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Patient Assessment and Instruction in Use of Inhaler

Purpose: To identify possible problem areas in the use of an inhaler and to orient a patient to good technique for optimum drug delivery.

Description

Delivery of medication by inhaler may be limited by patient and inhaler-specific factors. Identification of problem areas can aid in selection of the optimum inhaler for the patient and guide patient instruction. Direct observation is essential to ensure proper patient understanding and inhaler use.


 

Observation of the patient using the inhaler can allow grading of the technique.

Technique

Grade

good, with good drug delivery

A

poor, with partial drug delivery

B

very poor, with little or no drug delivery

C

 

Inhaler factors affecting patient use:

(1) need for priming

(2) trigger for delivery, either manual maneuver or air flow valve

(3) presence of an air vent

(4) presence of a spacer

(5) presence of a cover

(6) use of a powder or propellant

 

Patient factors affecting inhaler use:

(1) incoordination and/or confusion

(2) weakness

(3) breathing through the nose

 

Parameter

Problem

priming

failure to prime

manual triggering

unable to coordination with inhalation cycle

air flow triggering

shallow breathing insufficient to trigger

air vent

partial or complete occlusion

spacer

failure to place

cover

failure to remove

powder or propellant

cough and other reactions

breathing technique

breathing through the nose

 


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Specialty

Objective

ICD-10