Chilton, WI 53014
Health
Mrs. Tabetha Brocker
 
brockert@cpsdwi.onmicrosoft.com
(920) 849-9457 or ext. 2209
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Feb142017

Staff Administration of Non-Student Specific Epinephrine

Information
First published on 09 February 2017 Posted in Health

Chilton Public School District

Anaphylaxis is a severe allergic reaction which can be life threatening. It may occur within minutes after a triggering event or up to hours later. Chilton Public School District will plan for the management of pupils attending school whom have life threatening allergies as well as plan for first-time anaphylaxis emergencies. The school district will also maintain an emergency action plan for the management of pupils attending the school who have known life-threatening allergies.

The following procedure for emergency use of stock epinephrine is to be used only by appropriately trained staff to administer epinephrine to a person (pupil, staff member, volunteer, or other) with or without previously diagnosed anaphylaxis. Stock epinephrine may be administered to a pupil or other person who the school nurse or designated school personnel believes is experiencing anaphylaxis in accordance with the following procedure which has been reviewed and approved by the District’s Medical Advisor. The person administering the epinephrine auto-injector must, as soon as practicable, dial “911” or in an area where “911” is not available, the telephone number for an emergency medical service provider.

Students with known life threatening allergies and/or anaphylaxis should provide their own prescribed epinephrine auto-injector in accordance with that pupil’s prescription consent. This anaphylaxis policy is not intended to replace student specific orders or parent provided individual medications.

Any district employee may be authorized to administer epinephrine who:

  • is willing to assume that responsibility,
  • is authorized by the school principal or his/her designee,
  • has received Department of Public Instruction approved training, within four years, for the administration of epinephrine
  • Has been sufficiently instructed by the District Nurse:
    1. In recognizing the signs and symptoms of anaphylaxis,
    2. On the proper administration of epinephrine auto-injector,
    3. On proper follow up procedures following administration of epinephrine auto-injector.
  • Has successfully completed an annual return demonstration of administration of epinephrine auto-injector and has been deemed competent by the District Nurse.

This policy has been reviewed and approved by the District Medical Advisor

Procedure:

The district will maintain a supply of two stock doses of 0.15mg and 0.3mg epinephrine at each school building within the district. Stock epinephrine will be located within each building’s AED. Stock epinephrine standing orders must be renewed annually and with any change in prescriber.

Epinephrine auto injector dose:

  • 0.15mg (JR. dose) - if student is less than 66 pounds
  •             0.3mg (Adult/Regular dose) - if 66 pounds or greater

The medication will be stored in a secure but unlocked area that is clearly labeled “EpiPens” for “Severe Allergic Reactions.”

To determine JR. or Adult dose- When in doubt as to whether or not the person is 66 pounds or under, a measuring device (tape measure) with a length of 135cm would approximate the weight of 66 pounds. Measuring tape cut to the specific length of 135cm will be prepared for every health room and stored with the EpiPens. Unlicensed assistive personnel will be trained that if a student is shorter than the measuring device, the 0.15mg dose should be used. If the student is taller than the device, the 0.3mg dose should be used. Training will emphasize that if in doubt as to size/weight of the student, the higher dose should be used.

Common Triggers/Allergens and/or extreme sensitivity to one or more of the following:

  1. Food- peanuts, tree nuts, soybeans, milk, fish, shellfish, and wheat pollen
  2. Insect sting, usually bee or wasp
  3. Medication
  4. Exercise or asthma triggers
  5. Latex

For Any SEVERE SYMPTOMS after suspected or known ingestion of one or more of the following:

  1. LUNG: Short of breath, wheeze, repetitive cough
  2. HEART: Pale, blue, faint, weak pulse, dizzy, confused
  3. THROAT: Tight, hoarse, trouble breathing/swallowing
  4. MOUTH: Significant swelling (tongue and/or lips)
  5. SKIN: Many hives over body
  6. GUT: Repetitive vomiting, severe diarrhea

Or MORE than ONE MILD symptom from different body areas:

  1. NOSE: Itchy/runny nose, sneezing
  2. MOUTH: Itchy mouth
  3. SKIN: A few hives, itchy rashes, swelling (e.g., eyes, lips)
  4. GUT: Mild nausea/discomfort

1.     If student or other person in the building is suspected of having an anaphylactic reaction (see symptom list above) INJECT EPINEPHRINE IMMEDIATELY (per training instructions by the District Nurse). It is safer to give epinephrine than to delay treatment.

2.     Call 911, tell rescue squad epinephrine was given; request an ambulance with epinephrine.

3.     Continue monitoring.

4.     Stay with the person.

5.     Request that someone alert District Nurse and parent/guardian.

6.     Note time when epinephrine was administered.

7.     If available, a second dose of epinephrine can be given 5 minutes or more after the first if symptoms   persist or recur. Inject second dose in other leg. Note the time

8.     For a severe reaction, consider keeping student lying on back with legs raised.

9.   Administer CPR if needed.

10.  Remain with the student (or other person) and treat student even if parents cannot be reached.

11. Upon arrival of emergency medical personnel, care and responsibility of the person is then handed over. (Even if symptoms subside, 911 must still respond and individual must be evaluates by a physician. The student will not be allowed to remain at school or return to school on the day epinephrine is administered).

After epinephrine administration:   

  1. Complete appropriate documentation (incident report, medication administration, etc.).
  2. School staff involved in emergency response and those on the medical alert team should meet to debrief on the incident and make any necessary changes to policy or procedure or emergency action plan.

Epinephrine should be stored in a safe, unlocked and accessible location, in a dark place at room temperature (between 59-86 degrees F). The District Nurse, will assume the responsibility for maintaining a monthly schedule for tracking the medication status, contents of medication, and expiration dates as well as ordering replacement epinephrine for those expired or used. The solution should be clear; if it is discolored or contained solid particles, the unit should not be used and will get discarded.

Note- Non-student specific epinephrine may be permitted to be taken on field trips based on the Building Administrator’s discretion for that particular activity. If a student or other person is appearing to have an anaphylactic reaction on a field trip (who does not have their own prescribed epinephrine and the stock supply of epinephrine was not brought on this particular trip) immediately call “911.” Stock epinephrine and/or trained staff may not be available for administration during before or after school events (practices, games, etc.), and in this case “911” should be called if needed.

References:

Food Allergy and Anaphylaxis Network.  (2011). Food Allergy Action Plan.  Available at:http://www.foodallergy.org/files/FAAP.pdf

Food Allergy and Anaphylaxis Network (FAAN). (2001). School Guidelines for Managing Students With Food Allergies. Available at:http://www.foodallergy.org/school/guidelines.html

National Association of School Nurses. (2014). Implementation of a Stock Epinephrine Protocol. Available at: http://nas.sagepub.com/content/29/6/287.full.pdf+html

National Association of School Nurses.  (2011). Suggested Nursing Protocol for Students without an Emergency Care Plan.  Available at:http://www.nasn.org/portals/0/resources/faat_no_ECP.pdf

Wisconsin State Legislature.  (2013). 2013 WISCONSIN ACT 239.  Available at:https://docs.legis.wisconsin.gov/2013/related/acts/239

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Jul142016

Guidelines for Keeping Sick Children Home

Information
First published on 14 July 2016 Posted in Health

Chilton Public School District encourages regular school attendance for all students. Unnecessary absences have a negative effect on school performance and academic success. Here are some guidelines to use in determining whether your child should stay home in order to promote quicker recovery and prevent the spread of illnesses at school. The following information is not intended to take place of your pediatrician’s advice, but rather to provide a guideline to be followed until your doctor can be contacted for his/her opinion.

1. FEVER: A child with an oral fever of 100 degrees or higher should be kept at home. Please keep your child home until they are fever free for 24 hours without the help of fever reducing medications.

2. VOMITING, DIARRHEA: Children should stay home until they have been free of vomiting and/or diarrhea for 24 hours and until he/she can keep fluids and food down.

3. COLDS/COUGHS: Unfortunately, colds are a common occurrence in the classroom. If your child is moderately uncomfortable, has a constant runny nose with green or yellow discharge, exhaustion, or muscle or body aches, please keep your child at home to provide rest and adequate fluids.

4. SORE THROAT: If your child has a sore throat but no other symptoms, they may go to school. If the sore throat is severe enough to interfere with swallowing or if white spots can be seen in the back of the throat or a fever is present, keep your child at home. Strep throat is a highly contagious condition caused by bacterial infection. Symptoms include sore throat accompanied by fever, pus in the back of the throat, or rash. A child with strep throat needs to be kept at home, medically evaluated and treated with antibiotics for 24 hours.

5. UNDIAGNOSED SKIN RASH: A rash may be the first sign of one of many childhood illnesses. If a rash is present, your child should see a healthcare provider to determine if it is safe to be at school.

6. ANTIBIOTIC THERAPY: Antibiotics are sometimes prescribed to treat bacterial infections. If antibiotics are prescribed your child must be on them 24 hours before returning to school.

7. HEADACHE: Keep your child at home if headache is severe enough to interfere with learning. Over the counter pain medication can be given to your child if you bring properly labeled medication in its original container with a medication authorization form. (See “OTC Medication Administration” tab).

8. EYE INFECTIONS: Students with red, sore eyes that also have white, yellow, or green drainage present should be kept home and consulted with a physician. Once a student has been on antibiotics for 24 hours, they may return to school, unless otherwise stated by a doctor.

9. EARACHE: If your child has moderate or severe pain, consult your health care provider.

**When your child is ill, be sure to provide plenty or rest and fluids. Handwashing is the single most important method of preventing the spread of illness. Be sure both healthy and ill family members get into the habit of washing their hands with soap and water several times a day especially after using the bathroom and before eating.

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Jul142016

Allergy Letter to Parents

Information
First published on 14 July 2016 Posted in Health

Dear Parent/Guardian:

Chilton Public School District is aware that your child has a potential life-threatening allergy that may require treatment at school. In order for us to be prepared in case of emergency, we ask that you and your child’s physician work together to fill out the attached Emergency Allergy Action Plan. The plan is for you and your child’s doctor to discuss, complete, and requires both parent and physician signature. Please then return to your child’s school office as quickly as possible.

This Emergency Action Plan will be made available to all appropriate staff in your child’s school building so that the school is aware of what steps to take in case an emergency were to arise.

It is important for your child’s safety that we have the proper medication consent forms, supplies, and medications at school in order to respond to an emergency. All prescription medication consent forms require a parent and physician signature. Non-prescription consent forms require a parent signature only. Both consent forms are available in the school’s office and on the district health website. This paperwork must be completed annually before the first day of school and be brought to the school office.  

Please call the District Nurse or school office if you have any questions or concerns. Thank you for helping us to ensure a safe and healthy year for your student at Chilton Public Schools.      

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Jul142016

Seizure Letter to Parents

Information
First published on 14 July 2016 Posted in Health

Dear Parent/Guardian:

Chilton Public School District is aware that your child has epilepsy (or another seizure disorder) that may require treatment at school. In order for school to be prepared in case of emergency, we ask that you and your child’s physician work together to fill out the attached Seizure Action Plan. Please also fill out the form, Questionnaire for Parents of a Child with Seizure. The plan is for you and your child’s doctor to discuss, complete, and requires both parent and physician signature. Please then return to your child’s school office as quickly as possible.

This Emergency Action Plan will be made available to all appropriate staff in your child’s school building so that the school is aware of what steps to take in case an emergency were to arise.

It is important for your child’ssafetythat we have the proper medication consent forms, supplies, and medications at school in order to respond to an emergency. All prescription medication consent forms require a parent and physician signature. Non-prescription consent forms require a parent signature only. Both consent forms are available in the school’s office and on the schools website, under health tab. This paperwork must be completed annually before the first day of school and be brought to the school office.

Please call the District Nurse or school office if you have any questions or concerns. Thank you for helping us to ensure a safe and healthy year for your student at Chilton Public Schools.

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Jul142016

Asthma Letter to Parents

Information
First published on 14 July 2016 Posted in Health

Dear Parent/Guardian,

Asthma is the most common chronic disease of children and is one of the leading causes of school absences. Our school records show that your son or daughter has a history of asthma. If this is incorrect please call and notify the office. Asthma can be managed in the school setting so that children can be active, healthy, and available to learn. Addressing asthma in the school setting is a collaborative effort.

Per recommendations of the National Asthma Education and Prevention Program, The Center for Disease Control, and the American Lung Association, ALL students with asthma should have a written Asthma Action Plan in place in the school setting. This plan will provide information about medication, symptoms, triggers, and when to step- up treatment for worsening symptoms or other special considerations such as a pre-exercise plan.

If your child is prescribed an inhaler and will be using it at school or any school functions, Chilton Public School District requires that the Inhaled Medication Authorization form be filled out and signed by the child’s physician and signed by the parent. If you would like your child to carry their inhaler, your child’s doctor and parent permission needs to be indicated on the Inhaled Medication Authorization Form. Please update the school with any modifications made in his/her treatment throughout the school year.

The Asthma Action Plan and the Inhaled Medication Authorization Form can be found on the district health website or in the school’s office. This paperwork must be completed annually before the first day of school and be brought to the school office.

Your time and effort in completing these forms is greatly appreciated. This is another step in keeping your child safe while getting the best possible education at school. Please feel free to contact me if you would like to discuss your child’s condition or need help completing these forms. Thank you!

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