Version July 2025
Please read the Disclaimer at the end of this page.
What are discharge instructions? —
Discharge instructions are information about how to take care of yourself after getting medical care in the emergency department ("ED").
What should I know? —
You came to the ED for breathing problems. The doctors gave you a metered dose inhaler ("MDI") to help you breathe more easily. The MDI releases medicine when you press down on the top of the canister.
It is important to use your MDI exactly as instructed.
How do I care for myself at home? —
Ask the doctor or nurse what you should do when you go home. Make sure you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.
You should also do the following:
●Call your regular doctor and tell them you were in the ED. Make a follow-up appointment if you were told to.
●Every inhaler might be a little different. Follow the instructions from the doctor about how often to use yours.
●The first time you use your inhaler, you need to get it ready. This is called "priming." To do this:
•Take the cap off the mouthpiece.
•Shake the inhaler for 5 seconds.
•Press down on the canister to spray the medicine into the air (away from your face).
•Repeat these steps 3 more times.
If you don't use your inhaler every day, check when it needs to be primed again. Most need to be primed if you haven't used them for more than 1 or 2 weeks. This means following the steps above before you use the inhaler again.
After your inhaler is ready, you can use it as prescribed.
●Each inhaler comes with its own directions. Your doctor or nurse will show you how to use yours. In general, to use an MDI (figure 1):
•Take the cap off the mouthpiece.
•Shake the inhaler for 5 seconds.
•Hold the inhaler upright with your finger on the top of the canister and your thumb holding the bottom of the inhaler.
•If you were given a spacer (a device that attaches to the inhaler's mouthpiece), use it with the inhaler as instructed. When you press down on the canister, the medicine sprays into the spacer and sits there until you breathe it in.
To use a spacer with your inhaler, follow the directions above to get the inhaler ready. Then:
-Put the inhaler into the spacer.
-Breathe out a normal breath.
-Close your lips around the spacer's mouthpiece.
-Press down on the canister.
-Breathe in deeply and slowly, and hold your breath for 5 to 10 seconds. Breathe out away from the spacer.
-If you are supposed to take 2 puffs of your inhaler, wait 15 to 30 seconds before you take the second puff. Shake the inhaler again before the second puff.
Some spacers let you know if you breathe in too fast by making a whistle noise. If you hear a whistle noise when you breathe in, breathe in more slowly.
•If you were not given a spacer, prepare the canister by shaking as above. Then, breathe out a normal breath.
•Close your lips around the mouthpiece, or hold the mouthpiece 1 to 2 inches (4 cm) in front of your mouth.
•As you start to inhale the next breath, press down on the canister.
•Keep inhaling deeply and slowly through your mouth.
•When your lungs are full, hold your breath for 5 to 10 seconds to keep the medicine in your lungs.
•Let your breath out.
•If you are supposed to take 2 puffs of your inhaler, wait 15 to 30 seconds before you take the second puff. Shake the inhaler again before the second puff.
•Put the cap back on the mouthpiece.
•If you use a "glucocorticoid" (steroid) inhaler, rinse your mouth out with water, gargle, and spit out the water.
●If you use your inhaler every day, clean it at least once a week. If you don't use your inhaler every day, you can clean it less often. To know when you need to clean it, look inside the mouthpiece. Clean your inhaler when you see powder in or around the hole.
To clean the inhaler:
•Remove the canister and cap from the mouthpiece. Do not wash the metal canister or put the canister under water.
•Run warm water through the mouthpiece for 30 to 60 seconds.
•Shake the water off the mouthpiece. Let air dry overnight.
•Put the canister back in the mouthpiece. Replace the cover.
●Keep track of how many doses are in your inhaler. There might be a counter on the side of your inhaler, or you might have to write this down.
●If you use a spacer, follow the instructions that came with the spacer on how often to clean it. To clean a plastic spacer, wash it with warm water and dishwashing soap. Rinse it, and let it air dry. Some hard plastic spacers can go in the dishwasher.
If you use a cardboard chamber every day, replace it every week or if it gets wet or damaged. Do not wash the bag.
When should I get emergency help?
●Call for emergency help right away (in the US and Canada, call 9-1-1) if you:
•Are having so much trouble breathing you can only say 1 or 2 words at a time
•Need to sit upright at all times to breathe or cannot lie down
•Are very tired from working to catch your breath, or are sweating from trying to breathe
●Return to the ED if:
•Your breathing is not getting better even though you used your inhaler a few times.
•You have trouble breathing when talking or sitting still.
•You are using your inhaler to relieve symptoms more often than every 2 hours.
When should I call the doctor? —
Call for advice if:
●You have any questions about how or when to use your inhaler.
●You cannot do your normal activities because of trouble breathing.
●Your cough gets worse, or you cough up yellow or green mucus.
●You are running low on your asthma medicines.
●You have new or worsening symptoms.
Patient education: How to use your metered dose inhaler (adults) (The Basics)
Patient education: How to use your child's metered dose inhaler (The Basics)
Patient education: Medicines for asthma (The Basics)
Patient education: Inhaler techniques in adults (Beyond the Basics)
Patient education: Asthma treatment in adolescents and adults (Beyond the Basics)
Patient education: Asthma inhaler techniques in children (Beyond the Basics)
Patient education: Asthma treatment in children (Beyond the Basics)
