Steam inhalation therapy

Abstract

I think the conclusion of the article Steam inhalation therapy: severe scalds as an adverse side effect1 is excessively restrictive. I do not know how ‘steam inhalation therapy’ is administered in the Netherlands, but I know practice in Britain has changed in the last four decades. We no longer use Nelson inhalers. Many patients inhale over a washing-up bowl of boiling water, which brings in risks of transporting water from kettle to bowl to accessible table. I recommend either the use of a mug-full of boiling water, or the less-risky ‘hot beverage’, that certainly appears to reduce the risks in handling and in the total quantity of thermal energy if there is a spill. Alternatively, I recommend ‘steaming’ in a bath or shower of normal bathing temperature, this is substantially less than boiling, and should not induce more scalds than the ordinary weekly ablutions. I disagree with the article’s conclusion that there is no evidence of therapeutic benefit. There is a huge amount of anecdotal evidence for its therapeutic efficacy, in ENT and chest medicine in hospital as well as in general practice. I have never seen a scald from steaming; I have seen many from hot drinks: should we ban drinking?