The document is an instructional guide in english on how to use a metered-dose inhaler (MDI) with a spacer. It provides detailed, step-by-step instructions for using the device effectively to manage respiratory conditions like asthma. The guide emphasizes the importance of correct technique, preparation of the inhaler, and proper administration to maximize the medication's effectiveness. It also highlights essential points for cleaning the spacer and mentions contacting a healthcare professional for additional assistance or guidance.