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module menu icon CUSTOMER SCENARIO

CUSTOMER SCENARIO

21-year-old Sunita is struggling with symptoms associated with acute sinusitis, such as congestion, facial pain and a fever. Through the Pharmacy First service, she has been provided with a corticosteroid nasal spray; however, she would like some advice about what else she could do to help improve her symptoms and reduce the spread of infection.

Note: Whether or not your customer is eligible for treatment via Pharmacy First, you should ALWAYS offer self-care and safety netting advice.

Click through the slider below to learn about different self-management strategies she could try5,9

Saline nasal sprays

Stérimar Sinusitis Very Blocked Nose nasal spray can be used before the corticosteroid nasal spray to help rinse out the sinuses and provide additional relief.

OTC medicines

Sunita could try paracetamol and/or ibuprofen to help relieve her pain and fever. Some other customers may wish to consider other OTC medicines, such as decongestants and corticosteroid nasal sprays.

Rest

It’s important that Sunita has plenty of rest to encourage a swift recovery.

Hydrate

Sunita should drink enough fluids to stay hydrated.

Avoid allergens

Sunita should be conscious of any allergens that could make her sinusitis worse and avoid them. This could include pollen, dust and pet dander.

Reduce the spread

Sunita should use a tissue and wash her hands with soap to prevent the spread of infection to others.

Sunita comes back after a few days and seems much worse. The pharmacist assesses her and then refers her for URGENT medical attention.

Think about what red flag symptoms would indicate urgent referral

Red flags9,10
  • Signs of sepsis, such as:

    • Acting confused, slurred speech, or not making sense

    • Blue, grey, pale or blotchy skin, lips or tongue – on brown or black skin, this may be easier to see on the palms of the hands or soles of the feet

    • A rash that does not fade when you roll a glass over it

    • Difficulty breathing, breathlessness or breathing very fast

  • Passing little or no urine

  • A severe headache

  • Chest pain

  • Difficulty swallowing or drooling

References

1. Ah-See KW, et al. Sinusitis and its management. BMJ. doi: 10.1136/bmj

2. Schalek P, et al. The relationship of C-reactive protein levels and positive culture with quality of life in acute rhinosinusitis.
Patient Prefer Adherence. 2015. doi: 10.2147/PPA.S76915

3. NHS England. Pharmacy First Clinical Pathways. 2023. Available at: https://www.england.nhs.uk/wp-content/uploads/2023/11/PRN00936_ii_Pharmacy-First-Clinical-Pathways-v.1.6.pdf#page=6

4. Vincent P. Nasal Congestion. 2023. Patient. Available at: https://patient.info/ears-nose-throat-mouth/nasal-congestion

5. NHS. Sinusitis (sinus infection). 2024. Available at: https://www.nhs.uk/conditions/sinusitis-sinus-infection/

6. Cleveland Clinic. Nasal irrigation. 2022. Available at: https://my.clevelandclinic.org/health/treatments/24286-nasal-irrigation

7. Peters B. How to use saline nasal sprays effectively and safely. 2024.
Available at: https://www.verywellhealth.com/saline-spray-snoring-allergies-3015306

8. Church & Dwight. Data on file. 2018

9. NHS England. RTI leaflet for community pharmacies. Treating your infection- respiratory tract infection. 2018.
Available at: https://elearning.rcgp.org.uk/mod/book/view.php?id=13511&chapterid=787

10. NHS. Sepsis. 2022. Available at: https://www.nhs.uk/conditions/sepsis/

Online references last accessed June 2025.

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