When using an MDI the correct technique when inhaling is to?

Índice Show

Medications
Checklist of steps
Common problems
Getting the most out of your inhaler
Other inhaler types
Acknowledgement

0:00 Hello, I’m Omar Usmani. I’m a Consultant Respiratory Physician. I’m going to show you how to use what’s called a Pressurised Metered Dose Inhaler, or pMDI. It’s also sometimes known as a ‘puffer’. Getting your inhaler technique right is very important because it helps you manage symptoms better. It may take a few tries to feel comfortable using your inhaler, but it does get easier with practice. If your doctor or nurse has advised you or your child to use a spacer with your inhaler, watch our other videos on using a spacer. When you first get your inhaler or if you haven’t used it for five days or more, you will need to test it. To do this: Take the cap off. Shake the inhaler well. Pointing the mouthpiece away from you, press the canister to release a puff into the air. How many test sprays you need to do will depend upon your inhaler, so do check the instructions. This means it is now ready for use. Some pMDI inhalers have a dose counter. If yours has one, check it is not empty. Now, hold your inhaler upright and take the cap off. Check that there’s nothing inside the inhaler mouthpiece. Shake the inhaler well. Sit or stand up straight and slightly tilt your chin up, as it helps the medicine reach your lungs. The next steps all happen smoothly in one action. Breathe out gently and slowly away from the inhaler until your lungs feel empty and you feel ready to breathe in. Put your lips around the mouthpiece of the inhaler to make a tight seal. Start to breathe in slowly and steadily and at the same time, press the canister on the inhaler once. Continue to breathe in slowly until your lungs feel full. Take the inhaler out of your mouth and with your lips closed, hold your breath for up to 10 seconds, or for as long as you comfortably can. Then breathe out gently, away from your inhaler. If you’ve been prescribed a second puff, wait 30 seconds to a minute and shake the inhaler again. Then repeat the steps. When you have finished, replace the cap on the inhaler. If you’ve used an inhaler that contains steroids, rinse your mouth with water and spit it out to reduce the chance of side effects. For more tips on using your inhaler, why not watch our other videos.

This video is not a substitute for professional medical advice. If you find it hard to use your inhaler, or find breathing problems are interfering with your daily life and sleep, see your GP. If you are having an asthma attack right now or cannot breathe normally and your blue reliever inhaler isn't helping or if you don’t have one, please call 999 for an ambulance. Asthma + Lung UK does not endorse nor recommend specific products. See our general disclaimer.

It’s important to keep track of how much medicine you’ve used so you can replace your inhaler before you run out of medicine. Many inhalers include a “counter” on the back that keeps track of how much medicine is left in the device. If your inhaler does not, you can use the following method to figure out when you’ll need to get a refill:

With a new inhaler, the canister will usually have the number of puffs available printed on the label. Divide the number of puffs in the canister by the number of puffs you take each day. The number you get will be the number of days the canister should last. For example, if you take 4 puffs each day from a 200-puff canister, you will need to have a new canister every 50 days.
Using a calendar, count forward that many days to see when your medicine will run out. Choose a day 2 days before this date to have your prescription refilled so you won’t run out of medicine.
With a permanent marker, write the refill date on the canister and on your calendar.
If you use your inhaler for rescue medicine (when you are struggling the most to breathe), ask your doctor if he or she will write a prescription for 2 inhalers. Rescue inhalers aren’t used regularly, so it will be difficult to plan a refill date. Get your prescription filled when the first inhaler is empty. This way, you’ll always have enough rescue medicine on hand.
Clean your inhaler regularly. Read the directions on your inhaler’s packaging. You also can ask your doctor to show you.

Using your inhaler (puffer) properly is important when you have asthma or COPD (chronic obstructive pulmonary disease).

This short clip shows you how to use a standard metered dose inhaler (MDI), often called a puffer.

Medications

A standard puffer is used with many different medications. These include:

Airomir (salbutamol)
Alvesco (ciclesonide)
APO-Salbutamol (salbutamol)
Asmol (salbutamol)
Atrovent (ipratropium)
Flixotide and Flixotide Junior (fluticasone propionate)
Flutiform (fluticasone propionate)
Intal and Intal Forte (sodium cromoglycate)
Qvar (beclomethasone)
Seretide (fluticasone propionate plus salmeterol)
Tilade (nedocromil sodium)
Ventolin (salbutamol)

Checklist of steps

Remove cap (some must be squeezed at the sides to release)
Check dose counter (if device has one)
Hold inhaler upright and shake well
Breathe out gently (away from inhaler)
Put mouthpiece between teeth (without biting) and close lips to form good seal
Start to breathe in slowly through mouth and at the same time press down firmly on canister
Continue to breathe in slowly and deeply
Hold breath for about 5 seconds or as long as comfortable
While holding breath, remove inhaler from mouth
Breathe out gently (away from inhaler)
If more than one dose is needed, repeat all steps starting from step 3
Replace cap

Common problems

Holding the inhaler in the wrong position
Not breathing in at the same time as pressing the canister
Not breathing in deeply enough
Not holding breath for long enough
Taking several puffs without waiting or shaking the inhaler in between

Your inhaler will come with instructions in the package. Always check the package insert for any specific instructions.

Tips

Keep your chin up and the inhaler upright (not aimed at the roof of your mouth or your tongue)
If you are using a standard inhaler for a corticosteroid preventer medication, also use a spacer
If you are using this inhaler for a corticosteroid preventer medication, with or without a spacer, rinse your mouth with water and spit after inhaling the last dose to reduce the risk of side-effects
People with weak hands or osteoarthritis who have difficulty using a standard inhaler should ask their pharmacist about a Haleraid device

Getting the most out of your inhaler

Ask your doctor, pharmacist or asthma & respiratory educator to:

Explain how your inhaler should be used
Check you are using your inhaler properly
Tell you where to find the expiry date on your inhaler
Show you how to check if your inhaler is empty or nearly empty
Discuss any unwanted effects from your medication
Explain how to clean your inhaler and spacer (if you have one)

Different brands of inhalers sometimes have slightly different instructions to each other for similar steps. The checklists in our How-To Video library have been simplified and standardised where possible to reduce confusion.

Your inhaler will come with instructions in the package. Always check the package insert for any specific instructions.

Other inhaler types

See our complete How-to video library for other inhaler types and how to use them.

Acknowledgement

Thanks to Ms Judi Wicking, asthma and respiratory educator, and the patient who participated in this film clip.

Development of this How-to video was supported by the Australian Government Department of Veterans' Affairs as part of the Prevent Puffer Problems campaign. The National Asthma Council Australia retained editorial control.

Disclaimer

Although all care has been taken, this video is a general guide only, which is not a substitute for assessment of appropriate courses of treatment on a case-by-case basis. The National Asthma Council Australia expressly disclaims all responsibility (including for negligence) for any loss, damage or personal injury resulting from reliance on the information contained herein.