Are you using your inhaler the right way? I mean, how hard can it be, right?!
I’m at the airport waiting for my flight, and I watched the woman across from me start to cough violently and then use her inhaler.
My husband leaned over and said, “She didn’t use that right. She doesn’t have a spacer.” I answered, “And she didn’t wait one minute between puffs!”
As a Certified Asthma Educator (AE-C), should I have approached her and corrected her technique? Well, some people are Happy Travelers and some….aren’t. And some people don’t like others telling them what to do.
So I’ll share a little info here. These are the Top 7 Mistakes I see when I work with families:
1. Not checking the opening of the inhaler for debris.
Depending on where you keep your inhaler, the opening can collect all sorts of things – dimes, lint, crumbs, etc. Always check the opening! I heard of a woman who pulled her inhaler out of her purse, didn’t check the opening and inhaled a dime that was stuck in the inhaler. I have a family member who keeps his inhaler in his pocket and he inhaled – you guessed it – lint.
2. Not priming your inhaler.
If you drop your inhaler, or it hasn’t been used in 2 weeks, you must prime it. This varies by brand, but most manufacturers recommend priming your inhaler by spraying the inhaler 1-4 puffs BEFORE you use it. (You may need to look up your brand of inhaler and see how many puffs you need to spray to prime it.) This makes sure you get the right amount of medication.
3. Not shaking your inhaler before use.
You must shake your inhaler to mix the medicine and propellant. Kind of like how you shake up a can of spray paint before you use it.
4. Not exhaling BEFORE your use your inhaler.
You need to breathe out first so there’s room in your lungs to take a nice deep breath and inhale all that lovely medicine.
5. Not using a spacer/holding chamber.
Best practice recommends using a spacer (tube like device) that attaches to your inhaler. You spray your inhaler into the spacer/holding chamber which will “hold” the medicine until you breathe it in. It can be easier for people that can’t coordinate when to spray the inhaler and when to breathe in. (I have no coordination – in fact I can hardly chew gum and walk at the same time! So I use a spacer.)
NOTE: If you don’t use a spacer, you must use a different inhaler technique. You would start to breathe in FIRST (with the inhaler in your mouth and lips closed around it) and THEN press down on the inhaler. Since you are already breathing in, it’s easier to pull the medicine down into your lungs. If you spray it and then try to breathe in, most of the medicine can end up in the back of your throat.
6. Wait one minute between puffs.
A pharmacist told me there are a couple of reasons why. The 1st puff will go about half way through the lungs and stop. (Your lungs branch out 28 times – like tree branches – so the medicine has a long ways to go.) Since the 1st puff has cleared a path, that makes it easier for the 2nd puff to quickly travel through the first part of lungs, then plow through to the end of the lungs.The other reason is that it gives the propellant and medicine time to swirl around and mix.
7. Not rinsing your mouth after you use your controller inhaler.
Have you ever heard of thrush? It’s a nasty fungal infection on the tongue. Your tongue can turn white and can get red spots on it which can bleed. Food may also taste a little “off.” Controller inhalers are made with a yeast base, so if you don’t rinse your mouth out, you can get thrush.
Good technique is so important to make sure you are getting ALL of the medicine you need!
If you want to review the steps, here is a video from one of the most well known lung hospitals in the the U.S. – National Jewish Health on How to use an inhaler with a spacer
National Jewish Health also has a video that shows How to use an inhaler