How to Review Inhaler Device Technique

Always use a checklist, one for you one for patient to review as you go through steps. Consider use of video on patient or caregiver's phone to capture correct technique and or coaching tips. Involve family or caregiver in all teaching, as this may assist with adherence (even if technique is good). See the resources below for provider (and patient) checklists; you may also view lung.ca's video of a patient following correct technique.

Hover over the highlighted sections of the checklist to identify common errors.

How to use a MDI with a spacer

Interactive Checklist

All patients using an MDI should use a spacer, no exception. This improves drug delivery to lungs.

Prepare the device

  1. Remove cap from inhaler device
  2. Shake well, about 5X (this mixes the propellant and drug together)
  3. Remove cap from the spacer and insert mouthpiece into the spacer (above the air intake valve)

Get ready to inhale.

  1. Breathe out
  2. Place spacer mouthpiece in mouth between teeth, close lips around it to make a good seal
  3. Press down on the MDI canister once
  4. Inhale slowly and deeply for 3 to 5 s (spacer should not whistle. If it does the patient is inhaling too fast, ask them to slow down to get more drug in their lungs)
  5. Hold breath for 5 to 10 seconds, while removing mouthpiece from mouth
  6. Breathe out
  7. If a second dose is required, wait at least 30 seconds and shake before repeating steps 4 to 8.
  8. If the patient is having difficulty holding breath or breathing deeply in, then the patient can breathe in and out of the spacer normally for 5 breaths.

Resources

Lung.ca instructional video

How to use your MDI (with spacer)

MDI (with spacer) Provider Checklist

Knowledge Check

Before proceeding, we suggest that you download the provider checklist above, to review the correct technique steps, so you can answer the module questions which ask you to identify patient or nurse errors in the clips.

How to use a Respimat

Interactive Checklist

Prepare the device:

  1. Turn the clear base until it clicks (half turn)
  2. Open the cap

Get ready to inhale

  1. Breath out
  2. Close your lips (and teeth) around the end of the mouthpiece. Watch for avoiding covering air intakes with mouth.
  3. Start to take a slow, deep breath
  4. Press the dose release button and continue to breathe in slowly for as long as you can till you get a full breath in.Watch for poorly synchronised hand actuation and inhalation and breathing in too fast Suggest to keep cap on until loaded in case accidently press release button and medication goes into patient's eyes.
  5. Hold your breath for 5- 10 seconds

Repeat steps 1-7 as prescribed. Watch for only taking 1 dose of Spiriva or Inspiolto daily, don't realize full dosage is 2 doses to get full prescription.

How to know when you need a new device

When the pointer enters red scale there are less than 30 doses left. Once it hits zero the whole device will lock up on you so you can't turn it.

Resources

Lung.ca instructional video

How to use your Respimat

Respimat Provider Checklist

Knowledge Check

Before proceeding, we suggest that you download the provider checklist above, to review the correct technique steps, so you can answer the module questions which ask you to identify patient or nurse errors in the clips.

How to use a Genuair

Interactive Checklist

Prepare the device:

  1. Remove the protective cap
  2. Hold with the coloured button facing straight up
  3. 3. Press the coloured button all the way down ONCE and release. Watch for: Inhaler being shaken with mouthpiece facing the ground or leaving finger on the coloured button (not releasing it) or button pressed while inhaling.
  4. Check that the colour control window is GREEN. Green means ready. Watch for this window not being GREEN before inhalation.

Get ready to inhale

  1. Breathe out completely, away from the inhaler
  2. Place the mouthpiece between your teeth and lips with a tight seal. Inhale strongly and deeply through the mouthpiece
  3. While you breathe in you will hear a CLICK which signals you are using the inhaler correctly, continue breathing in for a full breath after you hear this click. Watch for the patient stopping their inhalation when click is heard.
  4. Hold breathe for 5 to 10 seconds, while removing inhaler from mouth
  5. Hold breath for 5-10 seconds
  6. Breathe out away from inhaler (watch for inhalation into the inhaler).

How to know that a dose was delivered

  1. Make sure the control window has turned to red. This confirms that you have inhaled your full dose correctly
  2. If the window has not turned RED repeat steps 5 to 11
  3. Replace cap

Resources

Lung.ca instructional video

How to use your Genuair

Genuair Provider Checklist

Knowledge Check

Before proceeding, we suggest that you download the provider checklist above, to review the correct technique steps, so you can answer the module questions which ask you to identify patient or nurse errors in the clips.