Name of the Procedure:

Holding Chamber or Spacer for use with an Inhaler or Nebulizer; without Mask (S8100)

Summary

A holding chamber or spacer is a device used with a metered-dose inhaler (MDI) or nebulizer to deliver medication into the lungs. It helps to ensure more of the medication reaches the lungs rather than staying in the mouth or throat. This version does not come with a mask, making it ideal for older children and adults who can use the mouthpiece.

Purpose

Holding chambers and spacers help manage respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD). They ensure efficient delivery of medication, minimizing loss and maximizing therapeutic effects.

Indications

• Asthma
• Chronic Obstructive Pulmonary Disease (COPD)
• Difficulty coordinating inhalation with the actuation of the inhaler
• Children (typically over 4 years old) and adults

Preparation

• No special fasting or medication adjustments required
• Patients should have a prescribed inhaler or nebulizer medication
• Instruction on proper use should be provided by a healthcare professional

Procedure Description

1. Assemble the spacer or holding chamber according to the manufacturer's instructions.
2. Attach the inhaler to the spacer/holding chamber.
3. Instruct the patient to exhale fully.
4. Place the mouthpiece of the spacer/holding chamber in the patient's mouth, ensuring a good seal with the lips.
5. Press the inhaler to release the medication, then the patient should inhale slowly and deeply.
6. Hold the breath for 10 seconds or as long as comfortable.
7. Repeat as directed by the healthcare provider.

Duration

The entire process typically takes less than 5 minutes.

Setting

The procedure can be performed at home, in a doctor's office, or in a clinical setting.

Personnel

While a healthcare provider (e.g., nurse, respiratory therapist) may initially instruct the patient, the patient can perform the procedure independently thereafter.

Risks and Complications

• Mild throat irritation or coughing
• Dry mouth
• If improperly used, ineffective delivery of medication

Benefits

• Improved delivery of medication to the lungs
• Reduced medication loss in the mouth and throat
• Enhanced control of asthma or COPD symptoms, often noticeable within minutes

Recovery

• No recovery time necessary
• Patients may resume normal activities immediately
• Follow-up appointments may be scheduled to monitor condition and technique

Alternatives

• Inhaling directly from the MDI without a spacer (requires good technique)
• Using a nebulizer with a mouthpiece or mask (for those unable to use a spacer)
  • Pros: May be easier for very young children or those with severe symptoms.
  • Cons: Bulkier equipment, longer administration time.

Patient Experience

• During the procedure, patients may feel cool or have a mild taste in their mouth.
• Post-procedure, there should be minimal to no discomfort.
• Patients should experience improved breathing and relief from symptoms soon after use.