Vashon Island School District

1. Vashon Island School District Health Services Update Life-threatening Health Conditions

2. Protect your health Hand washing Flu shot Tdap – booster to prevent pertussis/whooping cough

3. Is your classroom ready for a medical emergency? Mini first aid kit: band aids + gloves + gauze pads Disaster first aid backpack Classroom emergency card School medical emergency protocol Call 911 if needed Send 2 runners to office with emergency card, name of person & nature of problem – 1 runner to class next door

4. Life-threatening Health Conditions • Asthma • Allergy – Anaphylaxis • Diabetes • Seizure

5. ASTHMA Asthma tends to make a person’s airways irritated and swollen or inflamed For students with asthma, breathing problems can turn into a serious emergency

6. PREVENTION: control triggers • Exercise • Pollen • Mold • Dust • Carpeting • Strong odors • Animals • Cold air • Illness

7. Early Warning Signs • Coughing or itchy throat • Stuffy or runny nose • Funny or tight feeling in chest • Fatigue • Behavioral changes, agitation, irritability • Decreased appetite • Dark circles under eyes • Headache Sit, rest, use inhaler if self-carry Otherwise, escort to nurse

8. When to call 911 IF breathing is so difficult that the student has trouble talking or walking ORthe student’s lips or fingernails look gray or blue OR the inhaler rescue medicine is not helping (breathing should improve within 15 minutes after the first puffs from the inhaler) If you call 911, stay with the student until help arrives and call the office so that they can notify nurse and student’s parent or guardian

9. Allergy – Anaphylaxis • Allergic shock or generalized allergic reaction • An allergic reaction that can result in death due to airway obstruction or a severe drop in blood pressure • An extreme total body reaction

10. Common Causes of Anaphylactic Allergic Reaction • Food • Milk • Eggs • Peanuts • Tree nuts (such as almonds, cashews, walnuts) • Fish (such as bass, cod, flounder) • Shellfish (such as crab, lobster, shrimp) • Soy • Wheat • Wasp or Bee Sting • Other • Medications • Latex • Cold • Pollen

11. Follow the plan to avoid exposure to allergen • Reactions can be unpredictable, always be prepared • A child can have a very severe allergic reaction, even if previous reactions have been mild • Children with asthma are at risk for a more severe food allergy reaction • Changes in routine pose the greatest risk of exposure to allergens • Field trips • Birthday parties • Special events • A delay in getting help and the administration of epinephrine are believed to be a factor in fatal reactions - Don’t hesitate. Medicate.

12. Think F.A.S.T. Face Itchiness, redness, swelling of face and tongue Airway Trouble breathing, swallowing or speaking Total body Rash, itchiness, swelling, weakness, paleness, sense of doom, loss of consciousness Stomach Stomach pain, vomiting, diarrhea Give Epinephrine Call 911

13. Remove the EpiPen Auto-Injector from the carrier tube and follow these 2 simple steps: Hold firmly with orange tip pointing downward. Remove blue safety cap by pulling straight up. Do not bend or twist. Swing and push orange tip firmly into mid-outer thigh until you hear a “click.” Hold on thigh for ten seconds. Built-in needle protection When EpiPen is removed, the orange needle cover automatically extends to cover the injection needle, ensuring the needle is never exposed.

14. DIABETES Type 1 – Insulin Dependent Diabetes Autoimmune disease Body destroys insulin-producing beta cells in the pancreas Insulin is required by the body to use glucose Without insulin, body starves to death Short and long-term consequences Serious disease that can affect academics and student health greatly Students with diabetes have legal rights – If no IEP will have 504 plan

15. What affects blood sugar? • Insulin • Foods eaten • Exercise • Illness • Growth spurt • Stress and any changes in routine Diabetes is a 24/7 disease Requires constant juggling to prevent high or low blood sugar

16. High vs. Low Blood Sugar High blood sugar Increased thirst, frequent urination, nausea, fruity breath, fatigue, blurry vision, drowsiness, confusion • Develops more slowly • Insulin is treatment Low blood sugar Hunger, headache, dizziness, change in behavior, poor coordination, blurry vision, drowsiness, confusion • Can get to dangerous level more quickly • When in doubt, give sugar (candy, juice)

17. Student either independent or nurse assist: • Blood sugar monitoring before all meals and snacks & before PE • Counting carbohydrates in all food eaten • Dosing w/ appropriate dose of insulin • Problem solving for equipment problems, illness, low & high blood sugar Never send student with low blood sugar to office alone Speak to office secretary or send with escort

18. Glucagon • Given if student cannot swallow safely eg. seizure or unconscious • Hormone releases sugar stored in liver • Only nurse, parent or trained personnel can give • Kept in health room

19. Know the plan & make sure your substitute teachers know the plan Provide unlimited access to water & bathroom Provide accommodations for students with diabetes - no penalty for time out of classroom due to diabetes Notify the parents/guardian and school nurse well in advance of changes in the school schedule : class parties, field trips, special events. Eating meals and snacks on time is a critical component of diabetes management. High or low blood sugar could result in behavioral change and cognitive impairment.

20. Seizure Avoid further injury: Remove glasses, protect head Turn on side if on floor Track time, document seizure activity Remain with student Notify nurse See health plan for type of seizure, do they need post-seizure medication

21. When is a Seizure an Emergency? First time seizure (no medical ID and no known history of seizures) Convulsive seizure lasting more than 5 minutes Repeated seizures without regaining consciousness More seizures than usual or change in type Student is injured, has diabetes or is pregnant Seizure occurs in water Normal breathing does not resume

22. Questions?