Spacer device with face mask attachment for giving bronchodilators to infants with asthma.

ratings of different diagnostic groups yielded no significant differences except that "being in hospital" was more highly regarded by those with alcohol or drug dependence, manic patients rating this as the least helpful (one way analysis of variance; df= 6; F = 2 224; p<O005). Comment Ironically this study shows that the thing psychiatric inpatients value most about being in hospital is their ability to leave. Of the therapeutic items, simply talking to a care giver, be they doctor or nurse, was widely regarded as the most helpful aspect of care. We emphasise that, unlike some American studies,' the sample contained many highly disturbed psychotic patients. Nevertheless, being able to confide in a member of staff was still regarded as rewarding. Contact with other patients, both informally and in ward groups, was not judged favourably. This may be unduly confrontational for some, yet for others may provide a degree of support and exchange of information unavailable elsewhere. Drug treatment was judged on average to be only "quite helpful." The professionals' opinions were not surveyed, but from the consumer's point of view psychiatric training would be well advised to pay as much attention to "talking therapy" as it does to hospitalisation, treatment with drugs, occupational therapy, and ward rounds. We conclude that just as patients need help to understand the benefits of their drug treatment, so doctors need to be reminded that the time given to talking to the mentally ill in hospital, albeit less than one hour a week according to three quarters of our sample, is time well spent. KM's participation was made possible by an Astor Sclare scholarship. ASD is supported by the Medical Research Council. We thank the patients and staff of the Bethlem Royal and Maudsley Hospitals for their cooperation. About two fifths ofwheezy infants respond to nebulised ipratropium bromide with dramatic improvement in clinical signs and lung function within 15 minutes.' Over the past two years we used a disposable coffee cup as a spacer device when administering ipratropium bromide aerosol to young children. Most children aged under 18 months, however, disliked the jet of aerosol hitting their face, and compliance was poor. We adapted a spacer device for a metered dose inhaler (Nebuhaler) by adding a face mask, allowing children of all ages to be given the aerosol. Patients, methods, and results Eight children admitted to hospital for an exacer-bation of wheeze were studied. …