Inhaler Technique Flashcards
How should you provide an overview of the patients inhaler?
“You have been started on ….(name of inhaler)…for your asthma.”
“This is what the inhaler looks like.”
“This is the mouthpiece, this is the canister containing the medication and this is the dose counter.”
Explain what a reliever (Salbtamol) inhaler is?
“(Name of inhaler) is a reliever. This is useful to help relieve sudden asthma attacks. It works by relaxing the airways so that you can breathe more easily. You shouldn’t need this more than three times a week if your asthma is well-controlled. Ask your GP for a review if you are using this more frequently. I would like you to inhale (x puff(s)) when you feel short of breath.”
Explain what a preventer inhaler is and when it should be used?:
“(Name of inhaler) is a preventer – it helps to reduce the swelling in the airways and stops them from tightening up.
You use this inhaler to reduce the risk of having asthma attacks. I would like you to inhale …(x puff(s))…(x time(s) a day)… every day. It’s really important that you don’t miss doses, as regular use is key to keeping your asthma under control.
”
You should also remind the patient to rinse their mouth out after use due to the increased risk or oral candidiasis
How would you explain what a SMART (Single maintenance and reliever therapy) is?
“Symbicort is used as both a preventer and a reliever. You need to use this regularly …(x puff(s))…twice a day to prevent symptoms and …(x puff(s))…each time you have an attack.”
What is an important thing to check once you’ve explained the different inhalers to the patient?
Ask the patient to summarise the key points back to you to check their understanding:
“To make sure you’ve understood everything I’ve said could you tell me what type of inhaler you have and when it should be used? Don’t worry if you can’t remember everything right away, we can always go back over the important information.”
What is the next stage of the consultation?
Ensure you clearly explain and demonstrate the following steps to the patient using a dummy inhaler.
What should you do before using the inhaler?
If the inhaler hasn’t been used for 5 days or more, the patient should be advised to test the device before using it:
- Remove the cap and shake the inhaler well.
- Point the mouthpiece away from you and press the canister to release a puff into the air.
- Check the number of remaining doses left in the inhaler -> ask them to check its not empty and seek replacement whilst there are several doses left.
- Check the expiry date - seek replacement if not.
How do you prepare the inhaler before using it?
- Hold the inhaler upright.
- Remove the cap from the inhaler and inspect to make sure there is nothing inside the inhaler mouthpiece.
- Shake the inhaler well.
What is the inhalation technique?
- Sit or stand up straight and slightly tilt your chin up. This position helps the medication to better reach the lungs.
- Breathe out gently and slowly away from the inhaler until your lungs feel empty.
- Put your lips around the mouthpiece of the inhaler to create a tight seal.
- Start to breathe in slowly and steadily whilst at the same time pressing the canister on the inhaler once.
- Continue to breathe in slowly until your lungs feel full.
- Remove the inhaler from your mouth and seal your lips.
- Hold your breath for 10 seconds, or as long as you are comfortably able to.
- Breathe out gently, away from your inhaler.
What are the final steps of the inhaler technique?
Once you have finished using your inhaler, replace the cap. If you’ve used an inhaler that contains steroids, rinse your mouth with water to reduce the chance of side effects.
What should you do if you need to do multiple doses?
If you’ve been prescribed a second puff, wait 30 seconds to a minute for repeating steps 3-12.
What should you do once you have demonstrated the technique?
Assess the patient’s inhaler technique:
- Provide feedback based on what you observe to allow the patient to refine their technique.
- Point out the positives…“You are doing X&Y very well”… then introduce room for improvement …“but doing A&B may help your inhalers work more effectively for you.”
- Continue to repeat the cycle of observation and feedback until the patient is able to use their inhaler effectively.
Why are spacers used?
Spacers are used to improve drug deposition in the lungs. They are also useful for reducing the side effects of high dose inhaled corticosteroids by decreasing the amount of drug deposited in the mouth.
What are commonly used spacers?
Volumatic and AeroChamber
How would you explain how to use a space inhaler?
- Prepare the inhaler as previously explained.
- Attach the inhaler mouthpiece to the spacer device.
- Breathe out gently and slowly away from the spacer until your lungs feel empty.
- Place your lips around the spacer mouthpiece to create an effective seal.
- Release one dose of the inhaler into the spacer device.
- Breathe deeply, both in and out, through the spacer mouthpiece several times.
- Administer a second dose if required.
