Babies and toddlers who resist nebulizer treatments greatly increase the challenge of managing asthma and bronchiolitis. A trick I learned while trying to calm a child with severe asthma has proved useful with many subsequent patients: Making sure to maintain eye contact with the patient, I sing a song-any song with a quick tempo-while the child is receiving nebulization. Singing often distracts young children for a good five to 10 minutes, long enough to ensure effective treatment.
One recent winter, when I was taking care of children with asthma and bronchiolitis in an inpatient unit, I encouraged parents to sing to their child when he or she received nebulization. At regular intervals, the staff was entertained by parents serenading their children.
Stephen Reingold, MD Brooklyn, N.Y.