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. 2018 Jul 3;13(5):488–490. doi: 10.1016/j.jtumed.2018.06.002

Table 2.

Metered-Dose Inhaler (MDI) appropriate use.

Step MDI
N = 49 (100%)
1 Shake the inhaler well.a 29 (59.2)
2 Remove the dust cap.a 49 (100)
3 Exhale slowly through pursed lips. 19 (38.8)
4 If using the “closed-mouth” technique, hold the inhaler upright and place the mouthpiece between your lips. Be careful not to block the opening with your tongue or teeth. 13 (26.5)
If using the “open-mouth” technique, open your mouth wide and hold the inhaler upright 1–2 inches from your mouth, making sure the inhaler is properly aimed.
5 Press down on the inhaler once as you start a slow, deep inhalation.a 11 (22.4)
6 Continue to inhale slowly and deeply through your mouth. Try to inhale for at least 5 s. 21 (42.9)
7 Hold your breath for 10 s (use your fingers to count to 10 slowly). If 10 s makes you feel uncomfortable, try to hold your breath for at least 4 s. 20 (40.2)
8 Exhale slowly. 16 (32.7)
9 Wait at least 30–60 s before inhaling the next puff of medicine. 18 (36.7)
a

Critical steps.