Life-Threatening Health Conditions

1. Nursing Services Fall 2009 It is that time of year that we review the state requirements for students with life-threatening health conditions. We will also discuss personal safety which includes blood borne pathogens and updates on the H1N1 (Swine) Flu.It is that time of year that we review the state requirements for students with life-threatening health conditions. We will also discuss personal safety which includes blood borne pathogens and updates on the H1N1 (Swine) Flu.

2. RCW 28A.210.320 states � �life-threatening condition� means a health condition that will put the child in danger of death during the school day. July 2002 the legislature passed a law that requires all school employees having contact with students must attend an in-service to learn about their health conditions. Student conditions such as life-threatening allergies, asthma, seizures, unstable cardiac conditions and diabetes are considered life-threatening. In order for the student to attend school the nurse must receive doctor orders, medications, health supplies and develop the Individual Health Plan (IHP) before the student can start school. This impacts close to 4000 students in our district alone.July 2002 the legislature passed a law that requires all school employees having contact with students must attend an in-service to learn about their health conditions. Student conditions such as life-threatening allergies, asthma, seizures, unstable cardiac conditions and diabetes are considered life-threatening. In order for the student to attend school the nurse must receive doctor orders, medications, health supplies and develop the Individual Health Plan (IHP) before the student can start school. This impacts close to 4000 students in our district alone.

3. Prior to attendance at school, parents of a student with a life-threatening health condition must present the medical and/ or treatment order which addresses the health condition. Following submission of the medication or treatment order, the Individual Health Plan (IHP) is developed by the School Nurse for the student. Teachers and staff are then educated about the individual student and his needs while at school. Once all these steps are completed the student can then attend school.Prior to attendance at school, parents of a student with a life-threatening health condition must present the medical and/ or treatment order which addresses the health condition. Following submission of the medication or treatment order, the Individual Health Plan (IHP) is developed by the School Nurse for the student. Teachers and staff are then educated about the individual student and his needs while at school. Once all these steps are completed the student can then attend school.

4. Students with known medical conditions such as: Asthma Life-Threatening Allergies Diabetes Unstable Seizures These are just some examples of medical conditions that are considered life-threatening.These are just some examples of medical conditions that are considered life-threatening.

5. �Allergens� cause allergies and symptoms can vary from person to person. Kent School District has the second highest medical needs of all districts in the state of Washington. We have close to 1200 students with life-threatening allergies. Allergy reactions differ among each person. Some potential allergens include ��..Kent School District has the second highest medical needs of all districts in the state of Washington. We have close to 1200 students with life-threatening allergies. Allergy reactions differ among each person. Some potential allergens include ��..

6. Food Allergies Food is the leading cause of anaphylaxis in children. Eight foods cause 90% of food allergy Reactions. Milk Eggs Tree Nuts Peanuts Soybeans Wheat Fish Shellfish Some students can grow out of a daily allergy but allergies to nuts and fish intensify as the student gets older.Some students can grow out of a daily allergy but allergies to nuts and fish intensify as the student gets older.

7. Anaphylaxis is a sudden, severe allergic response that produces breathing difficulties, circulatory problems and possible death. Anaphylaxis is an emergency � do not wait call 911 immediately!Anaphylaxis is an emergency � do not wait call 911 immediately!

8. Tingling lips, mouth or tongue Flushing of the face and body Itchy eyes, nose, face Swelling of eyes or face Hives Diarrhea Wheezing Symptoms includeSymptoms include

9. Allergy symptoms are controlled by: Medications Diphenhydramine HCL (Benadryl) Fexofenadine HCL (Allegra) Loratadine (Claritin) Diet Allergen-free area Allergy symptoms are controlled thru medications prescribed by a licensed health care provider. Also, if a child has a food allergy it is important for that child to take responsibility for what foods he/ she chooses to eat. Some schools have �nut free� tables but this is not the case in all our schools. The best bet is to educate the student so they can make a wise decision.Allergy symptoms are controlled thru medications prescribed by a licensed health care provider. Also, if a child has a food allergy it is important for that child to take responsibility for what foods he/ she chooses to eat. Some schools have �nut free� tables but this is not the case in all our schools. The best bet is to educate the student so they can make a wise decision.

10. Epinephrine Effects will last for only 15 minutes Symptoms can recur 4 to 8 hours later

11. 1. Pull off gray safety cap. 2. Place black tip on outer thigh. Stabilize the thigh. You may inject through clothing. 3. Press forcefully to active mechanism. Hold pen in place for 10 seconds. 4. Dispose of Epi-Pen � as a contaminated sharp. 5. Massage the injection area for 10 seconds. NOTE: You must demonstrate this skill using the Epi-Pen Trainer to your School Nurse. Show how to work the Epi-pen. Most students in the secondary schools carry their Epi-pen and have a second pen as back-up in the health room.Show how to work the Epi-pen. Most students in the secondary schools carry their Epi-pen and have a second pen as back-up in the health room.

12. What is asthma? Chronic lung condition that causes breathing problems (asthma attacks) Who has asthma? 1 in 5 Washington children Severity varies from person to person Asthma is another chronic medical condition and July 2006 became classified as a life-threatening condition.Asthma is another chronic medical condition and July 2006 became classified as a life-threatening condition.

13. What happens during an asthma attack? Airways in the lungs become smaller and extra mucus can block air flow Symptoms include: coughing, wheezing, chest tightness, shortness of breath

14. Triggers for Asthma attacks include: Respiratory Illness Allergens Weather Irritants Emotions Exercise Triggers for asthma include��.. WASL testing always has an increase in students using their inhalers. Emotions � especially at the secondary schools on Friday when the planned date is abruptly cancelled.Triggers for asthma include��.. WASL testing always has an increase in students using their inhalers. Emotions � especially at the secondary schools on Friday when the planned date is abruptly cancelled.

15. Shortness of breath Coughing Wheezing Chest Pain Chest Tightness

16. Rescue Meds provide quick relief by relaxing the muscles around the bronchial tubes Bronchodilators Long-term control medications reduce inflammation of the airways Reduce inflammation The primary medication in use is the hand held inhaler. At secondary schools most students carry their inhaler on their person. If you have a student that carries an inhaler we will notify you.The primary medication in use is the hand held inhaler. At secondary schools most students carry their inhaler on their person. If you have a student that carries an inhaler we will notify you.

17. A chronic illness that results from failure of the pancreas to make the hormone called insulin. Without insulin, sugar accumulates in the blood stream and will cause symptoms. Diabetes is a chronic life-long condition that requires medication � insulin - for treatment. The number of early onset diabetes cases is dramatically increasing.Diabetes is a chronic life-long condition that requires medication � insulin - for treatment. The number of early onset diabetes cases is dramatically increasing.

18. Most children have Type 1 Diabetes Not contagious Can�t be cured, but can be managed Treatment includes: Blood testing Insulin Dietary control School Accommodations Again, the nurse will give specific training to teachers that have students with diabetes. Students must be checked off by the nurse to determine independence prior to testing and administering insulin in the classroom. These students must also have access to their snacks, water and bathroom use as needed.Again, the nurse will give specific training to teachers that have students with diabetes. Students must be checked off by the nurse to determine independence prior to testing and administering insulin in the classroom. These students must also have access to their snacks, water and bathroom use as needed.

19. Hypoglycemia � too much insulin & too little glucose Hyperglycemia- too little insulin & too much glucose This is an example of a gluco-meter and the student is checking her blood sugar.This is an example of a gluco-meter and the student is checking her blood sugar.

20. Taken by injection Lowers blood sugar Different types of insulin have different onset of action This is a picture of an insulin pen. The student dials in the amount of insulin needed and then self-injects.This is a picture of an insulin pen. The student dials in the amount of insulin needed and then self-injects.

21. Epilepsy is a chronic disorder of the brain characterized by the tendency to have seizures. Seizures are another life-threatening condition especially if the seizures are unstable.Seizures are another life-threatening condition especially if the seizures are unstable.

22. Generalized Seizures Tonic/Clonic (grand mal) seizures Absence (petit mal) seizures

23. Medications-often students will be on 2-4 different medications. Ketogenic Diet-foods high in fat and low in carbohydrates and protein. Surgery Vagus Nerve Stimulator

24. Stay Calm Protect person from injury Do not restrain person Do not put anything in mouth Roll person to their side Allow person to rest once seizure is over. The most important thing is to stay calmThe most important thing is to stay calm

25. Keep in mind follow the rules! Infection Control Universal Precautions Hand Washing Use of Disposable Gloves District Procedures/Guidelines Know the rules. Hand-washing is the number one way of preventing the spread of germs.Know the rules. Hand-washing is the number one way of preventing the spread of germs.

26. Do not eat, or touch your mouth or eyes, while giving first aid Avoid contact with another person�s blood or bodily secretions. Wash hands after bathroom use or contact with body secretions. Wash your hands before and after eating. Use gloves if contact with body fluids is anticipated. Wash your hands after glove use.

27. Hand washing is the single most important practice preventing transmission of infectious organisms! It can be bar soap or liquid soap. I believe all our washing areas have liquid soap. I know people would like to use waterless soap, but regular soap is much more cost effective and it is not as drying to your skin as the waterless soap.It can be bar soap or liquid soap. I believe all our washing areas have liquid soap. I know people would like to use waterless soap, but regular soap is much more cost effective and it is not as drying to your skin as the waterless soap.

28. Maintain a supply of gloves in readily accessible locations. Do not reuse gloves. Dispose of used gloves in a lined waste container. Wash hands thoroughly, following hand-washing procedure.

29. Exposure incident means that an employee is exposed to another person�s blood or other potentially infectious body fluid. Exposure means direct contact to the employee�s eye, mouth, and other mucous membrane or open wound.

30. Wash exposed area immediately. Report to Supervisor immediately. Complete an employee accident report Contact Risk Management to report the incident and for specific procedures to follow. Post-exposure medical evaluation and follow-up needs to be completed. If you are exposed to a bodily fluid contact your supervisor (head secretary at the schools) and complete an employee accident report. If you have not had the series of Hepatitis B shots I suggest you do so. Contact the Benefits Coordinator for the paperwork.If you are exposed to a bodily fluid contact your supervisor (head secretary at the schools) and complete an employee accident report. If you have not had the series of Hepatitis B shots I suggest you do so. Contact the Benefits Coordinator for the paperwork.

31. H1N1 (previously referred to as �swine flu�) is a new influenza virus causing illness in people. This new virus was first detected in people in the United States in April 2009. This virus is spreading from person-to-person, probably in much the same way that regular seasonal influenza viruses spread.

32. The symptoms are similar to the regular human flu fever cough sore throat body aches headache chills and fatigue The symptoms of H1N1 (swine) flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with H1N1 (swine) flu. In the past, severe illness (pneumonia and respiratory failure) and deaths have been reported with H1N1 (swine) flu infection in people. Like seasonal flu, H1N1 (swine) flu may cause a worsening of underlying chronic medical conditions. Efforts are underway to develop a H1N1 vaccine that could be available locally later in the year. While the amounts and delivery dates are uncertain at this time, public health is working with state and local partners to determine the most effective way to distribute the vaccine when it becomes available. Public Health will guide us this fall as to recommendations for prevention measures. The symptoms of H1N1 (swine) flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with H1N1 (swine) flu. In the past, severe illness (pneumonia and respiratory failure) and deaths have been reported with H1N1 (swine) flu infection in people. Like seasonal flu, H1N1 (swine) flu may cause a worsening of underlying chronic medical conditions. Efforts are underway to develop a H1N1 vaccine that could be available locally later in the year. While the amounts and delivery dates are uncertain at this time, public health is working with state and local partners to determine the most effective way to distribute the vaccine when it becomes available. Public Health will guide us this fall as to recommendations for prevention measures.

33. Cover your nose and mouth with a tissue when you cough or sneeze. Frequently wash your hands with soap and water. Avoid touching your eyes, nose or mouth. Avoid close contact with sick people. If you are sick with influenza stay home from work or school. The best way to prevent the flu � Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it. Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective. Wash your hands for 20 seconds. Avoid touching your eyes, nose or mouth. Germs spread this way. Try to avoid close contact with sick people. If you get sick with influenza, Public Health recommends that you stay home from work or school and limit contact with others to keep from infecting them. The best way to prevent the flu � Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it. Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective. Wash your hands for 20 seconds. Avoid touching your eyes, nose or mouth. Germs spread this way. Try to avoid close contact with sick people. If you get sick with influenza, Public Health recommends that you stay home from work or school and limit contact with others to keep from infecting them.

34. Disinfecting environmental surfaces is important in minimizing the spread of infection Clean environmental surfaces with an approved cleaning solution. Thanks for your time and help in keeping our students safe at school. Please feel free to contact me with any questions you may have.Thanks for your time and help in keeping our students safe at school. Please feel free to contact me with any questions you may have.

35. Have a great year!