Use of teddy bear nebulizers might make ED visits less stressful

Children are often apprehensive when in respiratory distress, and the use of a nebulizer can increase their anxiety. New Kid 02 aerosol and oxygen delivery systems shaped like teddy bears, in bright colors of yellow, orange, and green, are designed to calm children.

"Most kids will respond to the shape of a teddy bear because they probably have one at home. This is much less threatening than if you use a scary piece of medical equipment that looks like a big hose spewing vapor at them," says Conrad Salinas, MD, FACEP, chairman of the department of emergency medicine at San Bernardino County Medical Center (CA). "Instead of being apprehensive, they can hug the bear and not even realize they are getting medication."

Children are very nervous in this scenario, stresses Diane Lomax, RN, department administrator for emergency medicine at Kaiser Riverside Medical Center (CA). "Children who have respiratory problems and are unable to breathe effectively are very anxious," she notes. "Visits to the ED can be scary because we give medications and start IVs, so children are leery of any type of treatment we give them. If we can provide them with a cute little bear instead of a scary device, it’s very beneficial for the child."

The teddy bears can impact the quality of care a child receives, Lomax says. "If the child is crying and moving [his or her] head back and forth, they are not getting a benefit from the mist," she explains. "They are already having difficulty breathing so you don’t want to do anything that would increase their anxiety. If they are quieter and not fighting it, then you get a better result with the breathing treatment."

The bear-shaped nebulizers also have long-term benefits. "It helps physicians in the future, because the child will be apprehensive if a big mechanical device is thrust on them and they are held down," says Salinas.

The device also pleases parents, Paula Sletten-Fenton, RN, MS, CEN, ED manager Hemet Valley Medical Center (CA) says. "Parents of children we’ve given it to have very positive comments about it, because it makes the patient more willing to take the medication and distracts them. Parents would much rather have them use the bear than being held down because then the child develops a fear and doesn’t want to come to the doctor again."

However, cost issues are a factor, since the nebulizers are $15.95 per unit. "We’ve got a fairly large asthma population, and these units are relatively expensive. The regular nebulizers cost under a dollar, so this is a difference of about $15. Therefore, we are very judicious about how we use them. Instead of using them on every asthma patient, we use them on children in distress," says Sletten-Fenton.

The parent can shed light on whether the child will become anxious with the nebulizer. "Ask the parent if the child has had a breathing treatment before. If so, how did they take it? If they indicate that the child hasn’t done well in the past and has been very afraid, you know it’s a good idea to use the bear," says Lomax.

Children take the teddy-bear shaped nebulizers home. "Parents like the idea of having the teddy bear to take home. The next time the child comes to the ED, the parents bring the bear with them so we can use it again," says Lomax. "We just hook it up, and a regular nebulizer fits right into the back of the bear. Also, some of these children have machines at home, so they can use it on their equipment at home."

The teddy bear nebulizers are a concept that reflects a trend, says Salinas. "It’s an ingenious idea with many other applications," he says. "In the future, we [will be] looking at more surreptitious types of methods of delivering medications, especially to children."

Editor’s Note: For more information about Kid O2’s nebulizers, contact BLD Medical Products, 4450 Alpha Road, Dallas, TX 75244-4505. Telephone: (800) 872 9010. Fax: (972) 239 0310. World Wide Web: