PDF Handbook of Antistatics

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If a new plastic spacer must be used immediately, it can be primed by firing multiple at least 10 puffs of medicine into the spacer. It is not necessary for antistatic polymer spacers e. Ask patients to bring their spacer with them to be checked every 6—12 months. Check that there are no cracks and that the valve is working.

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Electrostatic surface charge on new spacers made of plastic e. Breath-A-Tech, Volumatic reduces the proportion of medicine available for delivery to the airway. The optimal number of actuations for priming is not known and the findings of in vitro studies vary widely.

When a new plastic spacer must be used immediately e. In hospitals and emergency departments, a new spacer that has not been pre-treated by washing can be primed using multiple at least 10 puffs of salbutamol. Disposable cardboard spacers e. Manufacturers of most pressurised metered-dose delivery devices recommend shaking the device before actuating. The physical characteristics of each formulation, including the effects of shaking, differ widely, 5 but for simplicity it is best always to recommend shaking of pressurised metered-dose inhalers. Pressurised metered-dose inhalers except for those that are breath-actuated can be used with a spacer.

This process should be repeated until the total intended number of actuations is taken. Patients should be trained to follow these instructions when using their inhalers. Inhaling slowly with a single breath maximises delivery of the medicine to the lungs and minimises deposition in the upper airways when using a manually actuated pressurised metered-dose inhaler with or without a spacer, or when using a breath-actuated pressurised metered-dose inhaler.

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Tidal breathing through the spacer e. First aid instructions should include how to use inhaler and spacer. In practice, optimal delivery of inhaled medicines involves a balance between maximising the proportion of respirable medicine and maximising efficiency of inhalation by the patient within real-world constraints.

The optimal delivery of salbutamol in real-world circumstances is not well defined.