1. Connect the mouthpiece to the reservoir (accordian) bag, and twist to tighten.
   
   
2. Open the bag all the way.
   
   
3. Remove the spray canister from the inhaler and shake 4-5 times.
   
   
4. Put the medication canister gently in the mouthpiece.
   
   
5. Put the mouthpiece in your child’s mouth
   (make sure the canister is pointing up).
   
   
6. Press down the spray canister so that 1 puff of medication is released
   (never use more than 1 spray at a time).
   
   
7. Have your child breathe in slowly and deeply
   1. The bag should squeeze shut completely.
   2. If your child breathed in too fast, you will hear a warning noise.
      
      
8. Have your child hold his/her breath for 5-10 seconds or as much as is comfortable.
   1. If your child is unable to hold his/her breath, then have him/her breathe in and out, very slowly, 5 times).
      
      
9. Breathe out through the mouthpiece, expanding the bag fully.
   
   
10. Repeat steps 2-9 for as many sprays of the medication as are recommended.

The mouthpiece should be cleaned and rinsed with warm water every day it is used.

The pieces should be air dried and completely dry before storing.

The reservoir bags need to be replaced monthly with routine use.

The reservoir bags should be replaced immediately if there is a tear or hole in them, or if there is any visible dirt in the bag.