Barbara Cirella, RN, MS, CPNP-PC, AE-C of Meridian Health Care System presented to the membership about the Community Outreach for Asthma Care and Healthy Lifestyle (COACH) Program. She discussed how school nurses are very important links to the care management of children with asthma.She noted that there are still many physicians conveying the idea that asthma is a one time thing. They are not explaining that is a condition that should be monitored and treated throughout one's lifetime based on the occasional flair-ups and need for maintenance.
Ms. Cirella stressed how there are two types of asthma- intermittent and persistent, describing the differences and different way each should be treated.
In NJ,we have a law (P.L. 2001, CHAPTER 61) that requires all student have an Asthma Treatment Plan, it was stressed that for "Red Zone" episodes, 4 puffs of MDI are to be given! This is noted on most recent ATP from PACNJ.org (click here) based on research from the National Heart, Lung and Blood Institute. If nebulizer treatments are ordered follow orders per ATP.
This discussion concern MDIs prompted a number of questions from school nurses. The main question asked was how do parents obtain an extra spacer that can be for school use or how can school nurses themselves get spacers without utilizing health office budget A few ideas were tossed about, but no firm solution. Use of a spacer in children was provided with a checklist tool. A key reminder to school nurses, is not to wrap or use paper towels on spacers and MDIs as the fibers can be inhaled into the lungs causing an infectious process. Spacers are to be air-dried and not stored in plastic bags or containers unless completely dry.
As indoor and Outdoor Air Quality affect people with asthma. The consideration for school nurses to consider teaming up with their school's ground and maintenance department for training toward becoming an Asthma Friendly School or Child Care Center (click here). Ms. Cirella shared an additional tool that schools can utilize for allergy and allergen assessment from the Asthma and Allergy Foundation of America (click here).
Ms. Cirella provided her contact information for school nurses to contact about school presentations for staff, parents and various grade-levels. [email protected]