How to give an inhaler or a nebulizer treatment
Other platforms explain it with text and video. In VMS you practice it on the patient.
Most patients use their inhaler wrong. Teaching the right technique works as well as adding a new drug.
Step by step
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]
Assess before
Breathing rate, effort, wheeze, saturation and pulse. [2]
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]
Between puffs
Wait about one minute before the next puff. Rinse the mouth after a steroid inhaler. [2]
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]
Assess after
Recheck breathing, wheeze and saturation. Albuterol can raise the pulse and cause tremor. [2]
Record
Drug, dose, device and the response. [2]
Common errors
- Pressing the inhaler and breathing in at different times.
- No spacer for patients who cannot coordinate.
- Not checking the patient after the treatment.
Practice it in VMS
In VMS 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.
VMS cases that train this skill
Sources
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). VMS is not affiliated with these organizations. Updated: 2026-10-11.