Asthma

How to Use an Inhaler

The correct sequence of actions a patient performs when they are using an asthma inhaler is perhaps the most crucial part of treatment with this type of medications. Imagine the effects if a person is applying eye drops on top of their eyelids, or spraying a nasal spray right on top of the nose instead of inside one of the nostrils. It may sound silly, but these kinds of approaches are about just as inefficient as using an inhaler without first learning the proper technique. Let us examine the details of the method in question, step by step.

The Proper Inhaler Technique

Almost any pulmonologist (doctor dealing with asthma and other respiratory disorders) can tell you that not all patients with asthma have their inhaler technique patted down to perfection. In fact, at least 20% of asthmatics tend to use their inhaler incorrectly or with mistakes, missing on most of the beneficial effects it may provide.

In order to avoid this, it is important to follow a proper inhaler technique to ensure that no mistakes are made during the treatment:

  1. Remove the protective cap from the inhaler mouthpiece. Ensure that it is clean and ready to use.
  2. Shake the inhaler for a few seconds with lateral arm movements to ensure the pressurized contents can be released evenly.
  3. Get ready for inhalation by sitting or standing straight, and holding an inhaler upright with your index finger on top of the pressurized canister and your thump at the bottom of the inhaler.
  4. Take a few normal breaths and breathe out.
  5. Place the inhaler mouthpiece between your teeth and gently wrap your lips around it.
  6. Begin inhaling slowly through your mouth, and as you do - press on top of the canister with your index finger momentarily, which will release a "puff" of medication.
  7. As you finish inhaling, it is advised to hold your breath for 10 seconds, or less if you feel uncomfortable. You may put away the device at this point.
  8. Breathe out slowly.
  9. If additional applications are necessary, you may repeat steps 4 through 8. When you are done, put the protective cap back on the inhaler and store it away in a safe place.

Common Mistakes When Using Inhalers

Let us review the list and comment the points step by step to figure out where patients can get confused when trying to execute the proper inhaler technique:

In order to avoid this, it is important to follow a proper inhaler technique to ensure that no mistakes are made during the treatment:

1. Sometimes the inhaler mouthpiece can get dirty if the device was left lying around without the protective cap put on. Make sure the device is stored in a clean location with the protective cap put on when you are not using it. At times you may need to clean the inhaler to make sure you can use it safely without the risk of inhaling a random irritant or getting an infection.

2. If you were not using your inhaler for a while the contents of the pressurized container may shift into fractions and the medication will not be released correctly. Make sure to shake the inhaler before each use. You may need to "prime" it by releasing a few test puffs into the air if you were not using it for more than 10 days straight.

3. Using an inhaler when lying down may make it more difficult to inhale and apply the medication correctly. The right position of fingers is also important as it will help release the medication with very little effort and with great control over the direction of the spray. Unless you are sure the device is working as it should, avoid using the inhaler from an awkward position.

4. It is important to allow your breath to get steady before using the inhaler. For example, if you were engaged in some sort of physical activity or exercise when you felt the need to use the inhaler, your breath may get uneven or shallow, preventing you from using the inhaler properly. Take a few seconds to calm down and catch your breath, then use your inhaler.

5. One of the most common mistakes patients can make is place the inhaler mouthpiece in an awkward position before using the device. You have to place it inside your mouth, not in front of it, not away from it. The inhaler is constructed in a way so that if you can inhale with your mouth there is no need to create some sort of space through which air can get in - when you inhale through your mouth with the mouthpiece in the right position, the air is supplied through the gaps created between the canister and the plastic casing on top of the inhaler. This way, the aerosol can mix properly and be supplied directly into your lungs and airways. Also, it is important to point the mouthpiece in the direction of your throat, not at the top of your mouth, as it may result in releasing the spray directly above the uvula, denying the medication full access to lungs and springing the gag reflex.

6. The inhale is perhaps the most important part of the technique that needs to be performed as adequately as possible, since it directly influences whether or not the medication is transported to the problem areas of the respiratory tract. The timing on when to start breathing in and pressing the canister can be a little tricky without some practice. The essential part here is that you should press on the canister right after you start inhaling so that the medication can be delivered directly into the lungs and airways, carried alongside the inhaled air.

The most critical points here are:

  • Avoid spraying the medication on the back of your throat and inhaling afterwards. This pretty much negates any beneficial effects the medication can provide, be that a corticosteroid or a bronchodilator.
  • It is important to inhale deeply and slowly when you release the spray, so that you do not choke on the sudden burst of liquid. After some practice, you will be able take in the medication with one fast breath, but in the meantime try to breathe as calmly and as deeply as possible, filling up the lungs completely.
  • If you absolutely cannot match the timing due to breathing difficulties, or if your child can't get it right, you might want to use a spacer that will allow reaching the same effects without having to time your breathing. Spacers for asthma inhalers are simple and inexpensive add-on devices that resemble medium-sized plastic tubes or bottles that can be acquired at any place where the inhalers are sold or distributed.

7. Holding your breath is needed for the medication to get absorbed into the tissues. If you exhale too fast, or if you end up coughing, some of the medication may end being forced out from the designated areas, rendering the dose incomplete and therefore not as effective.

To elaborate:

  • If you cannot hold your breath for the whole 10 seconds, do not worry - simply hold out as long as you can, and breathe out slowly and calmly, since this is the key part here. This will amount to pretty much the same beneficial effect.
  • If you cough, do not take any more of the medication to compensate. Coughing up excess fluid is a natural response of the organism and should not be viewed as negative. One should only avoid rapid, forced coughing right at the moment when the medication is inhaled.

8. Again, a calm and relaxed exhale is key to allowing the medication stay where it is needed most. If you have trouble performing deep, slow breaths, you can review several breathing techniques that can make this task a little easier. Getting control of your breathing may serve a beneficial role in improving your asthma in general.

9. Storing the inhaler in a safe place and away from possible contaminants is an important part of keeping it clean and ready to use at any time.

Here are some basic tips:

  • You should not leave your inhaler in direct sunlight or allow it to freeze, as both of those things may render it unusable.
  • If you want to wash the inhaler, you should first remove the canister and the protective cap and wash the plastic casing (actuator) and the cap under warm water, without any soaps or detergents, then leave them to dry. Washing the canister itself is not recommended.
  • Since the mouthpiece is placed directly inside the mouth, the saliva left on it after use may facilitate an infection, even if the protective cap is put back on. If you want to be sure no contamination will take place, you can clean the mouthpiece with an antibacterial wipe after use.
  • If you want your inhaler to stay damage free and ready for action at any time, it is a good idea to store it in a protective case, even if you ordinarily carry it around in your purse, suitcase, or backpack. Various forms of cases, storage pouches and pockets are available, fit for any age and style.

That's it folks, now you know how to use an inhaler with expert proficiency. We hope you have found this guide to be helpful in your ordeal, and if you are interested in learning more about the treatment of asthma, we have a few more interesting articles available for you to check out.

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