← Back
Medications

How to give an inhaler or a nebulizer treatment

Other platforms explain it with text and video. In Making Synapses you practice it on the patient.

Nursing (NCLEX)EMS (NREMT)
Practice it in VR with Blocky

Most patients use their inhaler wrong. Teaching the right technique works as well as adding a new drug.

Step by step

  1. Check the rights

    Right patient, drug, dose, route and time. In EMS, the inhaler must be prescribed to the patient and follow medical direction. [1]

  2. Assess before

    Breathing rate, effort, wheeze, saturation and pulse. [2]

  3. Inhaler with spacer

    Shake, remove the cap, prime if new. Breathe out fully, seal lips on the spacer, press once and breathe in slowly and deeply, hold for about 10 seconds. [2]

  4. Between puffs

    Wait about one minute before the next puff. Rinse the mouth after a steroid inhaler. [2]

  5. Nebulizer

    Put the medicine in the cup, connect to air or oxygen at about 6 to 8 L/min, mouthpiece or mask, normal slow breaths until the mist stops. [2]

  6. Assess after

    Recheck breathing, wheeze and saturation. Albuterol can raise the pulse and cause tremor. [2]

  7. Record

    Drug, dose, device and the response. [2]

Common errors

Practice it in Making Synapses

In Making Synapses you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.

Making Synapses cases that train this skill

9 Making Synapses cases train this skill: open the case library

Sources

  1. NREMT psychomotor skill sheets (EMT and Paramedic)
  2. Open RN, Nursing Pharmacology 2e (CC BY 4.0)

Steps adapted from Open RN, Nursing Pharmacology 2e, licensed under CC BY 4.0. Facts and steps also follow NREMT psychomotor skill sheets (EMT and Paramedic). Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.