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If you have difficulty using your metered dose inhaler, you could ask your doctor or nurse for a spacer. There are large volume spacers and small volume spacers and you can use one or more breath with each. I will show you the one breath method with the small spacer and the multiple breath method with the large spacer. To use the small spacer, you remove the cap from the inhaler. Check again no dirt or dust, same with the spacer device. Check that there’s no dirt or dust. Shake the inhaler, four to five times. Pop it in the end of the spacer, like so. Put the spacer in your mouth. and as you start to breathe. Press the inhaler, big breath in and then hold for a count of ten like this (EXHALES, PUFF, EXHALES). To use the large volume spacer you have to connect the two halves. There is a notch in the spacer. And you just line it up (CLICK) and put it together like so. Then again you get your inhaler and I like to call this shake, rattle and roll. Shake then inhaler to mix it. Rattle the spacer a little bit to make sure the valve’s working. Pop your inhaler in the end. Put it up to your mouth. Press the inhaler once and then just breathe in and out, normally for four or five breaths. Like this (RATTLE, PUFF, BREATHING… BREATHING CONTINUES). Refer to the manufacturer’s instructions for cleaning and renewing your spacer device.