spacer with mask vs spacer with mouthpiece

[MMBJI]

Hi all,

I have recently been prescribed a spacer with a face mask- apparently it’s the latest recommendation.

I have used a spacer with a mouthpiece for years.

The idea is that you breathe normally through the mask , it should be more efficient at delivering the dose of inhaled medication- meaning that less gets caught in the mouth and more reaches the lungs.

However, when I press the inhaler to release a dose I can feel it blow into my face and get a strong taste - which does not happen with the mouthpiece style spacer.

This makes me suspicious about how much medication is reaching my lungs and how much gets caught in my mouth.,

It’s only been a few days , plus my asthma is severe and uncontrolled so I can’t tell any difference yet.

Any one else have such spacer experiences to share?

[Patk1]

My young grandson has a mask but I use mouthpiece. Do what's best4u - I don't want particles on my skin x

[peege]

Do you always shake well first?

[MMBJI in reply to peege]

Yes indeedy- it’s the sound my husband wakes to every day! 😂

[peege in reply to MMBJI]

😂 asking because I've read here over the years that some have an allergy to the propellant.....

[Shogi]

Did someone demonstrate how to use it? Asthma/ Lung UK video demonstration here, or ask for Asthma Nurse, GP, or even your pharmacist should help if you take it along with you.

youtu.be/v0tIdlAPhBY?si=y4_...(Not working as expected?)

Does not sound right when you say “when I press the inhaler to release a dose I can feel it blow into my face and get a strong taste”.

I’ve used one for years, and prefer to mouthpiece. However, having lost weight, I now find the adult size mask does not give me a good seal on my face, so will ask for the child size mask next time.

The mask is recommended for asthma that is severe and uncontrolled, as you can use tidal breathing at your own pace, which you cannot do with the mouthpiece. See how you get on, but go back to your old one in the meantime if this is causing you to worry about not inhaling enough of your medications. Watch the video, but think you should still seek advice.

All best wishes 👍

[Lysistrata Administrator Community Ambassador in reply to Shogi]

Hmm interesting, I've always done tidal breathing through the mouthpiece at my own pace. It seems to work most of the time but I didn't know a mask was recommended -will look into that. Though I do have home nebs (approved by my consultant) for when the inhaler and spacer don't work (and in that situation I do need the passive inhalation, even though the spacer is meant to be just as good. Perhaps that's the idea of the mask.)

I was just in hospital and the respiratory nurse said they now recommend everyone use a spacer with tidal breathing for a metered dose inhaler. Glad to know I was on the right track as that's how I use it anyway!

[Shogi in reply to Lysistrata]

I have a nebuliser too, for bad exacerbations, and invaluable when I’d bad Covid last December. Comes with a mouth piece and adult and child masks. Prefer using a mask, with nebuliser and spacer, as I used to have a lot of problems with Candida infections in my throat if I didn’t use a mask, in spite of rinsing after. When my breathing is good, I just inhale deeply through my nose in one breath, but take tidal breaths through nose and mouth if things are worse.

Was given a spacer with mask for Atrovent and Fostair on one hospital admission, in preference to one with mouthpiece, as I couldn’t control my in breaths. Do find I need to wipe around my mouth and moisturise after using spacer or nebuliser masks, as I find my skin eventually feels dry if I don’t. Whatever works best for each person 👍

[Emaych61 in reply to Lysistrata]

Certainly no one has ever recommended a mask to me for my use but years ago, when my younger son was diagnosed with asthma (aged just four years old), I was given a mask for him and told to use it with his spacer device.

[Lysistrata Administrator Community Ambassador in reply to Emaych61]

I've definitely seen masks recommended for children, on the basis they're easier to use and an adult can help them take their inhaler if needed, without the child having to do anything other than breathe normally. (Also cats - you can get feline face masks!) I think there's still work on getting everyone to use a spacer with or without a mask, including adults!

I was diagnosed with asthma aged 7 in 1992 and there was no mention of a spacer. I didn't know how to use the Ventolin inhaler properly (not sure if I was actually shown) so I was switched to Bricanyl (terbutaline) dry powder. It worked fine for me but not sure why they needed to switch reliever! I did later (after we moved house and surgery) have a large Volumatic spacer for my preventer, though i don't remember how I used it.

I assume anyone who knew what they were doing now would have started me off with a spacer and facemask straight away for Ventolin. I'd also have been on a preventer more - I don't remember that being consistent.

[Emaych61 in reply to Lysistrata]

It does, of course, depend on the inhaler. Anyone using an accuhaler wouldn’t have a spacer device as they don’t work with those. I have accuhalers for ventolin simply because they come with counting devices and I find they are usually sufficient for my needs. That said I do also have an evohaler for ventolin for the (very, very rare) occasion when the asthma flares to such an extent that using the accuhaler becomes difficult - a bad viral infection, for example.

[Lysistrata Administrator Community Ambassador in reply to Emaych61]

Yes - I didn't specify but was only talking about spacers in the context of metered dose inhalers (MDIs). I only have an MDI for Ventolin currently so only use for that.

I cannot get on with the Ventolin accuhaler at all. By the time I need my reliever, it doesn't work for me - I wish the MDI had a counter. I'm fine with using Fostair dry powder but found Symbicort hard to use when I was struggling.

[Emaych61 in reply to Lysistrata]

They’re not for everyone, certainly. If I recall correctly your asthma is more severe than mine. It’s very rare for me to have a bad flare that comes on so fast I need to use the evohaler, but for those who do get that I can appreciate that an accuhaler might not be suitable.

The biggest issue I have is justifying why I need both 2 accuhalers and an evohaler for ventolin when it comes to re-ordering them (which usually happens when the expiry date is reached not because I’ve run out of the medication). To be fair, once I’ve explained it they’ve never said no - yet.

[Lysistrata Administrator Community Ambassador in reply to Emaych61]

I have a friend with severe asthma who also finds both useful in different situations - can't remember the specifics now! She also has difficulty explaining why she needs both.

I do evohaler with spacer then nebuliser if that doesn't work (nebs approved by consultant). My asthma is definitely not well behaved!

This does show why it needs to be individual - I'm never happy with anyone who tries to justify decisions that don't work for someone by generalising to everyone with asthma.

[Avalta]

I have found there is a difference of opinion regarding this. ED say use the mask Specialists I have been see no mask. I have been going with what the specialist have said.