Patients who have artificial airways and who concurrently suffer with chronic obstructive airways disease encounter problems when administering inhaled bronchodilator and corticosteroid drugs via the tracheostomy. This is because most the devices are designed to deliver the metered dose of inhaled drugs via the oropharyngeal route and it is impossible to obtain an airtight seal from the inhaler device mouthpiece to the tracheostomy tube. The author describes a simple, effective and cheap modification of a spacer device designed by a creative patient to facilitate delivery of the aerosol via the tracheostomy tube to overcome this problem.