How to use a spacer without a mask for a child

Hi I'm Sonia, a respiratory physiotherapist. Using a spacer when helping a child use an inhaler means more medicine gets down into their lungs. It's a great way to help manage their symptoms. Getting the technique right is very important. It may take a few tries to feel comfortable giving the medicine this way but it gets easier with practice. If you're helping a child use a face mask with their inhaler and spacer, watch our other video. There are two different breathing techniques a child can use. I'll first show you 'tidal breathing'. If their healthcare professional has recommended 'single breath and hold' technique, we'll show you that next. To use the inhaler, hold it upright and take off the cap. Check there's nothing inside the mouthpiece. If the spacer has a valve, make sure the valve is facing upwards. Shake the inhaler well. Put the inhaler into the hole at the back of the spacer. If the spacer has a cap, take it off. Ask your child to sit or stand up straight and slightly tilt their chin up as it helps the medicine reach the lungs. Ask them to put their lips around the mouthpiece of the spacer to make a tight seal, and begin breathing in and out. Press the canister on the inhaler once and encourage them to breathe in and out slowly and steadily into the spacer five times. If their health care professional has recommended 'single breath and hold' technique, here's what they mean. Encourage your child to breathe out gently and slowly away from the inhaler and spacer until their lungs feel empty and they feel ready to breathe in Ask them to put their lips around the mouthpiece of the spacer to make a tight seal. Press the canister on the inhaler once and have them breathe in slowly and steadily until their lungs feel full. Take the mouthpiece of the spacer out of their mouth and with their lips closed, ask them to hold their breath for up to ten seconds or for as long as they comfortably can. Then have them breathe out gently away from the spacer and inhaler. Finally, if your child has been prescribed a second puff, with the inhaler and spacer away from their mouth, wait 30 seconds to a minute and shake the inhaler again, then repeat the steps. When you've finished, take the inhaler out of the spacer and replace the caps on the inhaler and the spacer. If your child is using a small volume spacer, some of them make a whistling sound if they are breathing in too fast. If they are using a large volume spacer like this one, the breathing techniques are the same. With tidal breathing, the spacer should make a clicking sound as they breathe in and out. If your child has used an inhaler that contains steroids, make sure they rinse their mouth out with water or brush their teeth to avoid side effects. Remember, you can get more top tips on helping your child use their inhalers by watching other videos.