Unexpected Painful Breath

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Unexpected painful breath. When teaching patients about the proper use of an inhaler, be sure to emphasize the importance of recapping the device after use. We were reminded of this recently when reading the April 9, 2015 BMJ Case Reports. A woman accidentally inhaled a small earring while using her asthma inhaler, which was uncapped and stored in her purse (www.ismp.org/sc?id=575). As she inhaled the medicine, she felt a painful scratch in her throat and started coughing blood. She was taken to the emergency department, where the earring was removed from her lung. If the inhaler's cap had been in place, the loose earring in her purse would not have gotten into the inhaler.
Another event was reported in April 2015, in England (www.ismp.org/sc?id=576). A woman used her inhaler and suddenly felt something shoot to the back of her throat. She began gasping for air and spitting up blood. She ran outside, and a neighbor came to her rescue and called emergency medical services. The woman eventually coughed out a fake nail that had been part of a set she had worn weeks ago. In this case, the inhaler's cover had been in place before use, so the nail had probably lodged in the inhaler while using it when wearing the nails.
Tell patients to always inspect the inhaler thoroughly before use to ensure that there are no unwanted objects within the inhaler. Also be sure to have them replace the inhaler cap after every use. Some of the newer inhalers have an attached cap. If a foreign object enters the inhaler, it places the person at risk of breathing in the object and causing choking or severe respiratory difficulties.
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