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What on Earth is "Hand-Breath Coordination"?

What on Earth is “Hand-Breath Coordination”?

When I was first diagnosed with asthma, I went to the pharmacy and picked up a rescue inhaler. I went home, ready to take some medicine to help me breathe after months of difficulty, and…
It all ended up in my mouth. All of it. I tried again and again and no success. I went back to the pharmacy the next day for a spacer, which helped—but it was, for about a year, the only way I could get meds into my lungs—with a spacer. There’s nothing wrong with this and spacers can help ensure medicine delivery, but as a high school student—soon to be university student—it really meant that I had to take some sort of bag everywhere I went instead of being able to toss my inhaler in my pocket and go out.

With some practice, though, I was finally able to get down the elusive “hand-breath” coordination necessary for taking an inhaler.

What on Earth is Hand-Breath Coordination?

You’re probably familiar with hand-eye coordination, which allows you to use information from your eyes to interact with your hands—for instance, to catch a ball or high-five someone accurately. Hand-breath coordination is similar, being able to time your breath—in this case, inhalation—with the action of your hand—pressing down on a canister—and doing both at the exact right moment to allow the medicine to flow into your lungs without getting ALL stopped within your mouth and throat.

What can you do if you struggle with hand-breath coordination?

As I’ve said, it took me a long time to get my hand-breath coordination up to proficiency. Here are things you can do in the meantime.

  • Use a spacer.
    Spacers take the need for hand-breath coordination out of using certain inhalers. Spacers can be used with pressurized metered dose inhalers (MDIs) as they allow the medicine to “float in the air” inside the valved chamber, meaning the puff of meds can escape when you breathe in… but not before!
  • Use a different type of inhaler.
    More and more breath actuated inhalers are on the market, so you have choices. Inhalers like the Turbuhaler or Turbohaler, Discus, Ellipta and Genuair—among others—are breath-actuated, which means that the medicine, usually a dry powder, is triggered to leave the inhaler by the force of your inspiration.
  • Practice and don’t give up! Although it’s frustrating, practice, practice practice! The only way you’re ever going to get hand-breath coordination down is by discovering the nuances that make using an MDI work. Tiny things like the tilt of your inhaler inside your mouth, in addition to a perfectly timed start to your inhalation and then pressing down on the canister, are crucial to using a pressurized MDI correctly and getting the meds into your lungs where they need to be.

Alternatives or interim solutions for hand-breath coordination

If you’re still struggling to use your inhalers, talk to your doctor. They may have other suggestions for you, including the ones I have listed above, or refer you to an asthma educator who can help you learn how to use your inhalers correctly. Because inhaler device options abound, research your options, and ask your doctor whether something different might be a good fit for your needs.

Did you or do you struggle with hand-breath coordination? Share your story, tips and tricks in the comments!

Always talk to your doctor before changing the way you take your asthma medications or use your asthma inhalers.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • LinnM
    7 months ago

    I’ve actually found myself educating others on how to use an inhailer. It surprises me how many doctors will prescribe an inhailer and not give any instruction on how to use it.

  • Kerri MacKay moderator author
    6 months ago

    LinnM, keep your eyes on Asthma.Net as I recently wrote a piece on this very topic, though I don’t know when it will be published! The research on inhaler demonstrations (or lack thereof!) by physicians and other health professionals was really interesting to me; if you see it, be sure to share your thoughts! 🙂

  • Leon Lebowitz, RRT moderator
    6 months ago

    Hi Kerri and LinnM –
    I think the demonstration you (Kerri) may be referring to was posted about a month ago (December 2, 2018) right here on It shows Kerri demonstrating the use of the Respimat Inhaler Device.
    If you’re interested, you can access it here:

    I do hope this is the one you had in mind, Kerri.
    All the best, Leon (site moderator)

  • Leon Lebowitz, RRT moderator
    7 months ago

    Hi LinnM and thanks for your post. That is a mystery for many of us in the field! I’ve come to understand that physicians who are able to prescribe inhalers may not know how to use them themselves. That may be why there is no instruction (from them) for the patient. That really isn’t the way it ‘should’ be, but it seems to be the way it is! Glad to hear that you’ve been able to assist folks in this regard. Keep up the good work! Leon (site moderator)

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