine will be trapped in the reservoir bag.
  5. Breathe in slowly over 3 to 5 seconds. (The reservoir will collapse as your child inhales. A whistling noise will sound if the breath is too fast.)
  6. Hold your breath for 5 to 10 seconds.
  7. Breathe out slowly back into the reservoir bag.
  8. Still using the bag, breathe in and out slowly once or twice more.

To use the MDI with the spacer and mouthpiece:

  1. Put the mouthpiece between the teeth and seal the lips around it.
  2. Depress the metered-dose inhaler. The medicine will be trapped in the reservoir bag.
  3. Breathe in slowly over 3 to 5 seconds. (The reservoir will collapse as you inhale. A whistling noise will sound if the breath is too fast.)
  4. Hold your breath for 5 to 10 seconds.
  5. Breathe out slowly back into the reservoir bag.
  6. Still using the bag, breathe in and out slowly once or twice more.

Cleaning the equipment

The mouthpiece should be washed daily with warm water and dried. (Do not put it into the dishwasher.) The manufacturer does not recommend washing the reservoir bag. The bag should be replaced when it wears out, or once every month.

Written by the Asthma Task Force at The Children's Hospital, Denver.
Published by McKesson Provider Technologies.
Last modified: 2006-10-31
Last reviewed: 2006-09-05
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright 2006 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved.
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