Pressurised metered dose inhalers (pMDI): risk of airway obstruction from aspiration of loose objects

The MHRA has received reports of patients who have inhaled objects into the back of the throat.  This has resulted in coughing, and in some cases aspiration of objects, causing airway obstruction.

Advice for healthcare professionals:

  • Patients should be trained in the correct use of their inhaler (instructions are included in the patient information leaflet)
  • Patients should be told to remove the mouthpiece cover fully, shake the inhaler to remove loose objects that may not be visible, and check the inside and outside of the mouthpiece are clear before inhaling a dose
  • Patients should be reminded to replace the cover immediately after use, ensuring that it clicks into place. This will prevent objects entering the mouthpiece of the inhaler during storage
  • Pharmacists dispensing a pMDI should emphasise to patients the need to clean the device regularly and to inspect the device for signs of damage in order that damaged devices can be immediately replaced
  • Any adverse incidents relating to the use of inhalers should be reported on a Yellow Card