Crucial errors in inhaler use

ErrorDevices affected
pMDIBA pMDIpMDI + spacerDPIRespimat® 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.