How to hold a small child to give an inhaler

1) Nurse consultation

The following scene is an example of a consultation between a respiratory nurse and a mum of  a child with asthma who is having problems getting her child to take inhalers. Respiratory nurses can give lots of tips about your child’s asthma.

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Scene 1

  • Nurse says “Hello Sarah”
    Nurse thinks “She looks tired!”
  • Mum says “Hi Elaine”
    Mum thinks “I’m exhausted. This is going to be another waste of time”

Scene 2

  • Nurse says “So I know you already know HOW to give Chloe her inhalers but I understand she’s not co-operating with you too well?”
    Nurse thinks “Perfectly normal behaviour for her age – I can help a lot here”
  • Mum says “Well I’m trying, but she doesn’t want to take them and has a tantrum”
    Mum thinks “To be honest I’m so tired fighting I haven’t really given them to Chloe for a few days, it’s just so much hassle. Easier not to bother!”

Scene 3

  • Nurse says “Well that is totally normal behaviour for her age and I can give you lots of tips and advice to get the medicine into her lungs more effectively!”
    Nurse thinks “This won’t be easy for Sarah but it will be worth it in the end”
  • Mum says “Whatever you think is best nurse”
    Mum thinks “Aye right!!”

Scene 4

  • Nurse says “OK there are 2 things you need to know. One is the practical side and the other is the emotional side. This is not going to be easy for the next week or so, but it will work”
  • Mum says “OK tell me …”
    Mum thinks “Oh dear I’m too tired for this”

Scene 5

  • Nurse says “We call the practical technique clinical (or therapeutic) holding, and we use that in young children when you have tried different distractions and encouragements and your child still won’t co-operate. Remember, at Chloe’s age she will push her boundaries with you, to see how far you will let her go”
  • Mum thinks “She’s pushing her boundaries all right, about everything just now. Tantrums all the time. She’s not like that with her gran!”

Scene 6

  • Nurse says “You wouldn’t let her put her finger in a socket or touch the cooker, so you have strong boundaries for these things. Her inhalers have to be the same. They can be life saving medicines at times. You need to be like Supernanny!”
    Nurse thinks “I don’t want to scare them but I do need them to take this seriously. Chloe had a severe attack last month when she was diagnosed with asthma and admitted to the children’s ward”
  • Mum thinks “I was so scared when she was unwell and couldn’t stop coughing and wheezing. I felt helpless and I don’t want to feel like that again”