Wednesday, July 7, 2010

Trick of the Trade: Blowing out the candle

How do you teach pediatric patients, especially toddlers, how to cooperate with your pulmonary exam? How do you get them to take adequately deep breaths in and out?

Trick of the Trade: Blow out a candle

With your stethoscope positioned on the patient's back, ask the child to pretend like they are blowing out a birthday candle. Personally I have had variable success with this trick, because the child has to imagine a candle in front of them. Sometimes it works, but other times they just look at me like I'm crazy.

However, what if they had a virtual candle in front of them?


Trick of the Trade (high tech): Candleflame iPhone app

This free iPhone app displays a virtual candle burning for about 20 seconds. It is a slight hassle because a brief ad pops up at the beginning, which you have to manually select to skip over. It's worth the minor hassle, because one can blow out the candle if you sufficiently blow hard enough at the virtual candle. The sensor is the iPhone speaker piece at the bottom of the unit.

Since then, I have used this as a means to grossly assess an asthmatic child's peak flow ability if s/he can't coordinate using a peak-flow meter. You can adjust and increase the distance from the child to the iPhone to encourage maximal expiratory effort.


(Turn audio on in this video to hear me blowing out the candle.)


Posted by
Labels: , ,

4 comments:

  1. Hi Dr. Lin,

    One of the "tricks" we use to distract children on the ambulance is to have a penlight which we pretend is a candle. We ask the child to try to "blow it out" when we turn it on. (We demonstrate this to the kids first and of course the medic can always blow the "candle" out.) Might be something to try if you don't have an iPhone handy!

    ReplyDelete

  2. Ha, that's a terrific idea! Much quicker than trying to load up an iPhone app as well. Thanks for the idea.

    ReplyDelete

  3. In our ER I like to use cotton balls. I place the cotton ball in the palm of my hand and blow (while quickly lifting my hand, its gives the ball some height). The child sees the cotton ball ascend through the air. I then ask them to do the same. The kids love blowing the cotton balls out of my hand and I can hear great lung sounds.

    ReplyDelete

  4. I'm loving the cotton ball idea. Sadly no cotton balls easily accessible in our pediatric ED side...

    ReplyDelete

Subscribe to: Post Comments (Atom)