When transport time for a child is extended, it can be increasingly difficult to get them to stay on task with your patient care plan, e.g., breathing properly so the albuterol treatment has a chance to work. This is even more difficult if spinal motion restriction steps have been taken.
Some agencies get small teddy bears and put agency T-shirts on them. Getting a new toy is always a plus to a kid, and you can use that to your advantage: "How about I listen to your bear breathe and then I will listen to you breathe?" Given the tough budget times, an inflated glove adorned with either pen or marker is still an all-time classic diversionary toy that works in a pinch.
Throughout the entire time a child is in your care, be honest in every aspect of your communications. Most kids have a finely tuned BS meter and know instantly if they are hearing a fairy tale. Being honest is especially important if you are going to do something that will cause pain or discomfort, whether it's starting an IV or splinting a fractured wrist or dislocated shoulder. Misleading or lying to a child is never a good idea. The long-term impact when such things do occur could be significant in planting seeds of mistrust that future healthcare providers will have to deal with.