More than 25 million Americans suffer from asthma, and if you or your child are one of them, you may have had worsened symptoms this spring. One reason is the explosion of pollen following a warm winter, but often overlooked is a cause you can control: improper inhaler use.
More than half of people with asthma use their inhalers incorrectly. It’s essential to think carefully about your inhaler technique, especially if you’ve had trouble getting your asthma under control.
[See: 8 Surprising Facts About Asthma and Seasonal Allergies.]
Complex Treatment for a Complex Disease
If asthma isn’t under control, inflammation in your airways isn’t under control. If that’s due to errors in your inhaler technique, you’re putting yourself at risk for unexpected visits to your doctor or ER, or worse.
Worsening asthma symptoms may be attributed to ineffective current treatment, leading some providers to increase the dose of a medication or add more medications. However, the cause of uncontrolled asthma may also simply be related to the way the medication is delivered.
As a pediatric allergist and immunologist at National Jewish Health, I find inhaler errors to be one of the most common reasons for poorly controlled asthma. Fortunately, inhaler problems are also easy to solve.
Taking it All In
Asthma is a chronic condition that can lead to missed days of work and school, ER and urgent care visits, and even hospitalizations. Treatment typically involves the use of inhalers. The use of an inhaler can be tricky and is prone to a wide range of mistakes in technique. When the inhaler is not used correctly, the inhaled medication may not get deep enough into the lungs and may end up coming right back out your mouth or deposited in the back of the throat, which will prevent symptoms of cough, wheeze and shortness of breath from being adequately treated.
If your asthma is not getting better with treatment, review your inhaler technique. There are several ways to use an inhaler incorrectly, but here’s what you need to do to get it right:
Step one is to always use a spacer, no matter how old or young you are. A spacer is a clear plastic tube that attaches to the mouthpiece of your inhaler and helps the medicine go deep into your lungs, rather than into your mouth or back into the air. In other words, using a spacer makes the inhaled medicine more effective.
It is important to then fully exhale so that when the medication exits the inhaler, you can subsequently take a slow, deep inhalation to get the medication into your lungs. For young children, a mask is attached to the spacer, and it’s important that the mask remains fully and securely on the face and that the child takes several breaths before removing the mask. For older children and adults, after the medication exits the inhaler and a deep inhalation is taken, it’s important to hold your breath for 10 seconds in order for the medication to reach deep into the lungs.
Getting inhaler technique down takes practice. At each visit, ask your doctor to review your inhaler technique and see if any improvements can be made. The key to great asthma control lies not only in taking the right medications, but also using your inhaler the right way.
[See: 7 Lifestyle Tips to Manage Your Asthma.]
10 Tips for Excellent Inhaler Technique
Here are the 10 most important tips to ensure you get an adequate dose of your inhaled medication. Every day, these steps significantly help our patients, and if poor inhaler technique is keeping your asthma uncontrolled, these should help you find relief.
1. Stand up.
Standing allows the lungs to fully exhale and gives you more power to deeply inhale.
2. Use a full inhaler.
It may be obvious, but a near-empty inhaler won’t help you. When your inhaler is half full, it’s time to place an order for new one so you’re never at risk of running out of medicine.
3. Shake the inhaler before you use it.
Every time you use your inhaler, shake it at least 10 to 15 times. If it’s a new inhaler or it’s been sitting for a few weeks, make sure to prime it with three or four test sprays.
4. Look straight ahead.
Do not lean your head too far forward or too far back; otherwise, the medicine won’t go much further than the mouth.
5. Use a spacer.
A spacer is a must-have device to insure the medicine gets where it needs to go, which is deep into the lungs. With your mouth sealed around the spacer, spray one puff and inhale slowly and deeply. Hold your breath for a count of 10, then exhale slowly. For young children who use a spacer with a mask, ensure the child takes five to six full breaths.
6. One breath per puff.
If your doctor has prescribed a dosage of more than one puff, take each puff separately. Don’t spray multiple puffs of medicine into your spacer. Multiple sprays just don’t work for a single breath.
7. Don’t let your tongue or teeth get in the way.
The spacer mouthpiece should be properly placed above the tongue and below the teeth.
8. Keep a good seal with your lips.
If you aren’t tightly sealing the mouthpiece with your lips, medicine will escape into the air.
[See: How to Survive Ragweed Allergy Season.]
9. Aim the inhaler at the back of the throat.
If the inhaler is aimed at the roof of the mouth or at your tongue, the medicine will never make it to the lungs. This is an extremely common, and difficult, problem with a very simple fix.
10. Inhale slowly.
When you inhale, inhale slowly. If you hear a whistling sound, you’re inhaling too quickly.
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10 Tips for Excellent Inhaler Technique originally appeared on usnews.com