West Windsor-Plainsboro School Nurses

1. Annual Employee Training:Asthma, Blood Borne Pathogens, Epilepsy, Diabetes andLife-Threatening AllergicReactions Requiring EmergencyAuto-injector Epinephrine and Glucagon West Windsor-Plainsboro School Nurses

2. Purpose • To comply with D.O.E. health services and policy and procedural requirement 6A:16-2.1 and NJSA 18A:40-12.0 – 12.21 (epinephrine) • To ask for volunteers to be trained as Epinephrine and/or Glucagon delegates. • To assist staff in the recognition of medical emergencies related to asthma, diabetes, seizure disorder, and anaphylaxis. • To obtain rapid medical response to the student who has a medical emergency. • To remind staff of the AED (Automated External Defibrillator) locations. • To make staff aware of universal precautions.

3. Asthma • Asthma is a disease that affects the lungs. It causes repeated episodes of wheezing, breathlessness, chest tightness, and nighttime or early morning coughing. • Asthma accounts for a high degree of absenteeism from school. • Asthma can be triggered by allergens and irritants. Controlling exposure to these triggers can reduce asthma episodes. Respiratory allergens and irritants include animals with fur or feathers, mold, dust mites (for example, in carpets and upholstery), cockroaches, and strong odors or fumes from such products as pesticides, paint, perfumes and cleaning chemicals.

4. Asthma continued: • Students may carry and self-medicate with their personally prescribed emergency inhaler, per district policy. • Two puffs from an inhaler in four hours is a normal dose…if you see a student using their inhaler more frequently, please report it to the school nurse. • Students with asthma are identified on Infinite Campus with a blue “Health Condition” icon.

5. Epilepsy (Seizure Disorder) • Epilepsy is a neurological condition that from time to time produces brief disturbances in the normal electrical functions of the brain. Seizures are a symptom of epilepsy. Seizures are not painful and the person does not remember having one. • There are many different types of seizures. People may experience just one type or more than one. Experts divide seizures into generalized seizures, partial seizures, non-epileptic seizures and status epilepticus. • Students with seizures are identified on Infinite Campus with a blue “Health Conditions” icon. Students with seizure disorders may have special precautions regarding physical education; especially heights and swimming.

6. First Aid for Seizures • Remain calm and call school nurse. Observe type and time of the seizure. Position the student on his/her side. • Protect the student from getting hurt; remove harmful objects from the student’s pathway or gently coax away from them. Do not hold them down. Do not put anything in their mouth. Use a soft, calm voice when talking to the student. • Protect the student from embarrassment / clear the classroom.

7. Diabetes • Type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes. In type 1 diabetes, the body does not produce insulin. • Type 2 diabetes is the most common form of diabetes and either the body does not produce enough insulin or the cells ignore the insulin. • The student who does not produce insulin needs to give themselves an insulin injection: either by drawing up a dose in a syringe, giving a prefilled insulin pen dose, or entering a dose given through an insulin pump (looks like a pager…so don’t take it away! They are not text messaging!) • Students with diabetes are identified on Infinite Campus with a blue “Health Conditions” icon.

8. Hypoglycemia:(Low Blood Sugar)NEEDS IMMEDIATE ACTIONPossible Signs & Symptoms MILD SYMPTOMS Hunger Sleepiness Shakiness Changed behavior Weakness Sweating Paleness Anxiety Blurry vision Dilated pupils Increased heart rate/palpitations MODERATE TO SEVERE SYMPTOMS Yawning Confusion Irritability/frustration Restlessness Extreme tiredness/fatigue Dazed appearance Inability to swallow Unconsciousness/coma Sudden crying Seizures

9. Hyperglycemia:(High Blood Sugar)Possible Signs & Symptoms MILD SYMPTOMS Lack of concentration Thirst Frequent urination Flushing of skin Sweet, fruity breath Blurred vision Weight loss Increased hunger Stomach pains Fatigue/sleepiness MODERATE TO SEVERE SYMPTOMS Dry mouth Vomiting Stomach cramps Nausea Labored breathing Confusion Profound weakness Unconscious

10. What to do if your student shows symptoms of hypoglycemia (low blood sugar): • Follow the plan given to you by your school nurse. A diabetic student who is not feeling well should never be sent to the nurse alone. • Allow student to eat a snack, if available, on the way to the nurse.

11. What to do if your student shows symptoms of hyperglycemia (high blood sugar): • Follow the plan given to you by your school nurse. A diabetic student who is not feeling well should never be sent to the nurse alone.

12. Blood Borne Pathogens • Staff are to follow Universal Precautions: assume that all blood and bodily fluid is capable of transmitting HIV, Hepatitis B, Hepatitis C, and other contagious diseases. • Use a barrier, such as latex free gloves, to prevent transmission when rendering first aid. The school nurse will supply gloves each year and replenish as needed. Wash hands immediately upon removal of gloves. • You are never expected to clean up blood or bodily fluid! Call the Building and Grounds office. Protect others by quarantining the area. • For more information, check virtual staff site.

13. Life-Threatening allergic reactions • A person can have a severe allergic reaction resulting in death! • Common allergens include, but are not limited to, bees/wasps, foods like peanuts, soy, tree nuts, milk, and items containing latex. • The student is to avoid the allergen! During celebrations know what your student is allergic to! • Students with life-threatening allergies are identified in Infinite Campus with a blue “Health Conditions” icon. SIGNS OF AN ALLERGIC REACTION INCLUDE: SYSTEMS: SYMPTOMS: • MOUTH/FACE Itching, swelling of lips, tongue, or mouth. Swelling of face, area around eyes. • THROAT Itching and/or a sense of tightness in the throat, hoarseness, hacking cough. • SKIN Hives, itchy rash, and/or swelling about the face or extremities, cold/clammy skin. • GUT Nausea, abdominal cramps, vomiting, and/or diarrhea • LUNG Shortness of breath, repetitive coughing, and/or wheezing. • HEART Thread like or weak pulse, passing out. The severity of symptoms can quickly change!

14. Treatment for life threatening allergy…ANAPHYLAXSIS! • During school hours immediately notify school nurse. • If you are a trained delegate, administer Epinephrine as per district policy. See attachment which needs to be completed and returned via email to your school nurse.

15. Where to Get More Information Epilepsy Foundation http://www.epilepsyfoundation.org/about/faq/index.cfm SchoolAsthmaAllergy.com http://www.schoolasthmaallergy.com/ Childrenwithdiabetes.com http://www.childrenwithdiabetes.com The Food Allergy and Anaphylaxis Network http://www.foodallergy.org/downloads.html The Pediatric/Adult Asthma Coalition of New Jersey http://www.pacnj.org