Better Inhaler Techniques (Tidal Method + One Other)

[Matman]

Two things:

1. Don't know if this is now 'old-news' (if so, apologies) but my Asthma Clinic Nurse introduced me to the Tidal Technique yesterday.

Apparently it delivers a 'much' higher dosage to lungs (something like 25% higher) than other techniques with / without a Spacer.

The Technique involves using a Spacer BUT in a particular way.

As usual you shake-up your inhaler, attach to Spacer then, once you've breathed out a bit and positioned the mouthpiece, you discharge just one shot into the Spacer, then slowly breath 'in and out gently' - but 'several' times - over twenty to thirty seconds (rather than taking a single big inhalation).

If your prescribed dose is two puffs, you wait a few minutes and then repeat the process. (Don't do two puffs in one go, apparently).

2. If Chest Sputum is one of your issues, something that helps me, is to to take just one puff, then wait for a full hour or so before repeating - I'll explain why I believe this can help. A layer of sputum / mucus covers the airway lining and is a barrier to inhaled drugs trying to reach the lining. About an hour or so after the first dose, folk who have sputum / mucus to contend with, frequently find that the 'first dose' has loosened things up, and they often cough and expel part of that barrier / layer within that first hour. This means that the second dose / puff, then has less of an obstacle to overcome in battling through the sputum layer to reach the airway lining.

None of this should be construed as medical advice (I'm not qualified to give any). You may, however, want to consider these points and / or ask your own Advisor about them.

[CDPO16]

I don't have a problem with mucous but have used the tidal breathing method using a spacer for my inhalers for several years. I find it much easier than trying to empty the spacer in one go. Good to know it is an efficient method for getting maximum benefit from the medication.

[Hidden]

Hi Matman, I read your comments with interest about tidal technique. The one thing that puzzles me is when you breath out back into the spacer does it not push the medication out through the whistle slot in the back.

[HaydiesMum in reply to Hidden]

I'm not sure how but no I dont think it does. My main experience of asthma is via my son who has been on medication since he was 10 months old and so has always had his meds through a spacer and was always told 10 breaths to each puff of medication. Now he is bigger some (although not all because when do we get a completely consistent message in anything asthma!) Say 5 more controlled breaths is fine. He is encouraged to try and breath deep into his lungs each time but no need to hold the breath.

[Hidden in reply to HaydiesMum]

Hi, thank you for the advice, I will give it a try.

[EmmaF91 Community Ambassador in reply to Hidden]

If you breathe back into the spacer the air goes out the vents near the mouthpiece, so does not got in to the chamber. I hope that helps

[HaydiesMum in reply to EmmaF91]

Ah that makes sense, knew it worked but hadn't figured out how

[Hidden in reply to EmmaF91]

Hi Emma, just tested it and you’re absolutely right.

Many thanks for that.

[Singinglouder]

Umm... That’s how I was taught to use a spacer 23 years ago - did it go out of fashion and come back in without me noticing? The spacers are much smaller and neater than when I started, tho - makes packing an overnight bag much easier

[EmmaF91 Community Ambassador in reply to Singinglouder]

Dw. It’s how I was always taught to do it too (tho it took a few years to be ‘officially’ taught). I think it depends on the medics confidence in asthma and instruction of how to do, because it is the best way to use a spacer. 😅

[Singinglouder in reply to EmmaF91]

I was diagnosed and taught at the old Cov & Warwick, and I think they were pretty well up to speed. I was actually sent because the gp suspected TB, got very thoroughly tested, and discovered I had atopic asthma, & had had it for years - I've never had tightness in my chest, so thought it couldn't be asthma - just thought I was very unfit that I got so short of breath... Luckily, as a trained singer & speaker, I breathe efficiently - the consultant couldn't quite figure out how I hadn't ended up in hospital before, and I think that must be why.

Re the inhaler - I can't quite think how else you'd use one - if you just take one deep breath, you might as well not bother with the spacer, surely? Or am I missing something?

[Matman in reply to Singinglouder]

Spacer still benefits even if inhaling in a single breath.

When you use an inhaler without the Spacer one of the issues is that much of the high-speed propelled meds are wasted because they hit your tonsils and adhere to soft-tissue. Even a ‘single’ inhalation via the Spacer is significantly slower, ensuring more of the dose reaches your airways.

Breathing back and forth into the Spacer also ensures the exhaled residue (otherwise lost when ‘not’ using a Spacer) is recaptured by the Spacer, and returned to the airways with second - and subsequent - exhalations / inhalations.

Appreciate, you already understand (as you use tidal method already) but this reply is to clarify to anyone else reading the thread.

[Singinglouder in reply to Matman]

Thanks for that - never occurred to me you could use a spacer for a single inhalation. Live and learn.

[Albertdog]

Does this apply to "reliever " as well as "preventer ". I ask in case they change my "preventer" again - as I was prescribed Fostair 2 puffs with Salamol as required. I have now been changed to Braltus "preventer" which is a powder in a plastic capsule that is punctured in a complicated contraction and to be sucked out in one go - so you see I can't use a spacer - but I could with my Salamol.

I ask incase they change the"preventer" again to some inhaler I could use with the inhaler they originally gave me with the Fostair....?

[Matman]

Understand using a Spacer is helpful for all MDI style Devices, preventers and relievers. For example, I use with Fostair, but would also use with Salbutamol (i.e. Ventolin) if / when needed.