How to Use Your Asthma Equipment

Proper use of asthma medication, inhalers and nebulizers is key to asthma relief and control.


You are one of the 10 million people in this country who suffer from asthma: an upper respiratory disease that affects your life in so many ways. You begin wheezing and coughing during athletic events, certain foods trigger your asthma, and you avoid the great outdoors during high pollen and allergy season for fear of evoking an asthma attack, not to mention the fact that you may have taken the preventative and sometimes expensive steps of dust-proofing your home. As a result, your doctor has prescribed medication therapy for you through a certain medical device, and, of course, you want to be sure to use it properly in order to obtain its full benefits. Proper technique is key, but for many, just the names of these devices may sound foreign and look intimidating. Fear not, below is a list of the most common asthma devices, and the proper ways to use them.

Metered-Dose Inhalers

For the past 30 years, metered-dose inhalers have been instrumental in transforming asthma treatment. These small, hand-held devices can be administered at any time, wherever you may be, by effectively allowing you to deliver the medicine directly into your lungs. But in order to get the right amount of medication, you must first be sure the positioning of the metered-dose inhaler is correct.

Metered-dose inhalers can deliver several types of medication. They include:

  • Corticosteroids – Most effective when taken on a daily basis, corticosteroids are used over the long-term to prevent inflamed airways. This medication is administered through the mouth, and can cause a yeast infection in the throat. To avoid this, gargle with water after taking corticasteroids with an inhaler, and spit out the water. Do not drink it, as it will be absorbed into your throat.
  • Non-steroid medications – Also used over the long-term to prevent inflammation.
  • Bronchodilators – Usually prescribed for a short period of time when symptoms are at their worst to provide immediate relief of asthma symptoms.
Misty Medication

The inhaler includes a pressurized canister with measured doses of medication inside. Squeezing the canister emits a fine-powder mist into your mouth that goes directly into your lungs. To do this properly, place your lips on the inhaler’s mouthpiece, and squeeze the canister while inhaling at the same time. This takes some amount of coordination. For many, this sounds easy, but you’ll be surprised to read that many people are not doing it correctly.

Common Mistakes
Some common mistakes reported with using a metered-dose inhaler include squeezing the canister and forgetting to inhale at the same time, while others squeeze and inhale through the nose instead. Some people are overzealous with their inhaler, and squeeze the canister twice while inhaling only once. There is also the issue with inhaling too quickly leaving deposits of medication on the throat instead of in the lungs. To avoid this mistake, inhale for at least 5 seconds and hold your breath for 10 seconds before exhaling. Practice this a few times before actually administering the medicine. And please, don’t forget to take the cap off the inhaler mouthpiece before using it.
How Spacers Help When Using a Metered-Dose Inhaler
A spacer is nothing more than a separate tube, 4 to 8 inches long that attaches to a metered-dose inhaler. Its purpose is to keep the medicine from escaping into the air. Releasing your medication into the spacer also gives you time to inhale more slowly. The spacer also decreases the amount of medicine that is deposited on the back of the throat and increases the amount that travels into the lungs.
Using a Spacer

Spacers sound easy enough to use, and they are. Here are some tips on using a spacer:

  • Shake the metered-dose inhaler well.
  • Attach the spacer to the mouthpiece at the end if the inhaler.
  • Sit up straight so that the medicine goes directly into your lungs.
  • Breathe in slowly while squeezing the top of the canister once. Keep inhaling even after you finish the squeeze. Continue inhaling for 5 to 7 seconds.
  • After inhaling, remove the spacer from your mouth and hold your breath for 10 seconds. Then exhale through your nose.
Compliance is Key
There is a tendency for people to forget to take their asthma medication, or to use it incorrectly. Many people report that they don’t feel any immediate benefit from their asthma medication. Others try to avoid the side effects associated with steroid medications. Your doctor will give you a treatment plan that will benefit you if followed correctly. Always check with your doctor if you think your medication is not working properly, or if you need additional help with the procedural steps of using your medical devices.
Peak Flow Meters
A peak flow meter could actually save your life and ward off an asthma attack by allowing you to respond quickly to asthma flare-ups such as coughing, wheezing, and mucus production. These devices were created to help you manage your asthma, especially during physical activity. Peak flow meters measure daily variations in your breathing letting you know that your body has reached its limit by the number indicated on the meter. If the number is lower than your optimal amount, you should stop and rest, and/or take medication, depending on your doctor’s orders. Your doctor will also be able to tell whether your asthma medication is working based on the readings of the meter. Many people take daily asthma medication along with using their peak flow meter on a daily basis. Peak flow meters are hand-held and portable, and give you the confidence of being able to monitor your asthma symptoms before they start. The higher the number, the healthier you are, so you know that your asthma management plan is working when your numbers are consistently higher.
How to Use A Peak Flow Meter

Peak flow meters are an essential part of your asthma management plan, and should be used correctly in order to get the best results. When you learn to use the peak flow meter, you can determine your optimal peak flow rate. This is usually the highest number you’ll get in the middle of the day after taking your medicine with a metered-dose inhaler. Your doctor will determine which type of peak flow meter is best for you based on your personal body composition, including gender, age, height, and weight. There are a variety of peak flow meters. Your doctor will determine which is the best one for you.

Here are instructions on properly using your peak flow meter:

  • Connect the mouthpiece to the peak flow meter.
  • Set the marker to the bottom of the numeric scale.
  • Take a deep breath
  • Tightly place your lips around the mouthpiece.
  • Blow into the mouthpiece as hard and as fast as you can.
  • Write down your peak flow rate on your chart. If you haven’t started a chart, it’s a good idea to start one now in order to monitor your daily results.
  • Repeat the above steps two more times, and record the highest peak flow reading of the three. That is your optimal number.
The Lights Know Best

Your peak flow rates fall into three color zones, or ‘traffic lights’, indicating different responses to your asthma.

  • The green zone includes peak flow rates that are 80 percent to 100 percent of your personal best. This is the best zone to be in, and means that you and your doctor have chosen the right management plan, and that you are following it properly. Keep up the good work!
  • The yellow zone indicates peak flow rates that are 50 to 80 percent of your personal best. Yellow means that your asthma is getting worse, and as with traffic lights, you should take ‘caution’. Perhaps rechecking your asthma management plan with your doctor, and discuss changing medications. You may also want to be aware of your environment – what is triggering your asthma, whether indoors or out, and how to change that.
  • The red zone includes peak flow rates less than 50 percent of your personal best. Red means ‘stop’. When seeing red, you should stop what you are doing before things get even more serious. Take a bronchodilator or other medicine to open your airways immediately. You and your doctor should have a plan about what to do when rates hit the red zone. Inform your doctor immediately of your dangerous peak flow rates and discuss medicines, lifestyle changes, and what to do in emergency situations.
How to Use a Nebulizer

A nebullizer is very similar to using a metered-dose inhaler without the luxury of it being a hand-held device. Nebulizers are prescribed mainly for young children you don’t or won’t sit still long enough to get the proper amount of mist into their lungs. An electronically operated machine, a nebulizer weighs approximately 8 pounds.

Steps to follow:

  • Plug it in.
  • Insert the other cord into the machine on one side, while inserting the other side of the cord into a canister.
  • Fill the canister with either 1/3 or 2/3 albuterol medication.
  • Add a tube of saline solution.
  • Place the cap on the canister.
  • You have the option of using a longer tube or a facial mask, allowing the mist to directly into the nose or mouth.
  • Hold the canister approximately two inches away from your face.
  • Turn on the nebulizer, being sure that you inhale the misty medication. Do not turn your face from the medication. Do this until the mist disappears which takes approximately 15 minutes. For severe asthma, your doctor may tell you to repeat this procedure four times a day.

Remember that compliance is key, but so is knowing how and when to use your medical devices. They can only help if you use them properly. Be sure to always check with your doctor if you have any questions or concerns regarding your asthma treatment and your health.

By Allergy Buyers Club Medical Staff Writers
© 2001