Health Safety. Lead Nurse Cullman County Schools

Transcription

1 Health Safety Lead Nurse Cullman County Schools

2 Seizures Convulsive Seizure (Grand-Mal, Generalized Tonic-clonic) The person will lose consciousness, May fall Stiffen Jerking movements Difficulty breathing may cause the person to turn pale or bluish, call 911. The person may drool or become incontinent (loss of bowel and/or bladder)

3 Treatment of Grand Mal Seizures Provide safety (guide student to floor, clear area, cushion head, and remove any tight neckwear). Time the seizure (if seizure last longer than 5 minutes, call 911). Provide privacy. Do not stimulate by rubbing chest, face or arms. Do not force the mouth open (student will not swallow tongue). Do not put anything in the mouth. Place student on his/her side (prevents aspiration). If student goes from one seizure into another one, call 911. Notify parent of all seizure activity.

4 Seizures Nonconvulsive (Partial complex) Signs & Symptoms: Blank staring Aimlessness Chewing motions or lip smacking Unable to interact

5 Treatment of Complex Partial Seizures Do not restrain. Stay calm and track time. Redirect from hazards or remove hazards. Do not agitate the student (speak calmly). Stay with the person until recovery. Reassure and reorient. Do not offer food or drink until fully conscious. Allow time to rest. Call parent and notify of all seizure activity

6 Impact on Education Teacher Pearls of Wisdom Antiepileptic Drugs Although not all children with epilepsy have learning disabilities, many are at higher risk for learning disabilities and behavior problems. Additionally, children who have epilepsy may suffer from low self esteem, anxiety or display low expectations for the future. The decision to initiate antiepileptic therapy is based on the risks and benefits of medication for the particular individual. Factors include the age of the child, timing of seizures, precipitating factors and the possible physical or emotional consequences of seizures versus drug side effects. It can take a considerable amount of time to find the right drug and the right dose. Once therapeutic drug levels are attained however, it does not necessarily imply cure or preclude a child s having a recurrence. The common side effects associated with many of the antiepileptic drugs may reduce mental or physical acuity. Learning or physical activity may be affected. Behavioral changes including depression or agitation are also common in children taking some antiepileptic medications.

7 Impact on Education Teacher Pearls of Wisdom Antiepileptic Drugs Frequent sore throats or fevers in an otherwise healthy child or when there are no infections circulating around through other classmates may be an early sign of blood cell toxicity from antiepileptic drugs. Similarly, yellowing of the skin or eyes may be indicative of liver toxicity. Proper compliance with dosage schedules is critical with antiepileptic drugs! Certain side effects are cosmetic in nature. Unusual or excessive hair growth and swollen or bleeding gums are common with Dilantin. Rashes or continuous rapid eye movements are also possible with antiepileptic drugs. These side effects can cause the student to become self-conscious or embarrassed. Worse, they may, in rare cases, cause the child or adolescent to purposely discontinue taking their medication.

8 Diastat SEIZURE EMERGENCY TREATMENT at SCHOOL Given rectally Can cause respiratory depression Be prepared to give CPR Legal issues Must be administered by licensed nurse Extracurricular activities require nurse present and extensive planning

9 Diabetes Type 1 (born with) Type 1 diabetes, previously called juvenile diabetes or insulin-dependent diabetes, is an autoimmune disease in which the body destroys insulin-producing beta cells in the pancreas. Insulin is required by the body to use glucose, the simple sugar into which foods are broken down by our digestive system. Without insulin, the body starves to death. It s important to note that everyone is insulin dependent. People without diabetes make insulin in their pancreas. People with Type 1 diabetes must inject insulin. Type 2 (develops over time) Hyperglycemia (high blood sugar) Hypoglycemia (low blood sugar)

10 Signs of Hyperglycemia (High blood sugar) Excessive Thirst Frequent Urination Hunger Blurred Vision Drowsiness Nausea Dry Skin

11 TREATMENT OF HYPERGLYCEMIA Review student s health care plan. Allow free use of bathroom. Encourage student to drink plenty of water or sugar-free drinks. Walking may be encouraged if ketones are negative. If ketones are present, student must not participate in physical activity.

12 Signs of Hypoglycemia (Low Blood Sugar) Shaking Fast heartbeat Sweating Anxious Dizziness Hunger Impaired vision Weakness Fatigue Headache Irritable

13 Treatment of Hypoglycemia Notify School Nurse Provide quick sugar source 4-6 oz of juice or regular soda (not diet) 3-4 glucose tablets Follow with snack of carbohydrate & protein (cheese crackers, meat sandwich) Wait 10 to 15 minutes Recheck blood glucose Repeat food if symptoms persists or blood sugar remains low

14 Treatment of Hypoglycemia An emergency food pack with these items along with a tube of cake icing gel or glucagon gel should be kept in each classroom, on the bus, or in the gym at all times and should be replaced immediately by the parent if used. It should be immediately accessible to the student. The emergency food pack should also go outside with the student if PE is somewhere other than in the gym. NEVER SEND A STUDENT WITH SYMPTOMS OF LOW BLOOD SUGAR ALONE TO THE NURSE OR THE SNACK MACHINES. Be sure your subs are aware of the emergency plan, where it is kept, and how it will be implemented.

15 Emergency Medication for Hypoglycemia at School Glucagon Injection Legal Issues Licensed nurse or Trained Diabetes Assistant must administer unless parent is present. For all school sponsored events, including extracurricular activities, field trips, tutoring, etc., a School Nurse, Trained Diabetes Assistant, or parent must be present.

16 Impact on Education Some teachers and other educational staff members think that kids with diabetes sometimes pretend to feel low or high to get out of the classroom or to get out of an activity that they do not like. With some exceptions, this is very unlikely. Most kids with diabetes don t want to be different, and they don t want their diabetes to cause them to be treated differently. If you think this is a problem, speak with the child s parents, but do not deny the child s request for water or a blood sugar test.

17 Anaphylaxis Anaphylaxis is a severe allergic reaction that may involve the entire body. It can result in trouble breathing, loss of consciousness and even death. Anaphylaxis is a medical emergency that requires immediate medical treatment. Signs & Symptoms Oral-swelling & itching of lips & tongue Skin-flushing, hives, swelling Gastrointestinal-nausea, abdominal pain, vomiting Cardiovascular-chest pain, dysrhythmia, low blood pressure Respiratory-tightness in throat, difficulty swallowing, airway obstruction 2007, American Academy of Allergy, Asthma and Immunology

18 Common Triggers Food Medicines Latex Insect venom Exercise Soy Peanuts (90%) Tree Nuts Milk Eggs Shellfish Wheat Anaphylaxis

19 Treatment of Anaphylaxis Benadryl EpiPen

20 Epinephrine (Epi-Pen) Epinephrine shall be in the form of pre-measured, auto-injectable syringes prescribed for each student individually by his/her physician. The parent/guardian must supply the medication and is responsible for making certain that the medication is in-date and that the prescription is current. Written permission to administer the medication from the parent/guardian and written orders from the physician should be congruent with the aforementioned medication guidelines. The school nurse, if available, will administer the injection. However, since this reaction may occur when a school nurse is not in attendance (e.g. bee stings on outdoor field trips, during PE classes, or recess), it is essential that the school nurse review the use of auto-injectors with designated personnel. Auto-injectors are designed for use by non-medical personnel. Students with a history of anaphylaxis should have ready access to epinephrine. Preferably, the student carries it on person. Immediately after administering the medication, the school nurse or school personnel designated by the principal should: Activate 911. THIS IS A MEDICAL EMERGENCY! Notify the parent/guardian and the principal.

21 Epinephrine (Epi-Pen) KNOW THE EXACT LOCATION OF THE MEDICINE!!! *Seconds and minutes can make a difference* When a sting or other allergic reaction occurs: An adult should remain with student at all times. Administer the injection as directed by the physician and on drug insert. Read directions ahead of time and be prepared. Notify the designated person to call 911. Send for school nurse or staff member trained in CPR. Notify parent. Notify principal. Transport to medical facility as soon as the ambulance arrives. Symptoms may improve, but can reappear as long as 2 hrs after the initial allergic reaction occurred. Unless directed otherwise by 911, send the empty needle and syringe with the student to the ER so their staff will know what was given. An approved sharps container should be available for disposal of needle and syringe if left at school.

22 Epinephrine (Epi-Pen) Directions for administering Epi-Pen Pull off safety cap. Place black tip on lateral thigh (can be given through clothes), not on seam of pants. Press hard into thigh until auto-injector mechanism functions. Remove injector and massage site for 10 seconds. Activate 911 and notify parent.

23 Asthma Signs & Symptoms Coughing Wheezing Shortness of breath and/or rapid breathing Chest feels tight and/or hurts Mouth is dry Neck feels funny or itchy Clipped speech

24 Treatment of Asthma If student has inhaler, 2 puffs every 4 to 6 hours is general protocol. If inhaler is located in school nurse s office and student is close by and not in distress, send to nurse. If student is away from nurse s office or is in distress, call nurse to bring inhaler. Do not push student to participate in physical activity if asthma attack is present.

25 Impact on Education ACTIONS FOR THE CLASSROOM TEACHER Know the early warning signs of an asthma episode. Have a copy of the asthma emergency plan in the classroom. Review it with the student and parents. Know what steps to take in case of an asthma episode. Develop a clear procedure with the student and parent for handling schoolwork missed due to asthma. Understand that a student with asthma may feel: 1. Drowsy or tired 2. Different from the other kids 3. Anxious about access to medication 4. Embarrassed about the disruption to school activities that an asthma episode causes. 5. Withdrawn

26 Impact on Education Know the possible side effects of asthma medications and how they may impact the student s performance in the classroom. Refer any problem to the school nurse and parents. Common side effects of medicine that warrant referral are nervousness, nausea, jitteriness, hyperactivity, and drowsiness. Reduce known allergens in the classroom to help students who have allergies. Common allergens found in classrooms include chalk dust, animals, and strong odors (perfumes, paints, dry erase markers). Encourage the student with asthma to participate fully in physical activities. Allow a student to engage in quiet activity if recovery from an acute episode precludes full participation.

27 PE Coaches and Coaches Encourage exercise and participation when asthma is under good control. Appreciate that exercise can cause acute episodes for some students. Exercise in cold dry air triggers asthma attacks. Know what the health care plan states. School nurse can obtain a pulse oximetry reading (oxygen level in blood).

28 Concussions SIGNS & SYMPTOMS (observed by coach or other) Dazed Confused Forgets plays Unsure of game, score, or opponent Moves clumsily Answers slowly Slurred speech Loss of consciousness Behavioral changes Personality changes Can t recall events before or after injury Vacant facial expression SIGNS & SYMPTOMS (observed by athlete) Headache or pressure in head Nausea or vomiting Balance problems/dizzy Double or blurry vision Sensitivity to light Feels sluggish, hazy, foggy, or groggy Poor concentration or memory problems Confusion Doesn t feel right Neck pain Unusual sleep patterns Emotional Changes Seizure or convulsion

29 THANK YOU FOR ALL YOU DO TO KEEP OUR SCHOOL SAFE AS POSSIBLE!