Asthma at School: What This School Nurse Wants You to Know

Asthma at School: What This School Nurse Wants You to Know

School can be a stressful place for students, especially for those with special circumstances like asthma.  As a School Nurse I would like to encourage you to keep us in the loop of your student’s asthma.  Every student experiences asthma differently and their asthma management is specific to them.  With open communication, continuous education and planning managing your student with asthma at school will run smoothly.  Keeping the School Nurse updated on medication changes, even sending a quick e-mail to let us know when the last nebulizer treatment was given ensures continuation of care for your student when they are not feeling their best.  Notifying the Health Office about triggers and ER visits gives us the information we may otherwise not know to keep a closer eye on them when they may be struggling at school.  We want to be there to support, to comfort and the intervene as appropriate to allow your student to have the best possible educational experience. 

To ensure that your care team is providing the most appropriate care for your student please have your physician complete an Asthma Action Plan.  Having documentation of all medications, expectations, triggers and interventions supports the School Nurse not only in caring for your student but also in educating the school staff on how to act when they are with the student until the School Nurse arrives.  Knowing exactly what to expect and do in the time of need for those nonmedical staff members builds confidence and awareness to subtle changes that may otherwise not be identified. 

Medications are key to managing asthma.  Having a rescue inhaler at school is essential.  The most stressful situation a student can be in, is having the need for their inhaler and waiting for someone to bring it in from home.  Having one on hand in the Health Office so the student can be assessed and treated within minutes can get them the support needed and back to class without incident. It is important for the students to not only know what medications they are taking, but also to know why they are taking them and what side effects they may experience.  The School Nurse has the opportunity to reinforce medication education, proper inhaler/nebulizer usage and assess for effectiveness at every dose they administer. 

As a School Nurse here are the top things, I want every student and parent/guardian to know about managing asthma at school:

  • Communication is so very important – let us know what is going on with your asthma!
  • Medications are essential for asthma management
    1. Have an rescue inhaler available at school
    2. New medication orders are required for every new school year
    3. Communicate last dose given
  • Education at home and at school about asthma, medications and management, supports the student in building confidence and ownership of self-care
  • Provide the School Nurse with an Asthma Action Plan completed by your Physician
  • The School Nurse is your advocate for any health-related issues in school
    1. Acts as team leader to educate staff about student care
    2. Advocates for health-related accommodations
    3. Liaison between physician and school

Asthma in school doesn’t have to be stressful when we focus on the student and keep in mind communication, education and planning.  When we do, we create a winning care team for the student and allow them to have a positive school experience.

Coronavirus Information & Resources

Coronavirus Information & Resources

Coronaviruses are a large family of viruses that are common throughout the world. These viruses can live in animals, such as camels, cats and bats, and at times, evolve and infect people, before spreading through human to human contact. Human coronaviruses spread just like the flu or a cold—through the air by coughing or sneezing; through close personal contact, like touching or shaking hands; by touching an object or surface with the viruses on it; and occasionally, through fecal contamination. This has occurred previously with the Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS) outbreaks.

People most at-risk of contracting a coronavirus are those who have traveled to places where the virus is occurring. In the case of the novel coronavirus, that location is China, and particularly the Wuhan area and the Hubei province.

The Pennsylvania Department of Health (DOH) frequently exercises and prepares for a potential infectious disease outbreak. They have been monitoring the coronavirus outbreak in China using information from federal and local partners and are preparing response teams in case of an outbreak here. DOH has talked with health care partners about the potential spread of the coronavirus into the United States and how they will work with public health to evaluate potential cases.

DOH has issued several fact sheets related to the Coronavirus.

Please share these fact sheets with early childhood education professionals and community partners.

In addition, the Bureau of Certification recently released information pertaining to child care professionals.

For more information, visit the PA DOH website.

Understanding TB Symptoms

Understanding TB Symptoms

Jessica Schuman RN BSN AE-C

Tuberculosis (TB) is a bacterium that is spread from one person to another through tiny droplets released into the air from coughs and sneezes.   In the United States, TB was considered to be decreasing in incidence over the past years due to strong control programs, but still remains a concern today.

Tuberculosis is categorized into two different groups; Latent and Active.

Latent TB is a condition where the bacterium remain in the body in an inactive state and with the help of the immune system, prevents you from becoming sick.  Even though people with latent TB have no symptoms and are not contagious, it can turn into active TB, so treatment for latent TB is very important to help control spread.

Active TB is the condition that makes you sick and can be spread to others.  It can occur anywhere from a few weeks to years after being infected by the bacterium.

Per the Center for Disease control (cdc), the signs and symptoms of active TB include:

  • Coughing that lasts three or more weeks
  • Coughing up blood
  • Chest pain, or pain with breathing or coughing
  • Unintentional weight loss
  • Fatigue
  • Fever
  • Night sweats
  • Chills
  • Loss of appetite

It is important to see your doctor if you have a fever, unexplained weight loss, drenching night sweats and a persistent cough.

The treatment of TB consists of taking medications for several months.  It is very important to seek treatment for exposure to TB, to help prevent the spread. If you feel if you have been exposed, immediately contact your doctor or local health department.   It is also important to use the NCBI recommendations for proper respiratory hygiene/cough etiquette by covering the nose/mouth when coughing or sneezing; cough or sneeze into elbow rather than hand. Cover your mouth and nose with a tissue when coughing or sneezing; use the nearest waste receptacle to dispose of the tissue after use, and perform hand hygiene with soap and warm water.

* https://www.cdc.gov/tb/default.htm
* https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3846148/

Protect Your Home & Family from Radon

Protect Your Home & Family from Radon

Written by: Douglas Kaup

January is Radon Awareness Month, making it a good time to share some facts about radon in western Pennsylvania.  Radon comes from the breakdown of trace amounts of uranium in our soil.  It is a gas it moves up into our homes where it becomes trapped, and presents a danger to us in the form of lung cancer.  Even at levels below the recommend remediation level of 4 pCi/L radon can still be dangerous; however a radon level of 0 pCi/L is considered impossible to achieve through modern remediation technology.

Pennsylvania radon levels are high compared to other states.  According to the Pennsylvania Department of Environmental Protection (DEP), 43% of the homes in Allegheny County are high in radon, along with 51% in Butler and 58% in Beaver.  Because of the high levels of Radon in Pennsylvania, lung cancer diagnosis is usually found later in the disease progression.

What can you do?  Test your home.  Licensed Measurement Technologists can be found on the state DEP web side.  Short-term self-test kits can be purchased through Breathe Pennsylvania. 

Additionally, when you buy a home make sure it is tested.  You cannot be forced to buy a home with high radon in Pennsylvania.  It is a great opportunity to have a home remediated before you move in.  Also, when you are selling a home make sure testing protocols are followed.  If your home radon level is high and you don’t properly remediate then you are potentially putting someone’s health in danger, and could inadvertently raise radon levels in your home. It is also worth knowing that tampering with an ongoing radon test is illegal. 

In the end radon can be remediated, and doing so not only benefits present owners, but future ones as well.

Air Cleaners and Indoor Air Quality

People, especially those with lung issues, are often interested in improving their indoor air quality or IAQ.  According to the EPA, one should take a three prong approach to improving IAQ.

The first prong is air cleaning.  Air cleaners alone will not keep your IAQ high, but when used with the other methods, one should be able to keep their air fairly clean.

When buying an air cleaner, think about what you want from it. There are three possible uses—limiting particulate matter, limiting germs or limiting smells.

If a homeowner is trying to limit particulate matter, they may already have an air cleaner in their home.  Most furnace and AC systems have a filter system.  Consistently changing the filter or cleaning the charged plates – if the filter system is electronic – should have a significant effect on limiting particles in the air.  Consult a licensed HVAC technician to verify if you have such a system at home and to instruct on proper usage.

Homeowners that do not have such a system in their home should consider buying a filter-based air cleaning system, and it should be properly sized for the home.

If you’re interested in limiting germs, consider a UV based system.  Ultraviolet light is known to be germicidal, and is commonly used to kill germs in both air and water.  Fortunately, there are many units on the market that claim to do both of these.

Getting rid of smells is a different issue.  Doing both filtration and killing germs can help remove the source of some smells.  However, if smells are a big issue then the best method of removal is carbon filtering.  Free standing carbon filter air cleaners can be purchased, and carbon filters for HVAC systems are also available.

TIP: Make sure that the air cleaner you choose is NOT an ozone air cleaner.

Two additional prongs for improving IAQ that should be used with an air cleaning systems:

Source control involves removing sources that can affect IAQ.  Look for mold-like staining (especially in basements), household chemicals that are no longer used should be thrown out, and remember to test for radon when buying a home.  A good dusting and sweeping routine will always be helpful to IAQ.

Ventilation is easy enough.  The air outside is usually far cleaner then the air inside.  When the temperature is not too hot or cold open the doors and windows and enjoy the fresh air.  However, be aware during alerts for ozone action days or high pollen.

A three prong approach should help keep IAQ good for those interested in keeping lungs healthy, or helping those whose lungs don’t work as well as they should due to various medical issues.

 

Information for this article based from https://learn.allergyandair.com/types-of-air-purifiers/

And the DEP at https://www.epa.gov/indoor-air-quality-iaq/ozone-generators-are-sold-air-cleaners

Have Lung Issues? Stay Away from Ozone Air Cleaners

Ozone is a gas that is comprised of three oxygen molecules and can easily interact with other chemicals.  Simply put, it is bad for our lungs.

According to the EPA “When inhaled, ozone can damage the lungs. Relatively low amounts can cause chest pain, coughing, shortness of breath and throat irritation. Ozone may also worsen chronic respiratory diseases such as asthma and compromise the ability of the body to fight respiratory infections.”  Additionally, when used at safe levels, ozone is ineffective at eliminating indoor particulate matter.

So what does all this have to do with air cleaners?  There are companies who make and market ozone producing devices, and then sell them as air cleaners.  The reason these devices are sold as air cleaners is because ozone, in large amounts, can neutralize strong odors.  This gives the user the feeling that the air is clean.  The assumption is made that the smell is gone so the air must be clean.

In short, if someone has issues with indoor air quality and their lungs they should not use an ozone generator based air cleaner.  How would one know?  Read labels carefully.  They are often marketed with phrasing the same as or similar to “energized oxygen or “pure air”.  According to the makeup of the molecule, Ozone is a different chemical with different “properties” then breathable oxygen.  These people should take other action to clean their air.

Some vendors say that these devices have been approved by the federal government.  In fact, NO federal agency has approved these devices for use.

For more about air cleaners, read this blog post.

 

Source: https://www.epa.gov/indoor-air-quality-iaq/ozone-generators-are-sold-air-cleaners

Peer Pressure and Vaping

The kids are back in school, and as the parent of a teenager, it seems as though one of the biggest fears I have surrounds peer pressure and positive decision making.  As a child enters the teenage years they tend to spend more time with their group of friends. I have no doubt that many friend groups make positive choices but the reality is peer pressure among teenagers is usually associated with risky, negative and impulsive choices.

This school year, our kids are going to be faced with different types of peer pressure and lots of challenging decisions.  Smokeless Saturday, which is a diversionary program for kids that are caught on school property with tobacco products, received over 1,300 referrals in the 2018-19 school year.  About 92% of these referrals were due to Electronics Nicotine Delivery Systems (ex. JUUL and Suorin).  If we have 1,300 kids that got caught with these products, can you imagine how many didn’t get caught?  Do you question how many students posted videos or pictures on social media with these products?  Do you think that your kids are seeing these products on the bus?  At the park?  On Snapchat?

The use of electronic cigarettes has drastically increased which has left school administrators and parents asking what they can do.  I encourage you to learn the current product trends (ex. devices, ingredients) and gather resources.   Then start the conversation with your kids regarding peer pressure, drugs and addiction.

So as we kickoff the 2019-20 school year lets work together on continuing the conversation and educating youth about the risk of using tobacco products.   Encourage your child to create a healthy lifestyle, make good choices and pursue meaningful goals over the upcoming school year.

For additional resources, please visit www.breathepa.org.

 

Sources:

https://www.health.pa.gov/topics/programs/tobacco/Pages/E-cigarettes.aspx

https://www.cdc.gov/tobacco/data_statistics/sgr/2012/pdfs/parent_card508.pdf

Breathe PA Awards Lung Research Grants

Breathe Pennsylvania awarded $40,000 to three individuals for the purpose of conducting research leading to improved care and outcomes of lung disease patients.

Congratulations to the recipients:

Merritt Fajt – “The Impact of Longitudinal Allergy Changes on Asthma and Severe Asthma in Western Pennsylvania”

 

Kathleen Oare Lindell (pictured with Dr. Frank Sciurba) – “Early Integration of Palliative Care for Patients with Advanced COPD and their Caregivers”

 

Brandy Hill – “Asthma Institute Registry (AIR)- environmental health assessment- a pilot study in the Mon Valley”

Loud, Frequent Snoring Could Indicate OSA

When it comes to sleep, I’m not afraid to admit that it’s something I look forward to and enjoy immensely. There’s nothing like getting into your own bed and getting ready for a great night’s sleep. But then it happens- your sleep partner starts snoring. It’s not just a gentle faint snore, it’s the kind of snore that makes the whole house shake! Most may not even realize their partner’s snoring or they snore just as loud themselves. Some may pass this off as an irritating event, but you live with it. Others may have a hard time sleeping at night due to their partner’s snoring.

While we may pass this off, loud and frequent snoring is an indicator of obstructive sleep apnea (OSA), a chronic sleep disorder characterized by pauses in breathing or shallow breaths during sleep that affects as many as 22 million Americans. If you or your partner are a frequent loud snorer, stop breathing throughout the night, experience restlessness at night or are excessively sleepy during the day you may want to discuss your symptoms with your doctor.

If your bed partner decides to speak with a doctor it would be beneficial to track behaviors you have observed from them including details of the time it occurs and how often. Since they are asleep some questions the doctor asks may be difficult for them to answer.

Observable behaviors you may want to record include:

  • Snoring- the intensity and what makes it worse
  • Occasional loud snorting
  • Twisting or kicking legs
  • Choking
  • Pauses in breathing
  • Talking in sleep
  • Wetting bed
  • Getting out of bed when not awake

When breathing pauses in a person with OSA, they are usually moving out of a deep sleep into a light sleep which lessens sleep quality. OSA can also trigger the release of stress hormones, change how your body uses energy, and make you feel tired and sleepy during the day. There is also evidence that OSA leads to a greater risk of high blood pressure, heart attack, stroke, congestive heart failure, atrial fibrillation, diabetes, certain cancers and even sudden death.

There are several potential negative health effects of insufficient sleep, such as weight gain, memory loss, skin aging and more. Treating either condition can decrease these risks. Part of living a healthy lifestyle is getting quality sleep.

Even if the snorer may feel as though the condition is not disrupting their sleep, their bed partner may feel differently. For everyone who is getting nudged or elbowed from a frustrated bed partner or those whose sleep has been disrupted it’s important to know what your partner’s snoring means and a way you both can get back to a good night’s sleep.

Back to School with Asthma

The time has come and kids are heading back to school.

At the top of your list of “must dos,” should be how to prepare for another successful school year supporting the management of your child’s asthma with anyone who interacts with him or her.

Who is on that list? Maybe a few people you hadn’t considered or maybe you have but didn’t know how to get started.

The school nurse, teachers, the school bus driver, and anyone who’s on the “need to know” list set by the school nurse and you. Establishing a good network of care will help to insure your child’s safety as well as encourage him or her to participate in all aspects of the new school year.

The whole process is much easier if roles and responsibilities can be defined for the asthma doctor, the school nurse, teachers, the school bus drive and, of course, for you and your child.

You and your child need to complete an Asthma Action Profile to verify what you do and don’t know about your child’s asthma. It is important your child be included in establishing a current asthma record because you won’t always be there when he/she needs help. Visit www.breathepa.org  or call 800-220-1990 and request an Asthma Action Profile. Make a copy of the one-page Asthma Record for the school nurse.

Next, meet with your physician, so your child and you can discuss, then create an Asthma Action Plan. This plan should cover medications used at home and school, purpose, dose, and what to do if your child has an asthma attack at school. Remember to provide current contact information and provide the needed medication for the school nurse office.

Meet with your school nurse and discuss what information should be shared with teachers and school bus driver. Your school nurse can determine the best way to share this information.

Everyone on the same page will help support your efforts in keeping your child healthy, in school and ready to learn. For additional information or to find out how you can bring an asthma program to your school, contact Jeannie Simms at 412-855-4594.