Asthma is one of the most prevalent chronic diseases managed by school nurses, and its management often includes the administration of bronchodilators delivered via a metered-dose inhaler (MDI). The use of an MDI requires coordination and mastery of steps that must be performed correctly and in the proper order. These steps are greatly enhanced, especially in the pediatric population, through the use of medical devices—spacers and valved holding chambers. The purpose of this article is to review the rationale and implications for the use of these devices in the school setting. Read the Publication: https://journals.sagepub.com/doi/10.1177/1942602X16646593