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Australian Asthma and Respiratory Educators Association National Conference Legends Hotel, Surfers Paradise Queensland Clinical Nurse Consultant – Acute Respiratory Sydney Children’s Hospital, Randwick 2031 The national conference provided an opportunity for respiratory educators from around Australia and New Zealand to learn and share from one another evidence based practices and clinical resources. The 180 delegates from a number of disciplines such as nursing, health education, pharmacy and medicine made this possible. The conference covered many topics encompassing asthma and COPD however this report will focus on topics of interest in relation to the management of paediatric respiratory illness. I have summarised the main topics as being “SMART”, and don’t forget to “CHECK”. Being “SMART” with Asthma was a keynote presentation by Dr Simon Bowler from Mater Hospital, Qld about a new approach to managing asthma – Symbicort (budesonide and eformoterol) Maintenance and Reliever Therapy (SMART) in one inhaler and how it may provide some patients simplification in treatment. This combination therapy provides fast bronchodilatation, and acts as an anti- inflammatory agent and hence only one medication is needed. This drug is for use for patients 12 years and above. Remember to be “CHECK” – The first presentation in this theme was from Pele Bennett from the Centre for Drug and Alcohol Studies QLD who coordinates a “SmokeCheck” Indigenous Tobacco Program which is a brief intervention that has been proven to work. As tobacco rates are 2 – 3 times higher in Indigenous population than national average. North Queensland Public Health Unit using Indigenous specific images and language in all parts of the training has developed this package for health professional working with Indigenous clients. The evaluation has resulted in reductions in nicotine dependence and daily cigarette intake. This program has now been adapted and implemented in Northern Territory. The other “CHECK” messages were from Dr Gus Cooper (Mater Children’s Hospital, QLD) remembering Chevalier Jackson’s comment in 1912 “not all that wheezes is asthma”. There has been a trend over a number of recent years for children to be labelled as asthmatic however in reality the illness may be a post viral cough, simple bronchitis and other respiratory tract infections such as Mycoplasma. This presentation highlighted the need for good history taking and not to always conclude a wheezing child is asthmatic. Remember structural abnormalities, foreign bodies and other causes of lung disease. Secondly “CHECK” the child’s upper airway – Obstructive Sleep Apnoea Syndrome in children presented by Pat Wales (no relation). This condition differs from its presentation in adults. Nearly all children with OSAS snore, which is often continuous and interrupted by periods of silence terminated by snorting or gasping. The main cause is adenotonsillar hypertrophy however there is no relation to the size of tonsils and adenoids and the degree of obstruction. This problem is often reduced by an adenotonsillectomy. Dr Jane Peake (University of QLD) discussed the atopic patient and the common problem of allergic rhinitis- there are 2 types –“runners/sneezers and blockers” and the classification is based on whether the symptoms are intermittent or persistent and mild or moderate to severe. Appropriate treatment includes allergen identification, avoidance and drug therapy. And finally remember to “CHECK” children are on appropriate medications. Maree Brown et al (ACT) presented research examining whether kindergarten children with asthma in the ACT were currently on appropriate doses of inhaled corticosteroids according to NAC guidelines. The findings showed 1/3 children were not taking the prescribed medications in accordance with NAC guidelines indicates health professionals working with children and their families with asthma need to consider ways to ensure dosage, delivery device and adherence are addressed in the correct manner. Thank you ACPCHN (NSW branch) for providing me with a grant which assisted me in attending this conference. Reference: AAREA National Conference (2007) Conference Proceedings.

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