Prep
- Check inhaler expiry
- Shake MDI vigorously (20 shakes)
- Assemble spacer
Technique (pMDI + Spacer)
Standard Technique (Older Child/Adult)
- Sit or stand upright
- Exhale gently (not fully)
- Seal lips around mouthpiece
- Actuate once into spacer
- Breathe in slowly and deeply
- Hold breath 10 seconds
- Breathe out gently
- Wait 30-60 seconds before next puff
NOTE
Single puff per breath - don't "stack" actuations
Tidal Breathing (Young Child/Mask)
- Apply mask to face (good seal)
- Actuate into spacer
- Take 4-6 tidal breaths through spacer
- Wait 30 seconds before next puff
CAUTION
Crying child = poor drug delivery. Calm first.
Common Errors
- Actuating before inhalation
- Breathing in too fast (impacts on oropharynx)
- Not holding breath
- Stacking multiple puffs before breathing in
- Poor mask seal (air leaks)
Finish
- Rinse mouth (especially with ICS to prevent thrush)
- Document puffs given
- Review technique at each visit
Checklist Complete