Cooler weather in Pennsylvania is here. Monitoring children’s temperatures during the health screening procedure may need to be adjusted if using a non-contact infrared thermometer (NCIT). The FDA describes the following pros and cons to using these devices. The benefits to using a non-contact infrared thermometer include: the reduction of risk of spreading disease since there is no contact between the person and the device, it is easy to use and disinfect, and it is a quick way to measure a person’s temperature. Improper use of NCITs may lead to inaccurate measurements.

The drawbacks to using a non-contact infrared thermometer include that the environment, placement, and clothing may affect the reading. Strictly follow the manufacturer’s guidelines and instructions for use for the specific thermometer. Typical use is to monitor the temperature of the forehead by holding the non-contact infrared thermometer perpendicular to the forehead at the distance and time specified in the manufacturer’s instructions. The environment should be draft-free and out of direct sun or heat sources. Environmental temperature should be within the range specified by manufacturer, usually around 60.8-104⁰F (16-40⁰C) and relative humidity below 85 percent. The person being screened should have a clean, dry forehead. Excessive clothing or head covers (headbands, hats, bandanas) could increase the temperature reading and should be removed with ample time to permit the temperature of the forehead to stabilize.

In a recent survey, early childhood education (ECE) providers offered suggestions to address possible issues with the cold weather affecting temperature screening, including:

Storage and Use:

-Store and use thermometer in area that is a constant temperature within manufacturer’s suggested range.

-Carry thermometer in and out when bringing the child to their classroom via the aprons that program provides. 

-Use other different types of thermometers, such as an ear thermometer with probe cover or a digital thermometer with disposable plastic covers, if the non-contact infrared thermometer doesn’t work. (Note that additional disinfection procedures of device may be necessary).

-Some manufacturers suggest aiming the thermometer at the area behind the child’s ear if forehead readings are inaccurate. 

Screening Variations:

-Screen students as they remain in their vehicles for temperature checks and screening questions during daily check-in. Parents exit vehicles and walk child to the entrance after all temperatures are taken for that drop-off group. Drop off times are assigned 10 minutes apart to allow time for this process.

-Take temperatures at the door and then again in the timeframe recommended in the manufacturer’s guidelines. Continue with mid-day scans of the children and staff to monitor temperatures throughout the day and at the end of the day.

-Perform the temperature screening indoors:

-Keep the thermometers inside and allow children to enter a small area that is indoors but outside of the center (i.e. a foyer or empty side room). Permit the children to remove their hat and coat.

-Screen children indoors while parents are still present at drop off. If temperature appears to be off, take temperature again 15 minutes later. The child should remain socially distant and wearing mask during this waiting period.

-Install a double door entry foyer.
Example: During a prior renovation, a program installed a double door entry foyer with a sink just inside the second door. Family members enter the first door, then check the student’s temperature. The adult shows the temperature recorded to the staff member through the glass wall of the second door. Staff member asks the health questions through the glass wall of the second door. Staff member determines whether child can be admitted. If yes, the adult uses the computer pad in between the two glass doors to clock in their student. This triggers door to open and student is admitted to center. The foyer entryway is heated via a small built-in-the-wall, heating unit.

Additional information can be found in "Are infrared thermometers safe?” by Elizabeth Murray, DO, FAAP at HealthyChildren.org, the American Academy of Pediatrics’ website for parents

Remember to update your COVID-19 Health and Safety plan if you modify screening practices.

Are you looking for tips and tools to address the unique challenges the COVID-19 pandemic has created for early childhood education (ECE) programs? The Pennsylvania Key offers a list of resources to help ECE professionals navigate new guidelines and requirements while continuing to prioritize children’s learning, growth, and development. Resources include announcements from the Office of Child Development and Early Learning (OCDEL), webinar recordings, and other key COVID-19 information. Visit the PA Key website to view the resource list.

Nebulizers, Asthma and COVID-19

Do you have children in your care with asthma? Parents/caregivers of children with asthma who use nebulizers should contact their child’s health care provider about using a metered dose inhaler (MDI) instead of a nebulizer. Use of inhalers with spacers instead of nebulizers involves decreased close exposure time during the medication administration. According to The Centers for Disease Control’s (CDC), people with asthma should use inhalers with spacers (with or without a face mask, according to each student’s personal treatment plan) instead of nebulizer treatments whenever possible during the COVID-19 pandemic. Children’s medical records/care plans should be reviewed to see who may require nebulizer treatments. Care plans should be updated as per the health care provider’s recommendations. Guidance for Operating a Childcare Center, Group Home or Family Child Care During the Coronavirus Pandemic in Pennsylvania - The Pennsylvania Key Resource for Frequently Asked Questions (FAQ) pages 16-17 offers important guidance to consider and precautions to take.

Increased cleaning and disinfecting is necessary because of the pandemic. Disinfecting products maybe a trigger for some children so care should be taken to prevent exposure to them:

If you have asthma:
    •  Ask an adult without asthma to clean and disinfect surfaces and objects for you.
    •  Stay in another room when cleaners or disinfectants are being used and right after their use.
    •  Use only cleaning products you must use. Some surfaces and objects that are seldom touched may need to be cleaned only with soap and water.
    •  Make a list of the urgent care or health facilities near you that provide nebulizer/asthma treatments. Keep it close to your phone.
    •  If you have an asthma attack, move away from the trigger such as the disinfectant or the area that was disinfected. Follow your Asthma Action Plan. Call 911 for medical emergencies. 10-27-20

 The Pennsylvania Key Infant Early Childhood Mental Health Consultation (IECMHC) Program Consultants worked collaboratively to create the social story and tips and resources to support re-entering into Early Education Centers after COVID-19. The social story, We are back in school!, can be used by early childhood education staff as a resource for support social and emotional as children and staff start the process of re-entering the child care setting. Each page in this social story contains Teacher Tips, Prompts, Resources and Activities which can help with discussions with children in child care. There are clickable links and even spots where staff can jot down their own notes! The Tip and Resource Guide provides additional information.

The American Academy of Pediatrics Parenting website has many COVID-19 resources to support families.  These include: Parenting in a Pandemic; Working and Learning; Getting Outside; Masks for Kids; New Baby Challenges; Disinfectant Safety and Breastfeeding.