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Struggling with Puffers?!?

aerochamber Asthma copd respiratory care

A Simple Device to make your Life and Breathing much Easier

Struggling with puffers or not getting relief from puffers? Not to worry, we have a solution for this. It is called an Aerochamber or Spacer. Many people who use a Metered Dose Inhalers (MDI), or commonly known as “puffers”, have a difficult time coordinating the actuation and breathing simultaneously. Furthermore, without a spacer, about 90% of the medication from an MDI will be deposited in the back of the throat. 5% of that will be able to get into the large airways where there is minimal if any inflammation and only the last 5% will be able to navigate further down to the distal airways to act where the swelling is happening. Can you see how it would be hard to get actual relief without a spacer?

Now the question is, does the spacer actually work? 

The spacers are made to reduce the speed of which aerosols are expelled from the MDI. By slowing the particles down, we are able to get majority of the medication suspended in the air and take a controlled deep slow breath to get maximum medication delivery to the distal airways where the swelling is actually going on. This is simply a gas /aerosol physics fact and a fact is a theory that has been tried to be proven wrong but unsuccessful. 

In the decade of performing respiratory procedures and teaching about spacers, there are a few common themes:

  • "I don't use it because it's too bulky and awkward to carry around"

  • "I don't use it because its too cumbersome"

  • "I don't feel any difference!"

These are just a few examples of what I have heard in my career as a Respiratory Therapist and a son of a COPD patient. The truth is, the Spacer (Aerochamber) DOES WORK. It is not voodoo nor a money grab. Just to think the difference of a $40.00 CAD item can do in terms of quality of health and reduction in shortness of breath, its a no brainer to me. Did you know even pets that are asthmatics will require a chamber with a mask for medicated aerosol delivery?

As much as you may not think it works, hindsight can be a gift. If we stop and think about if what we are currently doing is still not that effective and we are doing what WE think is right and not what SCIENCE has proven to be right, any guesses what the end result is? I think you got it: Shortness of breath.

How to properly activate your inhalers?

Another erroneous habit that people tend to do is to press their puffers twice in a row. Do not press the puffer twice in a row. I repeat, do NOT press the puffer twice in a row. This second actuation will only spray out propellant and not medication. The proper procedure is outlined:

  1. Insert the inhaler/canister into Aerochamber/Spacer and shake vigorously.

  2. Breathe out.

  3. Put the spacer mouthpiece into your mouth.

  4. Press down ONCE on the inhaler once.

  5. Breathe in slowly (for 3-5 seconds).

  6. If the spacer whistles, breathe in slower.

  7. Hold breath for 10 seconds.

  8. Exhale.

  9. Wait 30 seconds before 2nd puff and repeat Steps 1 through 7

Although most attention has been focused on the drugs used to control pulmonary diseases, it is increasingly recognized that effective delivery of these drugs to the lungs is equally as important, if not more. Using an Aerochamber can help reduce the coordination needed and is guaranteed to increase the amount of medication actually deposited in your distal airways where the inflammation is occurring and where we need the drug to have the most significant effects.

How much are Aerochambers and is there more than one type? 

Aerochambers are an relatively inexpensive tool for all ages, and can be used for both long-term preventative therapy and for short-term treatment of acute exacerbations. They can range between $30.00-75.00 CAD and there are several types on the market place. The most commonly used ones are the mouth piece types but there are also Aerochambers with masks to assist with the delivery of inhalers.The most common ones (with links to the best Canada-wide pricing) are:

AeroChamber Plus Flow-Vu with mouthpiece 


              Certified Polysomnograph Technologist (2018-2021)

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