Fixing a Bad "puffer".

Having problems with your puffer? Here's how to remedy that.

Properly deemed a Metered Dosage Inhaler (MDI), but more commonly known as "rescue inhalers" or "puffers", these devices are crucial to those of us with breathing problems, especially those with COPD (Chronic Obstructive Pulmonary Disease), or Asthma. The proper function of these units can be not only a source of relief, but a matter of life and death. Using albuterol, a combination of drugs, or steroids, MDI's deliver powdered drugs to the lungs of the user via a small, pressurized cylinder. Over time, these units can become clogged, dispensing less and less of the drug, until little or none is received. This can be deadly, especially for those of us who sometimes experience acute symptoms without warning. Some users can be fooled into thinking that the puffer is empty, when it actually is clogged with the powdered drug, and wind up disposing of a unit with material still inside the cylinder. Restoring proper function is simple, but care must be taken. Disclaimer: While I have done this procedure many times over the years, improper technique could result in damage to the unit, rendering it permanently useless, or worse, could cause the cylinder to explode causing injury, along with the remaining drug within being lost. If you proceed, you do so at your own risk, I claim no responsibility for injuries or cost to replace the unit. The following is my method for restoring function to a "bad puffer" which, may not only save you money, but could save your life or someone you love.

Remove the mouthpiece cap from the mdi and set it aside. Then, firmly holding the plastic body in one hand, grasp the cylinder top with the other, and pull firmly straight up to remove the cylinder from the body. Inspect the holes inside the body (where the drug passes through and the cylinder's dispensing tube inserts), from the top and at the back of the mouthpiece, to check for clogging (usually fine, white powder). Shake the cylinder close to your ear; if nothing is heard, the cylinder is empty. If you hear a very subdued "swishing" sound, there is material inside the cylinder, set it aside. Carry the cylinder and body to a sink, and prepare to clean them.

Turn your faucet on to the hottest setting (do NOT use boiling water on these parts, ever). Most hot water is set to be non-scalding, if it's too hot to hold under the water for more than a couple of seconds, add cold water to cool the hot water down a bit. Run water from the top of the body, through the bottom and the mouthpiece and out as shown (see picture) for 1 minute. Then run water through the mouthpiece (backflushing) for another minute. Shake the body vigorously for a minute to remove all water from the inside, then set aside for awhile to dry completely.

Hold the dispensing tube on the bottom of the cylinder in the flowing water for 10 seconds, stop for 10 seconds, then back in the water for another 10 seconds. Do NOT place the cylinder under the water for any period of time; this cylinder is pressurized, and the hot water could raise the pressure to where the cylinder could explode. This method should be sufficient to fully remove any powder from the dispensing tube. Shake the cylinder vigorously to remove the water, and set aside to dry.

When all parts are completely dry, reassemble the puffer. Carefully place the cylinder back into the body, and press firmly to insert the dispensing tube into it's hole (do NOT force anything, you should feel a bit of resistance, not a lot, if so, something's not aligned properly). Test the output by discharging the unit like you would normally use it, but into the air. The "discharge plume" should be comparable to a new unit, if not and material is confirmed to be inside the cylinder, disassemble the unit and clean it again. If there is material in the cylinder, the plume should look like one from a new, unused unit. This will ensure that when used, the puffer is delivering the proper dosage of medication intended to the user.

I hope this 'ible is useful to those of us who suffer with breathing problems, or are caretakers for someone who has breathing problems. Thank you for viewing. Be well, stay safe and God bless. Rev. D.