Respiratory – Metered Dose Inhaler SECTION: 9.11
Strength of Evidence Level: 3 __RN__RT__LPN/LVN__HHA
PURPOSE:
To instruct the patient/caregiver in the correct usage of a metered dose inhaler (MDI) for the effective delivery of inhaled medications.
CONSIDERATIONS:
An MDI gives one dose of medicine with each puff. The inhaler must be used correctly to effectively deliver the medicine into the throat and lungs. If used incorrectly, the medicine may be left on the tongue and back of oral cavity.
EQUIPMENT:
Inhaler
Spacer (optional)
PROCEDURE:
1. Adhere to Standard Precautions.
2. Instruct the patient to perform the following;
a. Shake the inhaler 5 or 6 times.
b. Remove the mouthpiece cover.
c. If using a spacer, place it over the mouthpiece at the end of the inhaler.
d. Put your lips and teeth over the mouthpiece/spacer being careful not to block the mouthpiece with your tongue.
e. Breathe in slowly. As you do so, squeeze the top of the canister once. (If using a spacer, squeeze the top of the canister first, and then breathe in slowly.)
f. Keep inhaling even after you finish the squeeze.
g. Continue inhaling slowly and deeply.
h. After inhaling, remove the mouthpiece/spacer from your mouth and hold your breath for up to 10 seconds.
i. If you need another dose of medication, repeat the previous steps.
j. Replace the mouthpiece cover and store equipment.
k. Rinse your mouth and gargle with water, spit out, DO NOT swallow.
3. Clean Equipment. (See Respiratory - Cleaning and Disinfection of Respiratory Therapy Equipment)
AFTER CARE:
1. Document in patient's record:
a. Instructions given to patient/caregiver.
b. Patient/caregiver understanding and return demonstration.
REFERENCE:
Mayo Clinic. (2009). Using a metered dose asthma inhaler and spacer. Retrieved March 11, 2010, from http://www.mayoclinic.com/health/asthma/MM00608