SCHOOL POLICIES
Albany R-III School District Health Office Standing Orders
ABDOMINAL PAIN- A student with a stomach ache or abdominal pain will be assessed for location, duration, and intensity of discomfort. History and general assessment to determine cause will be done. If indicated, student will be allowed to rest 15-20 minutes. If pain persists, becomes severe or nurse feels it is necessary, parents will be contacted and advised to seek a physician's care. Tums, 1 or 2 chewable tabs may be given for minor stomach upset.
ANAPHYLAXIS- When a student exhibits signs of anaphylaxis (sudden onset- apprehension, sweating, weakness, shallow respirations, tingling around mouth or face, nasal congestion, wheezing, low blood pressure with weak rapid pulse and loss of consciousness, shock, coma) EMS will be notified immediately, then parents will be called. EpiPen (epinephrine autoinjector 0.15mg-less than 30 kg or 0.3mg epinephrine) will be used if indicated. Supportive care will be given while awaiting EMS.
ALLERGIC REACTIONS-MILD- For less severe allergic reactions, Benadryl 25mg or 50mg po q. 4-6 hours (capsule or syrup) may be used according to age directions, with parental permission.
ASTHMA- A student Asthma Action Plan together with a parental signed inhaler self administration medication permit will be requested each school year. Parents/guardians are responsible to see that the school has this information for all students diagnosed with asthma; students may then carry their inhalers. Preschool through 5th grade students are required to keep a secondary inhaler in the school nurse office for emergency situations.
Asthma Action Plan Students-Students that do not have their inhalers at school and have an attack may utilize the Albuterol administered via small volume nebulizer by the School Health Aide.
BITES- Animal or human bites will be washed thoroughly with soap and water and covered with a dry dressing. Parents will be notified, as tetanus or rabies protection may be required. Law enforcement/public health authorities will be notified of animal bites.
BUMPS, BRUISES- For minor bumps and bruises, ice will be applied as indicated.
BURNS- First/second degree burns will be treated with cool water and Neosporini
CONTAGIOUS ILLNESS- If a student has symptoms of conjunctivitis (red, itching, eyes with purulent drainage), impetigo (skin lesion resembling raised pimples filled with fluids or pus and crusted areas), or other contagious illnesses, parents will be contacted, advised to seek medical care, if appropriate and literature sent home with the child as applicable.
COUGH/SORE THROAT- A cough drop, Chloraseptic spray or salt-water gargle may be used for a minor cough or sore throat.
CUT-Minor scrape- A minor cut or scrape will be cleaned with soap and water, then a clean sterile dressing (Band-Aid, gauze, or telfa) will be applied along with antibiotic ointment if indicated.
CUT-SERIOUS- A serious cut will be cleaned and pressure applied as indicated while the parent is notified and the student referred to their family physician or EMT notified as appropriate.
EYE, LIQUID- If a foreign liquid splashes into the eye, the eye will be flushed with water while the parent is notified so they may seek medical care.
EYE, FOREIGN BODY- For a foreign body of the eye (such as eyelash, dirt speck) the eye will be flushed with eyewash and/or warm water and parent notified if indicated. If blurred vision or severe pain occurs. A patch will be applied and parents notified so they may seek medical care.
FAINT- When a student faints, as assessment for injury will occur and the students will be allowed to rest. The parents will be contacted.
FEVER- If a student has a fever of 100.4 or above, a parent will be contacted and student will go home. Parent will contact family physician if indicated. A student will be fever free for 24 hours prior to returning to school.
HEAD LICE- If a student has head lice (lice and/or nits), parents will be contacted and child will be sent home with appropriate instructions on treatment. The child will not be readmitted to school until treatment has been completed. The school nurse will check the student's head prior to classroom admittance.
HEAD BUMP/INJURY- A head bump or head injury will be checked and ice applied if needed. The student will be observed for severe headache, nausea, and or vomiting, double vision, blurred vision, or pupils of different sizes, loss of muscle coordination such as falling down, walking strangely or staggering. In cases where unusual behavior such as being
confused, breathing irregularly or dizziness, convulsion, bleeding or discharge from ear are observed, parents will be notified so they may seek the advice of the family physician. EMS will be called if indicated.
HYPERGLYCEMIA (High Blood Sugar - When symptoms of hyperglycemia (severe nausea or vomiting, abdominal pain, rapid breathing, sweet odor to breath) are observed in a known diabetic, parent and EMS (if indicated) will be contacted. Diabetic plan of action followed.
HYPOGLYCEMIA (Low Blood Sugar)- When symptoms of hypoglycemia (shakiness, sweating, dizziness, pallor, numbness or tingling in lips, irritability, hunger, confusion, headache, double or blurred vision) are observed in a known diabetic the individual diabetic plan of action will be followed. Usually glucose tablets or juice is given: repeated in 10-15 minutes if symptoms persist. Parents will be contacted. If symptoms escalate, EMS will be called.
IMPETIGO- Student will be on treatment for 24 hours before he or she is able to participate in contact sports per MSHAA guidelines.
MOUTH DISCOMFORT- Vaseline or Blistex may be applied to dry lips. Cold sores, fever blisters or minor mouth pain will be treated with Blistex, Carmex, or Anbesol.
NAUSEA/VOMITING/DIARRHEA- If severe nausea, vomiting, or diarrhea is present, a parent will be called and the student will go home to seek the advice of their family physician if indicated.
NOSEBLEED (EPISTAXIS). Will be treated with application of pressure and cold pack if needed. If the bleeding does not subside within 10 minutes is severe or trauma to nose is evident, a parent will be contacted.
OTC- Over the counter medication may be given to students if brought in original containers and with parental signed instruction.
PAIN, MINOR- Acetaminophen or Ibuprofen may be given for a fever, headache, menstrual cramping and/or various other minor aches a 4-6 hours. This will be given only with parental permission as received annually with the District Health Update form.
Recommended Acetaminophen dosage:
4-5 years and/or 36-79 lbs.
3 chewable tablets/80mg each
6-8 years and/or 44-62 lbs.
4 chewable tablets/80mg each
9-10 years and/or 63-79 lbs.
5 chewable tablets or one 325mg tablet
11 years and/or 80-89 lbs.
6 chewable tablets or one 325mg tablet
12 years and older and/or 90+ lbs.
6-8 chewable tablets or one to two 325mg tablet/or one to two 500mg tablets
Recommended Ibuprofen dosage:
12 years and older
one to two tablets 200mg each
RASH- If a student has an unidentified rash, the parents will be notified, as the student will need to seek medical care to determine if the rash is contagious.
RINGWORM (Tinea). When a student exhibits signs of ringworm (small 1-3cm. reddish lesions on skin, which gradually spread while clearing in the center), topical Lotrimin. Micotin, Tinactin, or Disenex will be recommended for application to parents. Student will be instructed to use at least twice daily and keep lesions covered at school. Cases which do not improve in 23 days, severe cases, and cases with secondary infection present will be referred to their family physician for treatment.
SEIZURE- When a seizure occurs in someone with a known seizure disorder, they will be observed and protected from any environmental hazards. The parents will be contacted so they may seek the advice of their physician. When a seizure occurs for an unknown cause, emergency care will be sought.
SKIN Irritations- Minor skin irritations (allergic itches, rashes, insect bites, and sunburn) will be treated with Caladryl lotion, Benadryl Spray, or Hydrocortisone cream. Sunburn pain will be
treated with Aloe Vera Gel.
SPLINTER- A superficial splinter may be cleaned and removed and then a sterile dressing with antibiotic ointment applied and parents notified when indicated. The parents will be notified of a deeply imbedded splinter and advised to see their family physician.
STING- For an insect sting, a cold compress will be applied, and the stinger removed if present. If a student is allergic to stings, the parent will be notified. The student will supply medication to be kept in the clinic and will be used when symptoms indicate. EMS will be contacted if medically necessary.
TICK REMOVAL- Successful removal with head intact. Wash site with soap and water, apply Neosporin and contact parents. If removal resulted without the head intact, call parents and recommend they contact their family physician for further instructions.
TOOTH INJURY- In case of a broken or avulsed (knocked out) tooth, the student will rinse their mouth with warm salt water. The tooth (or pieces of tooth) will be placed in a cup of whole milk. Ice pack will be applied to face next to area of injury. Parents will be contacted and advised to seek immediate dental care.
Angelia Martin, MD
Sara Fish, School Health