Why is using a puffer correctly important?

The pMDI inhaler is the standard inhaler recommended for patients with asthma. It’s also commonly referred to as a ‘puffer’. Using a pMDI inhaler is very simple.

1. Remove the cap from the mouthpiece (you may need to squeeze the sides of the cap to release it)
2. Check the dose counter (if applicable)
3. Hold the inhaler upright and shake it well
4. Gently exhale to empty your lungs
5. Place the mouthpiece between your teeth and close your lips to form a tight seal. Do not bite down on the mouthpiece
6. Start to breathe in slowly through your mouth while simultaneously pressing down firmly on the canister
7. Continue to breath in slowly and deeply for the remainder of the breath
8. Hold your breath for around 5 seconds, or as long as feels comfortable
9. Remove the inhaler and then gentle and slowly exhale
10. If an additional dose is needed, repeat the steps listed above and then replace the cap

An Accuhaler may look quite different to a pMDI inhaler but using it should still be simple to do.

1. Hold the Accuhaler with one hand, placing the thumb of your other hand on the thumb grip. Push it around until it clicks to open the inhaler
2. Check the dose counter to make sure you have medication available
3. Slide the lever down until it clicks to load the medication
4. Exhale gently (away from the mouthpiece)
5. Place your mouth over the mouthpiece and take a deep, slow and steady breath through your mouth (not your nose)
6. Remove the Accuhaler and hold your breath for 10 seconds
7. Close the Accuhaler by placing your thumb into the grip and sliding it back around until the cover clicks back into place
8. If an additional dose is required repeat steps as necessary

A turbuhaler works a little differently to a pMDI or accuhaler, but is very easy to use once you know how.

Unscrew the turbuhaler’s cap anticlockwise and take it off.
Holding the turbuhaler upright, twist its coloured base to the right as far as it goes.
Then, turn it back to the left until you hear a click - this means your dose is loaded.
Breathe out away from the turbuhaler before placing the mouthpiece into your mouth. Make sure you’re not covering any of the air inlets, and you’ve made a good seal with your lips.
Breathe in quickly and deeply through the turbuhaler as far as is comfortable.
Hold your breath for 5-10 seconds.
Remove the turbuhaler from your mouth and breathe out.
If you need to take another puff, repeat steps two to seven.
Replace the turbuhaler’s cap and screw it shut.

An Autohaler is breath-activated, meaning you don’t need to rely on hand-breath coordination to successfully administer the treatment.

1. Remove the cover from the mouthpiece
2. Shake your Autohaler well
3. Holding the inhaler upright, push the lever up until it clicks into place
4. Exhale away from the inhaler and then place the mouthpiece into your mouth and seal your lips firmly around it
5. Breathe in slowly and deeply, filling your lungs. The Autohaler will release the medication automatically
6. With the Autohaler still in your mouth, hold your breath for 10 seconds
7. Remove the Autohaler and exhale fully
8. Press the lever down and replace the cap over the mouthpiece
9. If a further dose is required, repeat steps as necessary

Using an Evohaler is practically the same as using a pMDI inhaler.

1. Start off by standing or sitting upright.
2. Squeeze the sides of the mouthpiece cover and pull to remove it, and ensure the mouthpiece is free of loose particles.
3. Give the puffer a good shake four or five times to get rid of any loose objects and mix up the medication.
4. While holding your inhaler upright with your thumb on the base and your index finger on top of the canister, breathe out as far as you can.
5. Before breathing back in, place the mouthpiece into your mouth and between your teeth, but make sure not to bite down. Close your mouth to make a seal around the mouthpiece.
6. Slowly begin to take a deep breath in through the puffer. Just after you start to breathe in, firmly push down on top of the canister to release a dose of medicine. Continue your deep breath throughout this.
7. While holding your breath, take the inhaler from your mouth and remove your fingers from the canister. Keep your breath held for as long as is comfortable, then breathe out.
8. If you need to take another puff, wait around 30 seconds before repeating steps three to seven.
9. When you’re done, put the mouthpiece cover back on right away to make sure no dust or other particles get into your puffer. It should click into place.