OSCEs Explanation of a metered dose inhaler and spacer DONE

Question 1

Explain the correct use of a Metered Dose Inhaler

Answer 1

• Introduce yourself, say why you are there, check it is a good time for the patient
• Remove the cap and clean the mouthpiece on the inside and outside using an alcohol swab
• Shake the inhaler well
• Hold the inhaler upright with your thumb on the base and forefinger on top
• Breathe out gently
• Put the mouthpiece in your mouth between your teeth and close your lips firmly around it to form a tight seal
• You then have to press the canister (the top part here) down and at the same time start breathing in, slowly and deeply, until you cant breath in any further
• Hold your breath for 10 seconds, or as long as is comfortable
• (You demonstrate the technique to the patient now)
• If you need to take a second dose, wait for 30 seconds before you take it.
• (Get the patient to show you how to do it, to make sure they have understood)

Question 2

Explain how you use a spacer with a metered dose inhaler

Answer 2

• Introduce yourself and explain why you are there - make sure it is a good time for the patient
• Explain that the spacer will just make using an inhaler easier
• The spacer comes in two halves - they have to be fitted together first
• Wipe the mouthpiece with an alcohol swab (if one is available - its not in the book)
• Shake the inhaler
• Remove the cap from the inhaler and place it in the back of the spacer
• Breathe out gently
• Place the mouthpiece into your mouth beteween your teeth and make sure you make a tight seal around the mouthpiece with your lips
• Press the canister on top of the inhaler to release a puff of medication
• Now you can either take one slow, deep breath in and hold your breath for 10 seconds
• Or if you would find that difficult you can take 5 normal breaths
• (Find out which the patient feels they can do, and demonstrate that method)
• Take the spacer out of your mouth and breathe out normally.
• (Get the patient to show you how to do it, so you know they understand)
• If you need to take another dose, wait 30 seconds before taking it. You only every put one puff of the inhaler in the spacer at once
• Once a month, wash the whole spacer in warm soapy water and let it drip dry - this helps prevent medication sticking to the sides.
• You should get a replacement spacer once a year.