Student Health Staff Training 2016/2017

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Helen Houston
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1 Student Health Staff Training 2016/2017

2 Bloodborne Pathogens Organisms in blood and other body fluids that can cause disease Examples: HBV HCV HIV AIDS Protect yourself! Observe universal precautions - Treat all blood/body fluid as if infected. Follow guidelines in our BBP Exposure Control Plan located in office and on website.

3 Protective Measures

4 Exposure at Work Direct Transmission From one person to another through open cut, abrasion, sore, or membranes of nose, mouth, eyes Indirect Transmission Touching a contaminated object or surface

5 Yikes I m exposed! What now? Wash immediately! 1. Notify supervisor, school nurse, and Carol Eatman. 2. Complete Exposure Report & WC Form 19 by the end of the day of incident. 3. Go to Fast Med Urgent Care in front of hospital.

6 NRMPS at-risk Jobs Nurse Athletic Trainer Custodian How do I know if I m at-risk for exposure to Bloodborne Pathogens? Contact your school nurse. and Complete Exposure Determination Questionnaire.

Red Bag/First Aid Kit Located in each classroom. Do not allow students to get in the bag or carry the bag. Staff only. Do not put any medicine in the red bag without notifying the nurse first.

7 Red Bag/First Aid Kit Located in each classroom. Do not allow students to get in the bag or carry the bag. Staff only. Do not put any medicine in the red bag without notifying the nurse first. What goes in the bag? Gloves Band-Aids & other First-Aid Supplies Emergency Action Plans Emergency Medications - Inhalers, Epipens, Diabetic Supplies, etc. Take bag to cafeteria, playground/gym, and on field trips, fire drills with students.

First-Aid & Emergencies We have trained first responders,

If you would like to get certified or recertify, classes are

8 First-Aid & Emergencies We have trained first responders, certified in CPR/AED & First Aid. Please stand. If you would like to get certified or recertify, classes are offered 1/month NCC Sat. morning no cost 5 contact hours. Register on Nurses website. Departments Student Services Nurses Location of our AEDs 100 Hall by Main Gym 200 Hall by Elevator Upstairs by Mr. Brown s office

Diabetes The body does not Use glucose properly Due to insulin problems.

parent/guardian to come and handle. May need to call 9-1-1.

9 Diabetes The body does not Use glucose properly Due to insulin problems. Emergency Action Plans Provides medical directions for care. Kept in red first-aid bag. If no care plan is provided, contact school nurse, diabetic care manager, or parent/guardian to come and handle. May need to call Glucometer, Snacks, and Insulin Students are allowed to: Carry diabetic supplies at all times, Check blood sugar anytime they feel symptomatic; and, Have a snack when needed.

10 Diabetic Care Managers School staff members -- trained by school nurse to handle diabetic care of students at school (Please stand.) How to count carbohydrates How to check blood sugar How to recognize signs of distress

11 Low Blood Sugar Early Signs & Symptoms Sweaty If in doubt, Treat as low blood sugar. Nervousness Pallor

12 Low Blood Sugar Late signs & Symptoms Sleepy Stubborn Irritable Sad Angry Uncoordinated Pass out Seizure

13 Treating Low Blood Sugar 2-4 glucose tablets 4 ounces of apple or orange juice 4-6 ounces of regular soda 2 tablespoons of raisins 3-4 teaspoons of sugar or syrup 1 cup of low fat milk 1 tube of cake gel or 2 packets honey (if unable to swallow or unconscious) Students should carry a juice/snack at all times Parents are responsible for providing snacks/supplies. It is best practice to keep a snack in red first-aid bag.

14 Treating Low Blood Sugar Recheck blood sugar After 15 minutes, if still low give another snack. Check again in 15 minutes. If does not come up to normal call parent. Follow with carbohydrate/protein snack such as, peanut butter and crackers, meat, cheese, etc.

15 High Blood Sugar Signs & Symptoms Thirst Frequent urination Blurred Vision Nausea Nausea Mood Changes

High Blood Sugar Insulin is the only way

16 High Blood Sugar Insulin is the only way to the blood sugar. Exercise will not decrease the blood sugar! Treatment 1. Check care plan for orders. 2. Administer insulin, per orders. 3. If no care plan is in place, contact parent/guardian. 4. Offer student clear non-calorie liquids. 5. Do not exercise if the blood sugar is > 300.

17 Diabetic Emergency! Loss of consciousness Click photo for video: How to inject. 1. CALL Stay with student. 3. Send for nurse, Diabetic Care Manager, or First Responder. 4. Give Glucagon, if ordered. 5. Call parent/guardian.

Medicines at School Medication Authorization

carry /self-administer Adderall / Ritalin /

Supervised medication administration form

18 Medicines at School Medication Authorization Form: Required For staff to administer. For students to self-administer. Controlled substances: Never allowed to carry /self-administer Adderall / Ritalin / Psychotropic meds / Narcotic pain meds Supervised medication administration form required. Must be given / supervised by staff. Must be kept in locked area. Medication Record/Log: Required Initial when med is given. Code reason, if omitted.

Care plan (EAP) indicates where inhaler is kept; how, and when to administer; e.g., before exercise.

19 Asthma Inhaler Must be easily accessible and available especially for PE/recess inside or outside. Never deny access to student. High school students keep in pocket or book bag. Care plan (EAP) indicates where inhaler is kept; how, and when to administer; e.g., before exercise. Refer students to School Nurse: Frequent Absences. Severe/many episodes Chronic cough. Sitting out PE/recess. Abuse, misuse, overuse, and/or frequent use of inhaler. Student who has no inhaler.

Seizures Emergency Action Plan Individualized

20 Seizures Emergency Action Plan Individualized orders from doctor. Kept in red first-aid bag. Follow the guidelines for care. Notify school nurse / 1 st Responder Notify parent/guardian. Call Seizure lasts more than 5 minutes. Student doesn t arouse after a seizure.

Severe Allergies & Epi-Pens Emergency Action

first-aid bag Symptoms Swelling lips, eyes,

21 Severe Allergies & Epi-Pens Emergency Action Plan Refer to plan for care Kept in red first-aid bag Symptoms Swelling lips, eyes, face Tightening of throat / Hoarseness Hacking / Repetitive cough Shortness of breath / Wheezing Weak pulse / Fainting Pale / Bluish skin color Epinephrine Auto-injectors Epi-Pen video Auvi-Q video Inject Epinephrine into thigh Call 9-1-1

$Deep wound Excessive bleeding Possible fracture$ Sprain Unable to bear weight Significant swelling

22 Student Accidents Head injury Possible Concussion Deep wound Excessive bleeding Possible fracture Sprain Unable to bear weight Significant swelling Contact Nurse. Contact Parent. Complete accident form!

$Bleeding from Head Skull fracture Swelling / Bruising facial bones/area Nasal discharge Unequal pupil size Stiff neck Severe headache Loss of consciousness Slowed$

23 Head injury Definition Trauma to the scalp, skull, or brain Traumatic Brain Injury and Head Injury often used interchangeably Indications of Head Injury Scalp wound / Bleeding from Head Skull fracture Swelling / Bruising facial bones/area Nasal discharge Unequal pupil size Stiff neck Severe headache Loss of consciousness Slowed breathing

24 Concussion Definition A traumatic brain injury that alters the way the brain functions. Effects are usually temporary but can include headaches and problems with concentration, memory, balance and coordination. Signs/Symptoms Appears dazed / stunned Answers questions slowly / repeats questions Confused about events / Forgets recent info Irritable / Very emotional Brief loss of / No memory of events just before the injury / or just after the injury. Abnormal balance /gait Dizziness Nausea / Vomiting Headache Visual changes Disoriented Sensitivity to light/noise Drowsy

25 Concussion Return to Learning Policy and protocol for all students not just athletes. Effective Refer to website Nurses page.

Referrals to the School Nurse Examples Chronically sick student. Excessive absences due to illness. Asthmatic student with continued complaints, frequent coughing, wheezing, difficulty breathing.

26 Referrals to the School Nurse Examples Chronically sick student. Excessive absences due to illness. Asthmatic student with continued complaints, frequent coughing, wheezing, difficulty breathing. Diabetic with frequent symptoms of high, low, uncontrolled blood sugars. Squinting to see the board / close-up. Hearing problems. Call first! Make sure nurse is in / not with another student. Minimizes time out of class. Allows you chance to describe situation / concerns.

27 Staff Training / Resources Website Departments Student Services Nurses Staff Training Medication Administration Diabetes Allergies / Anaphylaxis Asthma More! Policies / Procedures / Protocols Health Forms

28 Questions? It s going to be a great year! Be sure you signed the roster for this training!

What is Diabetes? American Diabetes Association

What is Diabetes? American Diabetes Association March 2015 What is Diabetes? Diabetes mellitus refers to a group of diseases that affect how your body uses blood sugar (glucose). Glucose is vital to your health because it's an important source of energy