Asthma devices

A spacer is a device that goes around the end of your child’s inhalation device. The medicine is puffed into the hollow chamber of the spacer so it can be inhaled easily through a mouthpiece or mask.

Using a small volume spacer with a mask (children under four years old)

1. remove the cap from the puffer and shake the device
2. fit the puffer into the end of the spacer
3. gently place the attached facemask over the mouth and nose of the child, making sure there are no gaps around the edges
4. push down on top of the puffer to release one puff of medicine into the spacer
5. watch your child breathe normally in and out 4 to 6 times before removing the mask.

If more than one puff or dose is needed, repeat steps 4 and 5. Remember to shake the puffer before each dose.

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Using a small or large volume spacer without a mask (children over four years old)

1. remove the cap from the puffer and shake the device
2. fit the puffer into the end of the spacer
3. gently place the mouthpiece of the spacer between your child’s teeth and ask them to close their lips to form a seal
4. push down on top of the puffer to release one puff of medicine into the spacer
5. watch your child take four normal breaths in and out through the spacer.

For multiple doses, repeat steps 4 and 5, shaking before each use. Masks can be added for extra support, and older children can use them in the hospital to help with sleeping.

Metered dose inhaler or puffer

A puffer is a small device that delivers asthma medication. 

Children using a puffer should also use a spacer. If a child is over seven and can coordinate their breathing with the medicine, they may be able to use a puffer on their own.

Using a puffer on its own:

1. remove the inhaler cap or mouthpiece cover
2. shake the inhaler for 5 seconds
3. ask your child to breathe out gently, away from the inhaler
4. keeping the inhaler upright, tilt your child’s head back slightly
5. place the inhaler mouthpiece between your child’s teeth and ask them to close the lips to form a seal
6. ask your child to start breathing in slowly and deeply
7. as they breathe in, push down on top of the inhaler to release one dose of medicine
8. they should continue to breathe in slowly and deeply
9. remove the inhaler from their mouth and ask them to hold their breath for 6 to 10 seconds
10. they can then breathe out gently, away from the inhaler
11. if more medicine is required, repeat steps 4 - 8
12. replace the inhaler cap or mouthpiece cover.

Autohaler® (not recommended for children under seven years)

An Autohaler® is a puffer that works automatically when your child breathes in.

Using an Autohaler®:

1. remove the mouthpiece cover
2. shake the Autohaler®
3. hold the Autohaler® upright and push the lever on top into the upright position
4. ask your child to breathe out, away from the Autohaler®
5. place the Autohaler® in between your child’s teeth and ask them to close their lips to form a seal
6. ask your child to breathe in slowly and deeply
7. they should keep breathing in after hearing the click
8. remove Autohaler® from your child’s mouth and ask them to hold their breath for 6 to 10 seconds
9. they can breathe out gently, away from the inhaler
10. push the lever back down
11. if more medication is required, repeat steps 6 - 8
12. replace the mouthpiece cover.

Avoid placing your thumb underneath the device, as this may cover the air vent and stop it from working properly.

Dry powder devices have medication in a dry powder rather than suspended in air or gas.

Turbuhaler® (for children over six years of age)

A Turbuhaler® is a small inhaler shaped like a rocket. The Turbuhaler® is loaded with asthma medication and has a counter to let you know how many doses are left. Children need to be able to breathe deeply and strongly to use the Turbuhaler® properly.

To use the Turbuhaler®:

1. unscrew the Turbuhaler® cover
2. hold the Turbuhaler® in the upright position and turn the coloured base to the right as far as it will go
3. turn the coloured base slightly back to the left until it clicks
4. have your child breathe out, away from the Turbuhaler®
5. place the Turbuhaler® in between your child’s teeth and ask them to close their lips to form a seal
6. ask your child to breathe in as fast and deep as they can
7. remove the Turbuhaler® from your child’s mouth
8. ask your child to breathe out
9. if more medication is required, repeat steps 2 to 6
10. replace the cap.

Turbuhalers® should be kept upright while loading. To load, hold the coloured base and turn the top section. Avoid storing it in humid places.

Accuhaler® (for children over seven years of age)

The Accuhaler® is a small inhaler shaped like a circle that contains asthma medication. It has a counter to show how much medication is left. To use it properly, your child must be able to breathe deeply and strongly on their own. 

To use the Accuhaler®:

1. place your thumb in the groove and open Accuhaler® by pushing the groove to the right until it clicks
2. slide the lever to the right until it clicks
3. have your child breathe out, away from the Accuhaler®
4. place the Accuhaler® in between your child’s teeth and ask them to close their lips to form a seal
5. ask your child to breathe in slowly and deeply
6. remove the Accuhaler® from your child’s mouth and have them hold their breath for 6 to 10 seconds
7. ask your child to breathe out, away from the Accuhaler®
8. close Accuhaler® by pushing the thumb groove to the left
9. If more medication is required, repeat steps 1 to 7.

Do not shake the Accuhaler® and avoid keeping it in humid or moist places.

Ellipta® (for Breo® medication, not recommended for children under 12 years of age)

An Ellipta® is a small inhaler shaped like a box. The Ellipta® is loaded with the asthma medication and has a counter to let you know how many doses are left. To use it properly, your child must be able to breathe deeply and strongly on their own.

To use the Ellipta®

1. open the cover by sliding it in a downward motion until you hear a click
2. ask your child to breathe out gently, away from the Ellipta®
3. place the Ellipta® mouthpiece in between your child’s teeth and ask them to close their lips to form a seal
4. have your child breathe in steadily and deeply for up to 5 seconds
5. remove the Ellipta® from your child’s mouth and ask them to breathe out gently away from it
6. Slide the cover upwards as far as it will go to cover the mouthpiece
7. If more doses are required, repeat steps 1- 6.

Store the Ellipta® in a dry place and avoid shaking it. Open it only when your child is ready for their medication, and do not cover the vent with your hand. One dose is used up every time the device is opened. 

Follow these tips to clean your child’s spacer properly:

1. take the spacer apart if possible
2. wash in warm water with dishwashing liquid
3. do not rinse the dishwashing liquid off the spacer
4. place the spacer on a tea towel or drying rack and allow the parts to air dry.
5. when the spacer is dry, put it back together, ready to use.

Don't rinse or towel dry the spacer after washing. This creates static electricity, which makes the medicine cling inside. Check the cleaning instructions for your anti-static spacer.

Follow these tips to clean your child’s puffer properly:

1. remove the canister from the plastic holder and set it aside - do not wash the canister
2. rinse the plastic holder under warm running water
3. shake out any excess water and place on a tea towel or drying rack to air dry
4. place the canister back in the holder
5. keep the cap in place when not using the puffer.

Clean your child's spacer and puffer canister regularly, especially when the puffer doesn't spray well. 

Wash and change Intal® and Intal® Forte holders daily to prevent blockages. Wipe other plastic inhalation devices with a cloth. 

Store puffers below 20°C and check the expiry date to ensure medication is still effective.

To keep Turbuhalers®, Accuhalers®, Autohalers®, and Elliptas® devices clean, wipe the mouthpiece with a tissue after use and replace the cover tightly. These devices should never get wet or have contact with moisture. 

Make sure your child doesn't: 

• breathe directly into these devices
• put them in water
• use them with wet hands.