Symptoms of Hyperglycemia-

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1 Introduction The number of students with chronic health conditions has increased over the years. Not only are there more students with medical concerns but more complex medical conditions. Some of the common medical diagnosis include, life-threatening allergies, diabetes and seizure disorders. The purpose of this manual is to provide information to the teaching staff about the previous diseases. Review any health condition, in the manual, that pertains your students medical conditions. At the beginning of the school year(and for some, at the beginning of Term 2), we ask that you become familiar with your student roster and check out any medical conditions. You will find alerts on SIS/ASPEN by clicking on the red cross next to the student s name. Not all medical conditions are listed on SIS/ASPEN. The school nurse will send you an regarding some of the student s medical conditions at the beginning of the school year. The manual provides you with a written resource to review to give you a better understanding of these diseases. The important information may alert you to a student when he/she is experiencing a symptom that needs to be addressed by the nurse. Please remember that when you have questions you should contact the school nurses. The manual should not replace contacting the school nurse about a specific student and their health. Please keep in mind that you should always respect a student s right to privacy regarding their health condition. Keep in mind the importance of notifying a substitute teacher of a student s health condition. Section 504 of the Rehabilitation Act, the Americans with Disabilities Act, and the Individuals with Disabilities Education Act are Federal Laws which protect children with chronic health conditions. Schools may not discriminate against children with medical conditions and/or disabilities.

2 Diabetes Diabetes is a long-term chronic condition that is a result of the body s inability to use sugar for energy. Sugar, known as glucose, is derived from the carbohydrates that are found in the foods we eat. Insulin is a hormone needed for glucose to enter the body s cells from the bloodstream. The cells then use glucose to release energy. When the body has an inadequate amount of insulin production by the pancreas or inadequate usage of insulin, it causes the blood glucose to rise, resulting in diabetes. There are two forms of diabetes, Type 1 and Type 2. Type 1 diabetes is when the pancreas no longer is able to make a sufficient amount of insulin; therefore, insulin must be administered by injection. Students may use, syringes, insulin pens or pumps to administer their insulin. Pumps are small devices that provide a continuous flow of insulin through a catheter that is inserted under the student s skin, thigh, abdomen, or buttocks. Insulin is administered when a student has eaten food requiring a carbohydrate count to determine the correct insulin dose. Type 2 diabetes is usually diagnosed after the onset of puberty. The student s pancreas is able to produce insulin. This type of diabetes can be treated with oral medication that assists the body to use its own insulin more effectively. Medications do not cure diabetes but help to control the disease. If students do not control their blood glucose, it can lead to serious and long term health issues. Some of the variables that affect blood glucose levels are food, exercise, illness, stress, and injury. In most cases, food makes the body s blood glucose levels rise and exercise and insulin decreases the blood glucose. One of the most important parts of diabetes management is regular monitoring of blood glucose levels during the school day. When a student has a snack or lunch, before physical activity or when he/she is experiencing symptoms of hyperglycemia (high blood glucose) or hypoglycemia (low blood glucose). Symptoms of Hyperglycemia- increased thirst, increased urination, nausea, headache and fatigue. If a student with diabetes is experiencing hyperglycemia, the student may need to use the bathroom and drink water as needed. It is important to remember that the student should check with the nurse regarding their blood glucose level. Students with insulin pumps may need to check that the pump to make sure it is functioning properly.

3 Symptoms of Hypoglycemia- shaky, sweaty, hunger, dizzy, disoriented, confused, anxious, irritable, headache, weakness, and fatigue. Hypoglycemia can happen very suddenly. It is the greatest immediate danger to a student with diabetes. This may happen when a student delays their snacks or meal, does not eat enough or exercises to long. If you observe any of the signs or symptoms of hypoglycemia in a student with diabetes, send the student( as long as he/she is not confused or disoriented) with another student to the nurse or call the nurse immediately. The student will be treated with some quick-acting sugar. In the event of a lockdown, a student with diabetes needs access to food. It is preferable that the student carries snacks in their backpack. Diabetes may impact the student s education. When blood glucose levels are high or low, the student with diabetes may be unable to concentrate and have memory impairment. Please refer to the student s 504 accommodations or their IEP.

4 Life-Threatening Allergies Common causes of life threatening allergies (LTA) are foods, stinging insects, and latex. Common foods include: peanuts, tree nuts, seafood (fish and shellfish), milk, eggs, sesame, soy and wheat For the safety of student he/she should avoid the food that causes the life threatening allergy. Please check ASPEN and read your s from the school nurse about students with life threatening allergies. Please be familiar with signs and symptoms of life threatening allergies. If an allergic reaction occurs in the school building please notify the nurse immediately. If you are on a field trip, please call 911. Any student stung by a bee should have the stinger removed by scraping the stinger with a fingernail and then apply ice. Do not push, pinch, or squeeze the area as this might increase the amount of venom that enters the body. If the student has an allergy to bee stings, the student needs to be observed for 30 minutes for signs and symptoms of a reaction. If and when symptoms occur, an epi pen should be administered. A student with a latex allergy should avoid latex-containing products. Teachers please check labels on balloons, rubber gloves, adhesive tapes, band aides, erasers and rubber bands. There are latex-free alternatives to these products. When a student with an allergy is exposed to latex, stung by an insect, or ingests the protein of the allergic food, a severe allergic reaction called anaphylaxis can occur. Anaphylaxis is a life threatening condition and usually involves more than one body system. Signs and Symptoms include the following: Itchy skin or hives Swelling of lips, tongue, or face Difficulty breathing Voice becomes hoarse or squeaky Slurring of words Lump in back of throat Lips feel tight Call the nurse immediately for any of these symptoms. When on a field trip or school activity administer the epi pen and call 911. An epi pen should only be administered to the student that was prescribed the the Epipen. Do not

5 administer an Epipen to another student whom you think may be having a reaction, call 911. Administration of the Epi pen Remove the auto-injector from the clear carrier tube. Pull off the blue safety release. Firmly push the orange tip into the thigh(through clothing) until it licks. Hold firmly against the thigh for 10 seconds. Remove and massage the injection area for 10 seconds Call 911 to have the student transported to the hospital Give the used epipen to EMT. Keep student seated and he/she may become jittery after administration. The student must always be transported to the hospital since he/she may need more epinephrine.

6 Seizure Disorder Epilepsy, seizure disorder, causes a student to have two or more seizures without any clear cause. A seizure is a brief, excessive discharge of the brain electrical activity that changes how a person feels, senses, thinks or behaves. The cause is often unknown but can be caused by a trigger, ie related to not enough sleep or fever. Types of Seizures Absence seizures produce momentary loss of awareness, such as a staring spell, sometimes accompanied by movements of the face, blinking, or arm movements. These may be frequent. These events differ from daydreaming because they interrupt the ongoing activity. The student immediately returns to full awareness after one of these episodes. Management : make sure the child did not miss any key parts of the lesson. Simple partial seizures are limited to one area of the brain. Consciousness is not lost, though the student may not be able to control body movements. Senses may be distorted so the student sees, hears, smells, or experiences feelings that are not real. Management: If the student seems confused or frightened, comfort and reassure. Complex partial seizures produce a variety of autonomic behaviors in which consciousness is clouded. The student may not get up and walk around, be unresponsive to spoken directions or respond inappropriately. The student may mutter or tap a desk in an aimless, undirected way. He or she may appear to be sleepwalking or impaired. This type of seizure lasts only a minute or two, but feelings of confusion afterwards may be prolonged. The student is usually unaware of what happened during the seizure. Management: if a student appears dazed and oblivious to the surroundings, the teacher can take the student s arm gently, speak calmly, and guide the child carefully back to his/her seat. Do not grab hold or speak loudly. If the student resists, and is not a danger to himself/herself or others, let the seizure take its course. If the child is seated, ignore the automatic behavior but have the child stay in the classroom until full awareness returns. Help orient the student if he/she seems confused afterwards. Generalized tonic clonic seizures are convulsions in which the body stiffens and/or jerks. The student may cry out, fall unconscious and then continue with jerky movements. Bladder and bowel control may be lost. Seizures usually lasts a minute or

7 two. Breathing is shallow or may stop briefly until the jerking movements end. The student may be confused, weary, or belligerent as consciousness returns. Management: First aid for a convulsive seizure protects the student from injury while the seizure runs its course. The seizure itself triggers mechanisms in the brain to bring it safely to an end. It is important to time the seizure. First Aid for Convulsive Seizure Keep calm. Direct the other students to leave the room and notify the school nurse. Ease the student to the floor and clear the area around the student. Put something flat and soft(sweater, jacket) under the student s head Do not put anything in the student s mouth or restrain the student When jerking movements have stopped, turn the student to his/her side. Breathing may be shallow or even stop briefly. This can give the student s lips or skin a bluish tinge. Classroom Suggestions The student should be seated close to the teacher. The student should stand on the lowest riser when required for certain activities. The student should be closely monitored during physical education activities, especially those involving heights. Impact on Education Medication for management of seizures can affect a student s attention span and ability to concentrate. Seizures can affect memory and processing skills. After a seizure, some children are unable to remember anything that happened the previous day or immediately afterwards. Students with epilepsy may require an Individualized Educational Plan to address any specific learning issues that might put them at increased risk for underachievement.