What a spacer does
A spacer is a plastic chamber that clips onto a metered-dose inhaler. You fire the puff into the chamber and then breathe the cloud in over a few breaths. This solves the hardest part of MDI technique — the timing. The spray slows down and the largest, fastest droplets stick to the chamber walls instead of your throat, so more of the fine particles that matter reach the airways.
- Shake the MDI and click it into the spacer's open end.
- Seal your lips around the mouthpiece (or fit the mask for a child), then fire one puff.
- Breathe in and out slowly through the spacer 4–5 times, or take one slow deep breath and hold it.
- One puff at a time — never fire several puffs into the chamber at once.
Nebulizers: medicine as a mist
A nebulizer turns a liquid drug into a continuous fine mist that you breathe through a mask or mouthpiece during normal tidal breathing for several minutes. Because it needs no special coordination at all, it is useful when someone is too breathless to use an inhaler well — for example during a severe asthma attack or a COPD flare-up, or for very young or very ill patients. A driving gas (air or oxygen) or vibrating mesh creates the mist.
Choosing and keeping them clean
For day-to-day treatment of asthma or COPD, an inhaler plus spacer is the usual choice: portable, quick, and easy to dose accurately. Reserve nebulizers for acute illness or specific drugs that only come in liquid form. Whichever you use, hygiene matters — a damp chamber or nebulizer cup can grow mould or bacteria. Rinse spacers in warm soapy water and let them air-dry without wiping (wiping builds up static that traps droplets), and clean nebulizer parts after each use.