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Asthma: Using a Metered-Dose Inhaler (MDI) without a Spacer

What is a metered-dose inhaler?

Metered-Dose Inhaler
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Many asthma medicines are given using a metered-dose inhaler (MDI). An MDI is made up of a metal canister inserted into a plastic holder. The metal canister contains the asthma medicine. When the canister is pushed down, it sprays a puff of medicine out.

It is recommended that children of any age use an MDI with a spacer. However, it is not always possible to have a spacer available: you may forget to bring a spacer with you, or it may be hard to carry it around.

How to use an MDI without a spacer

Your child can follow these steps to take asthma medicine using an MDI without a spacer. Remember, young children under the age of 9 usually cannot use an MDI properly by themselves.

Step 1: Collect the MDI

  • Insert the metal canister into the plastic holder if they are not already put together. Make sure the canister is firmly in place.
  • Take the cap off the plastic holder.
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Step 2: Shake the MDI

  • Shake the MDI 5 times.
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Step 3: Get the medicine ready

  • Hold the MDI with a finger on top of the metal canister and your thumb on the bottom of it.
  • Stand or sit up straight.
  • Breathe out.
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Step 4: Take the medicine

  • Place the mouthpiece of the MDI into your mouth. Make sure the MDI is between your teeth and your tongue is flat. This will allow the medicine to go into your lungs. Close your lips around the mouthpiece.
  • Tilt your head back slightly.
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  • Breathe in very slowly. About one-third of the way into the breath, press down on the canister firmly. Keep breathing in all the way until your lungs are full.
  • Hold your breath for 10 seconds.
  • Breathe out very slowly through your nose.
  • If you need to take more puffs, wait for 1 minute, then repeat steps 2 to 4.
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Step 5: Rinse out your mouth with water

  • Rinse out your mouth with water after taking the medicine.
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Sharon Dell, BEng, MD, FRCPC

Bonnie Fleming-Carroll, MN, ACNP, CAE

Jennifer Leaist, RN, BScN

Rishita Peterson, RN, BScN, MN

Gurjit Sangha, RN, MN

James Tjon, BScPhm, PharmD, RPh