Crucial errors in inhaler use
| Error | Devices affected | ||||
| pMDI | BA pMDI | pMDI + spacer | DPI | Respimat® Soft MistTM Inhaler§ | |
| Failure to remove mouthpiece cap or device cover | ✓ | ✓ | ✓ | ✓ | ✓ |
| Incorrect preparation/priming of device or loading of dose* | ✓ | ✓ | ✓ | ||
| Failure to pierce capsule | ✓# | ||||
| Inhaler upside down | ✓ | ✓ | ✓ | ||
| Breathing out into device* | ✓ | ||||
| Firing device at or after end of inhalation* | ✓ | ✓ | |||
| Open-mouth inhalation technique | ✓ | ✓ | |||
| Weak or very slow inhalation* | ✓¶ | ✓+ | ✓ƒ | ||
| Inhaling through nose | ✓ | ✓ | ✓ | ✓ | ✓ |
| Stopping inhalation as device is fired* | ✓ | ✓ | ✓ | ✓ | |
pMDI: pressurised metered-dose inhaler; BA pMDI: breath-actuated pMDI; DPI: dry powder inhaler. *: common errors; #: single-dose devices; ¶: failure to trigger device; +: failure to open spacer valve; ƒ: too slow to aerosolise the dose; §: manufactured by Boehringer Ingelheim GmbH & Co. KG, Ingelheim, Germany.