IPN July 2022

Back to School Checklist for Children with Asthma

Asthma is the most common chronic condition among children, affecting one in 10 children and adolescents under 18. Children with the condition miss on average five days of school each year, making it one of the leading causes of absenteeism.

There is a dramatic rise in the number of children admitted to hospital for their asthma in September each year known as the “September spike”. Triggers which are commonly found in schools include:

• Chemical fumes

• Perfumes

• Aerosols

• Chalk dust

In addition, changes in weather, an increase in fungal spores, moulds and in an increase in circulating viruses such as RSV all contribute to an increase in asthma symptoms at this time of year.

Advice for parents:

This checklist should help you control your child’s asthma during September and into the winter months.

• Have your child’s asthma reviewed by your GP in August/September

• Ensure your child has an Asthma Action Plan and it is up to date

• Use the inhaler technique videos on asthma.ie to help your child take their inhaler properly

• Make sure your child carries their reliever inhaler (usually blue) at all times

• Check that they take their medication every day with a fridge planner

• Leave a spare reliever inhaler and spacer in the school, with their name clearly labelled

Written by Ruth Morrow, Respiratory Nurse Specialist, Asthma Society of Ireland

• If your child is participating in PE or other activities, place a reliever inhaler and spacer in their bag

• Never send a sick child to school

• Show them how to wash their hands correctly and explain why this is important

• An older child/teenager often require extra supervision and cannot be relied on to selfmedicate independently - put systems in place as they may avoid taking their medication

• Visit the school and make sure your child’s teacher is aware that they have asthma

• Explain what their triggers are and what to do if your child has an asthma attack

• Check if there is a School Asthma Policy in place

• If your child is starting a new school, speak to teachers about your child’s asthma, even if they are well right now

Asthma Policy for Schools

The Asthma Society of Ireland recommends that all schools have an Asthma Policy in place that is reviewed regularly. As part of their Asthma Policy, it is also recommends that schools create an asthma record sheet for all students with asthma. The Asthma Society is warning teachers to be vigilant for asthma triggers at this dangerous time of year and to talk to parents to ensure you are aware of any students with asthma in your class.

Students with Asthma – advice for teachers

When a student with asthma joins your class, there are a number of steps can be taken to ensure they are supported as much as possible which include:

• Familiarise yourself with the school’s Asthma Policy

• Always ensure that students with asthma have access to their reliever inhaler including during school trips, sports and PE. Relievers should never be locked away.

• Tell parents when their child has an attack or needs their reliever inhaler in school and encourage older students to tell you or another staff member if they use their reliever.

• Speak to parents about concerns over missed days, tiredness in class due to night-time symptoms or lack of concentration due to asthma. Students with severe or poorly controlled asthma may require extra support due to missed school days.

• Monitor students with asthma to ensure they don’t feel excluded or experience bullying.

• Provide opportunities for all students to learn about asthma in class.

• Think about requesting resources from the Asthma Society of Ireland to ensure the school is well informed about asthma and how to manage the condition.

Once you know what triggers the child’s asthma, you can take practical steps to reduce their impact.

• Damp dust chalkboard and classrooms regularly to get rid of dust mites and pollen

• Don’t keep furry or feathery pets in the classroom.

• Try to avoid fumes in science and art classes.

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• Rigorously enforce a non-smoking policy on school grounds.

• Make sure the school is cleaned regularly.

• Heating and ventilation systems should be well maintained.

• Air classrooms to avoid mould and condensation.

• Avoid plants that give off high amounts of pollen

• Use non-latex gloves.

• Make sure that play areas and sports fields are free of autumn leaves as they are full of mould and fungal spores.

• Avoid mowing sports fields or grassy areas during school hours.

• Make sure changing rooms and bathrooms are well ventilated.

• Avoid opening windows and allow students with pollen allergies to stay indoors when pollen is high, such as during and after thunderstorms.

P.E. and Sports

Exercise improves lung function and is an important part of a healthy lifestyle. Asthma symptoms shouldn’t stop children from taking part in sport and PE, provided that certain precautions are taken.

Asthma Safe Schools in 2021

This programme is run by the Asthma Society of Ireland. 32 schools in total were funded to take part in the Asthma Safe Schools Pre Hospital Care Council (PHECC), approved, and certified training in basic life support and the administration of Salbutamol for emergency treatment of adults and children (< 16 years) with an acute asthma attack. Schools were selected on a first come, first serve basis and each school nominated one teacher/SNA to attend the training day. The training was provided by the Irish Ambulance Training Institute. It involved an Asthma Safe School Webinar, Asthma Safe Schools Training Day and an Asthma safe school Pack.

A survey carried out by the Asthma Society on the Asthma Safe Schools Programme 2021 showed that:

• 55.5% of teachers who participated in the programme identified themselves of having gained considerable asthma management knowledge.

• 89% of participating teachers believe that they have been provided with the training and tools to provide a supportive and safe environment to children with asthma.

• 78% of teachers gave a star rating of 4 or more when asked how confident that they would be in the management of another person who is having an acute asthma attack in the out-of-hospital environment until handover to an appropriate person.

• When asked if the Asthma Safe School’s Programme has increased teachers overall

knowledge of asthma, 45% agreed and a further 46% strongly agreed.

• 90% of teachers said that they would recommend this programme to others and it was found that both the webinar and the training day were found to be the most beneficial aspects of the program.

• 100% of respondents said that they would use the Asthma Adviceline (1800 44 54 64) and the WhatsApp Messaging Service (086 0591032) if they had any asthma related queries.

This article has addressed managing asthma in schools at a time of year when asthma can be increasingly problematic. Strategies for children, parents and teachers were discussed.

Pharmacists and technicians can send a message to the WhatsApp service on 086 0590132 if they have questions/queries about asthma/COPD and an asthma nurse will respond.

Getting Ahead of Lice

Back2School Headlice

While several health concerns come to the forefront as students head back to their classrooms, head lice seems to top the list at most pharmacies.

Head lice are tan to grayishwhite, 6-legged, wingless insects typically measuring 2 mm to 3 mm in length, or about the size of a sesame seed. Because lice crawl and do not jump, head-to-head contact is the primary route of transmission. Once on the scalp, lice attach eggs to the base of hair shafts a few millimeters from the scalp surface.

Once laid, eggs hatch within 9 to 12 days, and the resulting nymph matures into an adult louse over the subsequent 9 to 12 days, for a full reproductive cycle of approximately 3 weeks’ duration.

Typical signs of head lice are usually itchiness on the scalp, around the ears and the back of the neck. However, some people may experience no symptoms at all.

Because lice eggs are located on hair shafts approximately 4 mm from the scalp, it is often easier to identify eggs by searching at the back of the hairline, where they are most visible. Research suggests that wetting hair before combing improves diagnostic reliability.

There are several methods that can be recommended for

managing a head lice infestation. Pharmacy teams should help customers choose the most appropriate product for their child because not all treatments will be suitable for everyone.

Understanding a person’s preference, medical and drug history, the product’s active ingredient, how the active ingredient works, how the product should be used and if anything has been tried previously will allow pharmacists and pharmacy staff to recommend and help parents choose the right head lice product.

Mechanical removal involves systematically combing the whole head of wet hair with a detection comb to remove the lice. The comb must be cleaned after each pass through the hair to remove lice and eggs, which is best done by wiping it on clean white paper or cloth.

The process must be repeated every few days for two weeks. Products containing dimeticone or isopropyl myristate kill the lice through physical action. Dimeticone coats the surfaces of head lice and suffocates them, while isopropyl myristate

dehydrates head lice by dissolving their external wax coating.

The advantages of these products are that they are easy to apply, they have few side-effects, are odourless or have only a faint perfume, and the head lice are unlikely to become resistant to them.

Instructions must be followed exactly otherwise the treatment won’t work. Some of these products don’t kill louse eggs either, so it is vital that the treatment is repeated after a week to kill any lice that have hatched since the first application.

Many parents are looking for allnatural remedies, so it would be wise for pharmacies to stock up on both traditional and alternative choices. It’s also important to alert parents to this topic, as they need to be inspecting their children for ticks and lice and so whilst stocking up on head lice products, education shouldn’t be missed.

Make sure head lice products are prominently displayed, along with educational brochures. Remind parents that their children should not share hats and also point out places where lice can be contracted.

PHARMACYNEWSIRELAND.COM