Resources · Managing Your Condition
Puffers & Inhalers

Puffer with a Spacer

pMDI used with a valved holding chamber.

For patients & health professionals
Metered-Dose Inhaler (pMDI / “Puffer”) Managing Your Condition · 13 of 26 Accuhaler
Authorship & review
Dr Sean James Ledger, BSc Physio (Hons) MSc PhD FHEA
Director and Principal Physiotherapist
Ahpra registration PHY0002298174
Version
1.1
Last updated
6 September 2026
Next review
6 September 2027
Every guide on this site is reviewed at least once a year, and sooner when the evidence changes.
How these guides are written and reviewed →
In plain language

A spacer is a clear chamber that clips onto a puffer (pMDI). You fire the puff into the chamber and then breathe it in — so the timing no longer has to be perfect. Spacers get more medicine into the lungs, less onto the throat, and are recommended for almost everyone using a pMDI, especially children, older adults and during a flare-up. A mask version is used for young children or anyone who cannot seal their lips on the mouthpiece.

Puffer with a Spacer
Puffer with a Spacer. Device shown for identification — your medicine and colour may differ.
Puffer and spacer fitted with a soft face maskA compact chamber spacer
A spacer can be fitted with a soft mask for young children (left), and compact travel spacers are also available (right).
One puff at a time — never two

Fire one puff into the spacer and breathe it in before adding the next. Two puffs fired together stick to the chamber walls and to each other, and much of the second dose is lost. Never pre-load a spacer and leave it, and never wash a spacer and use it wet — let it drip dry, or static will hold the medicine to the sides.

Examples of this type

Different medicines come in this device. Common examples include:

Brand names are examples only and availability changes — always go by the name on your own inhaler and your prescriber's instructions.

How to use it — step by step

1
AssembleFit the spacer together and remove the puffer cap. Shake the puffer and insert it into the open end of the spacer.
2
Get readyBreathe out gently. Put the spacer mouthpiece between your teeth and seal your lips (or place the mask gently over the nose and mouth).
3
One puffPress the puffer once to fire a single dose into the chamber.
4
Breathe the dose inTake a slow, deep breath in and hold for about 6 seconds — or, if that is hard, take 4 normal breaths in and out through the spacer.
5
One puff at a timeFor a further dose, remove the puffer, shake, re-insert and repeat. Never fire several puffs into the chamber at once.
6
FinishRinse your mouth after steroid medicines. Take the puffer out and replace its cap.

Getting the best from it

  • One puff per breath — multiple puffs at once stick to the chamber walls.1,2,3
  • Breathe in soon after firing; the mist settles within a couple of seconds.
  • With a mask, hold it gently sealed for about 5–6 breaths per puff.

Looking after your inhaler

Wash the spacer in warm soapy water about once a month, do NOT rinse, and let it air-dry (drip-dry) — rubbing creates static that attracts the medicine. Replace as advised, usually every 12 months.

Not sure your technique is right?

Most people lose some accuracy over time.4,5 We can check your inhaler technique at your appointment.

Getting your inhaler technique right →

Book an appointment

References & evidence base

  1. National Asthma Council Australia. Inhaler technique for people with asthma or COPD. Information paper for health professionals. Melbourne: National Asthma Council Australia, 2026.
  2. Australian Commission on Safety and Quality in Health Care. Inhaler technique — device-specific checklists. Sydney: ACSQHC, 2020.
  3. Vincken W, Levy ML, Scullion J, et al. Spacer devices for inhaled therapy: why use them, and how? ERJ Open Res 2018;4(2):00065-2018.

Further reading

References are numbered in citation order (Vancouver/BMJ style) and were current at the time of writing. Always follow the leaflet for your specific device and your prescriber's instructions.

How we treat this at the clinic

Everything starts with an assessment — your symptoms, breathing, exercise tolerance and daily function measured properly, so what follows is built on your lungs rather than an average.

Physiotherapy Assessment →
Important: This page is general information on inhaler technique, not a prescription or medical advice. Always follow the instructions from your prescriber and pharmacist, and the leaflet inside your specific medicine. If you are unsure your inhaler is working, or your breathing worsens, contact your care team — or in an emergency call 000. For a technique check, contact Inspire Clinic.

Corrections: If something on this page is wrong, out of date or unclear, we want to know. Email reception@inspireclinic.au with the page name and what you believe is incorrect. Substantive corrections are made promptly, and the guide’s version and last-updated date are changed to reflect it.