Managing Health Concerns at School

1. Managing Health Concerns at School Fran Cantrell and Allison Lambert, RN, BSN, NASN Millers Creek Elementary School

2. Nurse’s Schedule • Monday: Allison • Tuesday: Fran • Wednesday: Fran • Thursday: Fran • Friday: Fran WWHS Allison WCHS **This schedule is subject to change based on needs

3. Contact Info • EMAIL is a great tool to communicate with me: lamberta@wilkes...... cantrelf@wilkes.... • Online Calendar http://www.wilkes.k12.nc.us/

4. Kinders • 30th Day of School: Tues. Sept. 22th- ALL kinders who are not compliant with shots and/or physicals will be sent home • Please let me know if you have a kinder that enrolls during the next few weeks!

5. Pre-K Students • 30th day: Monday, Sept. 28th. Must have shots / physicals by then.

6. Mass Screenings Thurs. Sept. 3rd and Friday Sept. 4th in Multi-purpose Room and Hearing room. All students in Grades 1,2,3rd and 5th grades. Some kinders and 4th graders. You will get a schedule.

7. Mobile Dental Clinic • At the West District - March 2016 • For students w/o a Dentist and/or transportation issues. • Permission forms going home with students next week. • Please return all forms for the Dental clinic to School Nurses.

8. Staff Flu shot clinic • Will be here at MCES again this Fall, end of October. Date to come.

9. Student Accident Report • Please fill out a report if you witness an injury here at school, or happens on your watch. • Turn the report in to – School Nurse, it will go to Mrs. Price. • Will get these forms on Weebly

10. Emergency Health Care Plans • Informational plans regarding a health condition and how to manage it • Health Conditions (heart, lung problems, etc.) • Severe allergies (bees, foods, etc.) • Seizures • Asthma • Diabetes

11. Please notify your school nurse of ANY new health information!! • Be sure Emergency Plans are visible to subs>>> Also, make sure your first aid supplies (gloves, bandaids, thermometer) are easily accessible. • First Aid Bag / Backpack

12. Student’s Confidential Information Health Concern Lists and Emergency Plans need to be kept where Substitute teachers can locate them, but secure. *** Be careful who and where you talk about students at school, and do not share out in the community. ***

13. Be very careful with perfumes, aerosols, inhalants, cleaning agents, and some animals that may be in your classroom. These have been known to produce an allergic response for some children and adults with sensitivity, i.e. reactions, headache, etc..

14. North Carolina Law Require that each school year information be shared with staff in schools about Diabetes and Asthma.

15. Asthma • Recognize signs of attack • Coughing, wheezing, or shortness of breath • Verbal complaints: Chest hurts or feels tight, “I can’t breathe good,” or “I can’t catch my breath”

16. Management of Asthma • Have student sit down and rest • Get student to a cooler environment • Administer inhaler if available • Give cup of water to sip on • Student should respond to treatment within 15-20 min. • If no improvement, contact parent • If student’s condition worsens (turning blue, severe resp. distress, etc.) CALL 911

17. How to Administer an Inhaler • Shake the inhaler before each spray • Breathe out through your mouth • Push the top of the canister all the way down while you breathe in deeply through your mouth • Hold your breath as long as you can • Wait 1 minute and repeat

18. Anaphylactic (severe allergic) Reactions (Bees, Food, etc.) • Symptoms include • Swelling of face, lips, or neck • Coughing, wheezing, hoarseness • Tightness in chest or difficulty breathing • Generalized hives • Lips turning blue • Vomiting • Generally appears to be getting worse

19. How to Administer an Epipen • CALL 911 • Stabilize the student • Put your fist around the Epipen • Remove the blue cap • Hold the orange tip near the outer thigh • Swing and jab firmly into outer thigh (on top of clothes) • Hold in place and count to 10 • Pull the needle out and dispose in sharps container

20. Diabetes • Signs/ symptoms of low blood sugar (hypoglycemia) • Shaky • Sweaty • Fast heartbeat • Dizzy • Hungry • Headache • Irritable • Tired • Weak

21. How to treat Hypoglycemia • Test blood sugar if possible • Give student juice, coke, smarties, or glucose tabs (chocolate is not a good choice due to high fat, which cause slow absorption) • When blood sugar is back in normal range, give p-nut butter crackers. Protein will maintain blood sugar • If too drowsy & unable to eat or drink, squirt glucose gel in cheek • If unresponsive, CALL 911. Use Glucagon if available

22. Symptoms of High Blood Sugar (Hyperglycemia) • Extreme thirst • Frequent urination • Hunger • Blurred vision • Drowsiness • Nausea

23. How to treat Hyperglycemia • Test blood sugar • Give WATER • Walk • Administer insulin if ordered • Contact parent

24. Seizures • If NO KNOWN seizure disorder, CALL 911 • With known seizure disorder, follow ER plan- CALL 911 ONLY if seizure lasts longer than 5 min. or has one seizure after another • Remain CALM • Remove other students from room if possible • Lower student to the floor • Do not restrict any movements • Move desks to prevent injury

25. Seizures (cont.) • Do not give anything to drink until fully awake • Start CPR if student quits breathing or heart stops • Reassure student • Call parent

26. Medications • All medication requires a medication consent form w/ parent & physician signature • With parental & physician consent, a student may carry emergency meds. • Inhalers, Epipens, etc. may be kept securely in the classroom – this will be discussed with S.N. • Take medications on all Field Trips! • BIG CHANGE: Do NOT put any Calamine, neosporin, peroxide, etc. on a student. Contact parent, and/or refer to school nurse.

27. Medications (cont.) • 6 Rights of Safe Medication Administration • Right Child • Right Date • Right Time • Right Dose • Right Route • Right Documentation • Prescription & OTC meds. should be in the original container!

28. Assure that the med. is given as ordered. If it is not given when ordered, it is considered a med. error & should be documented. • If an error is made, call the School Nurse immediately! • If the start of the school day is delayed, remember that some meds must be given a certain # of hrs. apart (Ritalin). You must know when the last dose was given before you administer the med. on a delay day. Call School Nurse w/ questions or concerns

29. Proper Medication Documentation Is very important to document all medications given on Medication Log Sheets that are kept in First Aid room. Be sure to take medicines on all field trips, and return to First Aid room as soon as possible.

30. Bloodborne Pathogens (BBPs) • Always wear gloves when dealing with blood and/or bodily fluids from anyone. • Notify custodian when student has a nosebleed or other bleeding so that the area can be cleaned appropriately & trash can be removed

31. WHAT DO YOU DO IF YOU HAVE AN EXPOSURE? • Wash exposed area with antibacterial soap and running water • If exposure is to eyes, nose or mouth flush these areas with running water for 15 minutes • Immediately report incident to Principal, A.P., School nurse (if in building).

32. Questions, Comments/ Complaints….. • Thank YOU for ALL YOU DO!!!!!!!!!!