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Technique for use of a metered dose inhaler (MDI) with a spacer or chamber*

Technique for use of a metered dose inhaler (MDI) with a spacer or chamber*
Uncap mouthpiece and check for loose objects in the device.
Prime your inhaler if this is the first time you are using it, if you have not used it for several days, or if you have dropped it. Priming an MDI usually involves shaking it and spraying it into the air (away from your face) a total of up to four times. See the information that came with your inhaler for exact instructions.
Check the number of doses remaining in the MDI.
Insert MDI into spacer.
Shake canister vigorously for about five seconds.
Hold the MDI upright with your index finger on the top of the medication canister and your thumb supporting the bottom of the inhaler. Use your other hand to hold the spacer in a horizontal position.
Sit or stand up straight with the chin tilted up and neck slightly extended.
Breathe out normally through your mouth. Do not breathe out into the spacer.
Put the mouthpiece between your teeth and close your lips tightly around mouthpiece of spacer. (If using a mask attached to the chamber, place the mask completely over your nose and mouth.)
Make sure your tongue does not block the opening of the mouthpiece of the spacer.
Press down the top of the canister with your index finger to release the medicine.
At the same time, breathe in deeply and slowly through your mouth until your lungs are completely filled; this should take three to five seconds.
Hold the medicine in your lungs for about 5 to 10 seconds. If you didn't get a full breath or can't hold your breath long enough, you can inhale a second time to fully empty the chamber and hold your breath again for about five seconds. For infants and young children, or if unable to cooperate with a deep breath or breath-holding, 5 to 6 normal breaths will allow complete emptying of the chamber.
If you need more than one puff, wait about 15 to 30 seconds between puffs. Shake canister again before the next puff. Do not load both puffs into the chamber and then empty the chamber with a single inhalation.
When finished, recap mouthpiece.
If your inhaler contains a steroid medicine (sometimes called glucocorticoid or corticosteroid), rinse your mouth and gargle with water after you use it. Then spit out the water. Do not swallow it.
You can use your spacer for more than one medication. Just remove the first MDI and insert the other one.
These instructions do NOT apply to dry powder or soft mist inhalers. Cleaning instructions are provided separately.

MDI: metered dose inhaler.

* We prefer to use a "valved holding chamber" for the spacer. The valve holds the medicine in the chamber. This helps get the medicine into your lungs. Also, when you breathe out into the mouthpiece, the valve prevents your breath from going into the chamber.
Graphic 93619 Version 9.0