Spacers for inhalers are not available in Malawi. Here is how you can make your own with supplies that can be purchased at most pharmacies.
Asthma Spacer and Asthma Inhaler - for Kids with Asthma
Assessing of low-tech solutions for aerosol delivery: Comparative performance study of manufactured versus homemade spacers - ScienceDirect
How to Make a Homemade Spacer for an Inhaler – Healthy Global Kids
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Using a Spacer Device Asthma Society of Ireland
How to use a spacer- inhaler – Dr. Eisner, Pediatrician – Houston, Texas
Package: 1piece carrying case only, inhaler NOT included, travel case compatible with inhalers, asthma spacer, asthma mask for Adults and Kids. The
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How to Use a Spacer without a Mask American Academy of Pediatrics (AAP)