FOCP CLINICAL SKILLS: INHALERS AND THEIR USAGE CHECKLIST

Performing the technique of giving inhalers (MDI and DPI)

Tick() the box before each number if accomplished and (x) if not Remarks

A. INTRODUCTION

1. Introduce self and role

2. Wash hands
3. Confirm patient’s identification (ex. Asked name and age)
4. Check patient’s understanding of their inhaler. (Allowing you to tailor your explanation to the patient’s level of knowledge)
5. Explain when the inhaler device should be use (e.g. Preventer and Reliever inhaler)
6. Show patient the dose counter on the inhaler where applicable and expiration date.
7. Ask the patient to summarise the key points back to you to demonstrate understanding.

B. GATHER EQUIPMENTS
 Metered-Dose Inhaler (MDI):

BLUE SPACER with

SPACER FACEMASK
INHALER

 DRY-POWDER INHALER (DPI)

C. Position the patient in Semi-Fowlers or sitting position as tolerated.

 FOCP CLINICAL SKILLS: INHALERS AND THEIR USAGE CHECKLIST
D. METHODS OF ADMINISTRATION:

Explain the steps below as you demonstrate.

For Metered-Dose Inhaler (MDI):
1. Check dose counter (if applicable).
2. Hold canister upright and shake the canister vigorously prior to use (3-4 shakes).
3. Remove cap.
4. Breathe out gently, away from the inhaler.
5. Put mouthpiece between teeth without biting and close lips to form good seal.
6. Start to breathe in slowly through mouth and at the same time, press down firmly on inhaler
canister to release the medicine.
7. Continue to breathe in slowly and deeply, and HOLD breath for about 10 seconds or as long as
comfortable. Remove inhaler from mouth.
8. Breathe out gently, away from the inhaler.
9. If an extra dose is needed, wait approximately for 30 seconds and repeat the above steps.

For MDI with AEROCHAMBER (SPACER):

1. Shake the medicine.

2. Insert the mouthpiece of the inhaler into the rubber-sealed end of the spacer.
3. Breathe all the air out of your lungs and put the aerochamber into your mouth between your
teeth. Make a tight seal around the mouthpiece with your lips.
4. Press the metered-dose inhaler down once to release a spray of medicine. The medicine will
be trapped in the spacer. Breathe in slowly and deeply.
5. Hold breath for about 5-10 seconds or as long as comfortable and remove spacer from mouth.
6. Breathe out gently and remove inhaler from spacer
7. If an extra dose is needed, repeat the above steps.
8. Replace cap and disassemble spacer.
 FOCP CLINICAL SKILLS: INHALERS AND THEIR USAGE CHECKLIST
For Dry-Powder Inhalers (DPI):

1. Stand up straight.
2. Push away on the thumb grip until the mouthpiece is fully exposed.
3. Slide the lever away from you until it clicks. (This means the medicine has been released. Be
careful not to tip the inhaler or slide the lever again; the medicine will fall out and it will be
wasted.)
4. Take a deep breath in and breathe out to empty your lungs.
5. Put the mouthpiece in your mouth.
6. Breathe in quickly and deeply, then hold your breath while you slowly count to 10.
7. Rinse your mouth with water and spit it out.

E. ASSESS INHALER TECHNIQUE

1. Ask the patient to carry out the procedure themselves whilst you observe. Most patient’s techniques will require tweaking. (Check if they are
doing it correctly and correct any mistakes they are making.)

F. END PIECES:

1. Ask if the patient has any questions or concerns

2. Give instructions on the correct way of cleaning inhalers after use. (Provide information leaflet if available)
3. Thank patient
4. Wash Hands.

References: https://www.asthma.org.uk/advice/inhalers-medicines-treatments/using-inhalers/ Videos: https://www.youtube.com/watch?v=fHYTz-ZoRLw

https://youtu.be/von7cyXcj2c
http://www.pharmaceutical-journal.com/learning/learning-article/how-to-help-patients-optimise- https://youtu.be/hCAsW7OM9Ns
their-inhaler-technique/20201442.article https://www.youtube.com/watch?v=VYMDHaQMj_w
https://youtu.be/sJdG-c6y84I
Created by JMBien FOR FOCP2017-RESPIRATORY WEEK Stage 3