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EM-S ISD Health Services Overview
Basic first aid and health care is available at our school. It is the parent or guardian’s duty to arrange care for sick children promptly. A student who needs to see the nurse/nurse aide must have a pass from his/her teacher, sign the register, and will be seen by an administrator, secretary, nurse/nurse aide. An up-to-date health record, which includes immunizations, screening results, and other pertinent medical data, is maintained on each student. Each parent should keep the school and the registered nurse informed yearly about any special medical information that would be important should the student have a medical emergency that needs attention. To keep information updated, a Student Health Card should be completed by the parent/guardian each year.
It is the parent/guardian’s responsibility to provide current telephone numbers where they or alternate adults can be reached.
SCREENINGS
During the year, school Health Services screens all new students and students in Pre-K, K, 1st, 3rd, 5th, & 7th for hearing and vision. Students in other grades can be screened at the parent's request. Spinal screening for scoliosis is conducted in the 5th and 8th grades. Students are screened for scoliosis individually, while fully clothed. All 1st, 3rd, 5th, and 8th grade students are screened for Acanthosis Nigricans (AN) by observing the back of the neck for a light brown-black, velvety marking, which may indicate a hyperinsulin condition or precursor to Type 2 diabetes.
IF YOU DO NOT WISH YOUR STUDENT TO BE SCREENED FOR SCOLIOSIS AT SCHOOL PLEASE SEND A NOTE TO THE SCHOOL BEFORE OCTOBER 1ST.
COMMUNICABLE DISEASES
A pupil who has symptoms of an infectious or contagious disease (including vomiting, temperature of 100 or greater, or rash of undetermined origin) shall be temporarily removed from school until the danger of transmitting the infection/disease has passed.
The student should be free of fever for 24 hours without fever reducing medication before returning to class. Students with rash will be readmitted with a written statement from the physician indicating treatment; freedom from communicable disease; or condition no longer exists.
The following table lists the most common communicable diseases, indicates the incubation period, and states the requirements set by the State Health Department for re-admission to school:
NAME OF DISEASE AND INCUBATION PERIOD REQUIREMENTS FOR READMISSION TO SCHOOL
Chicken Pox Exclude until all blisters are
2-3 weeks, commonly 13-17 days crusted and dry and child is free of fever.
Diphtheria Exclude case and/or close
2-5 days, maybe longer contacts until released by the physician.
Infectious Hepatitis Exclude until one week after onset
15-20 days, commonly 25 days of illness.
Impetigo Exclude unless under treatment
4-10 days by a physician.
Lice Exclude until student receives
Eggs hatch in 7-10 days medicated treatment for lice and ALL visible lice have been removed from the infested person. Nits (eggs) should be removed DAILY. Research indicates that total removal of nits is essential, including removal from bedding, clothing and the home.
Measles, Rubeola Exclude until released by
7-14 days physician or Health Dept. (proof of disease is required for vaccination exemption.)
Measles, Rubella Exclude until released by
14-21 days physician or Health Dept.
Meningitis Exclude until statement from
2-10 days, commonly 3-4 days physician that the person is noninfectious.
Mononucleosis Exclude until released by
2-6 weeks physician.
Mumps Exclude until released by
12-26 days, commonly physician.
Pink Eye Exclude until recovered, or
24-72 hours physician’s statement that the person is noninfectious and is under treatment.
Ringworm May attend school provided
4-14 days (skin or scalp) person is under treatment of a physician.
Scabies Exclude until under treatment
Several days or weeks and no open lesions are observed.
Streptococcal Infections Exclude until released by a
(strep throat, scarlet fever, physician, or until 24 hours after
scarletina) 1-3 days antibiotic treatment is begun and child is free from fever.
Tuberculosis Exclude until released by the
From infection to primary physician.
lesion about 4-6 weeks
Typhoid Fever Exclude case, carrier, and/or
Range 1-3 weeks household until released by
average 2 weeks physician.
Whooping Cough Exclude until released by
(Pertussis) physician, and completion of 5
commonly 7 days, usually days of antibiotic therapy.
within 10, not more than 21
EMERGENCIES AND ILLNESSES
In the event of injury or illness of a pupil, the school official shall attempt to notify the legal guardian or other designated responsible party. If the school office is unable to contact a responsible party, the principal and/or school nurse shall assume responsibility for obtaining appropriate emergency care. It is the parent/guardian’s responsibility to provide telephone numbers where they or alternate adults can be reached.
EMERGENCY TRANSPORT
The following classifications will be used in dealing with serious injury or illness requiring further medical care:
urgent: requiring prompt medical intervention. Parent will be notified and will transport the student for appropriate medical care. Basic first-aid will be given on campus. Condition is serious but not life-threatening.
emergency: existence of life-threatening situation requiring immediate medical assistance, transportation or advanced life-support measures. Basic first-aid will be given on campus and the 911 system will be activated, and parents will be notified.
Classification shall be determined by the school nurse, principal, person trained in first aid or as designated in the campus crisis management procedures. Since the most important step in managing true life-threatening emergencies is to transport the person to a facility where he can be treated as quickly as possible, time will not be spent repeatedly attempting to notify the physician or guardian. FIRST, 911 will be activated. SECOND, the parent or guardian will be notified. If deemed necessary by the paramedics, school nurse, principal or designee, the child shall be transported immediately without prior notification of the parent or guardian. The school office will continue to search for the parents or persons listed as the emergency contacts while the child is being transported. Our basic concern is the securing of immediate life-saving care for the student.
If a hospital preference is given, the child shall be transported there, if possible. If no hospital preference is given, the child shall be transported to Harris Hospital-Methodist or Cook Fort Worth Children’s Medical Center. The school district assumes no financial responsibility for transportation or medical treatment of the child.
IMMUNIZATIONS
Admission to school is not allowed until records are produced showing (1) that a student has been immunized in accordance with the rules of the Texas Department of State Health Services; (2) the student has an exemption from immunization requirements on file with the school in accordance with the rules of the Texas Department of State Health Services; or (3) that the child is entitled to provisional enrollment.
Provisional enrollment allows a student to be admitted to school on a temporary basis for up to 30 days. During the 30 day period, the parent is responsible for ensuring that the student receives the necessary immunization(s) as fast as is medically feasible and/or providing a complete and current immunization record to the school. If, at the end of the 30 day period, the student has not met the needed provisions the school shall exclude the student from attendance until the immunization record is complete and current.
Provisional enrollment allows a student to enroll in school under the following situations:
1. Transfer students from one Texas public/private school to another
2. Homeless students or active military families
3. Students In- Progress who have received at least one dose of each specified vaccines as required by Texas Department of State Health Services and completes the required remaining doses as rapidly as is medically feasible
The following immunizations are required for admission to or continued attendance in school:
DTaP, DPT, Tdap, and/or Td
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18 mo.-4 yrs: 4 doses
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5-6 yrs: 4 or more doses with at least 1 dose on or after the 4th birthday
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7+ yrs: 3 or more doses with at least 1 dose on or after 4th birthday; booster doses of tetanus/diphtheria (Td) vaccine are required every 10 years after the dose obtained on or after the 4th birthday.
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*For School Year 2009-2010: 7th grade students are required to have a booster dose of a tetanus/diphtheria/pertussis containing vaccine if at least 5 years have passed since the last dose of a tetanus-containing vaccine. If 5 years have not passed since the last tetanus-containing vaccine, then the dose will be due as soon as the 5 year interval has passed.
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**9th Grade: At the beginning of the student’s 9th grade year, verification of the required Td booster within the past 6 years shall be required.
Polio oral or injected (OPV/IPV)
Measles (Rubeola)
Mumps
Rubella (German Measles)
MMR
Hemophilus Influenza (HibCV) (type b conjugate vaccine)
Hepatitis A
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12 mo. – 4 yrs: 2 doses after 1st birthday
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*For School Year 2009-2010: Kindergarten students are required to have 2 doses of Hepatitis A vaccine with the 1st dose received on or after the 1st birthday.
Hepatitis B
Varicella (chickenpox)
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1 dose on or after 1st birthday is required for children under 5 years who attend school or childcare facilities and 1st –12th grades
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or written verification of having had chickenpox
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2 doses are , required if the student is 13 years old or older at the time of the 1st dose
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*For School Year 2009-2010: Kindergarten and 7th grade students are required to have 2 doses of Varicella vaccine received on or after the 1st birthday
Pneumococcal,PCV
Meningococcal (MCV, Menactra)
- *For School Year 2009-2010: 7th grade students are required to have 1 dose of Meningococcal vaccine
MEDICAL CONDITIONS
Physician’s instructions should be specific and on record annually for students with serious or other medical conditions. Parents need to consult with the Registered Nurse about any student needing a specialized nursing procedure (i.e.: nebulizer treatments, glucose monitoring, etc.). Written instructions from student’s physician and parents are needed yearly.
Every student with asthma should have an “Asthma Action Plan” filled out by the student’s doctor in consultation with the student’s parent/guardian on file and updated annually.
For students who have diabetes and who will seek care for the diabetes at school, HB 984 requires that the student’s parents and doctor submit a diabetes management and treatment plan. The principal, the school nurse, and the student’s parents will develop an individualized health plan. School districts are also required to provide trained, unlicensed diabetes care assistants (UDCAs) to assist students with diabetes at school, in the event a school nurse is not available.
MEDICATION
No medication may be given to a student without written parent permission.
All medication should be given outside of school hours if at all possible. If it is necessary for the student to have medication in order to remain in school, the appropriate request form should be completed and returned to Health Services. Original forms may be obtained from the school or printed from the district website. Medication, prescription or non-prescription, will not be given without written permission.
All medication will be kept locked in the Health Services office. Maintenance of adequate amounts of continuing medication is the responsibility of the parent or legal guardian.
Prescription medication requires that both the parent/guardian and the physician sign the request for administration of medication form. Prescription medication, including inhaler, must be in the original container, have a clear and legible label which includes instructions on how and when the medication is to be given, the student's name, date the prescription is dispensed and expiration date.
Non-prescription medication must be in the original container or package with contents and correct dosage listed. Only FDA approved non-prescription medications can be given. Medication will not be given after the 10th day without physician’s signature on the request form or a doctor’s order on file.
A hand written request shall be accepted for one day only. It must include the date, child’s name, name of medication, time, amount of dose, and parent’s signature. An official medication request form will be sent home with the student and must be returned in order for continued administration of the medication.
Students may NOT carry or self-administer medications at school unless determined to be a medical necessity by the physician and a written statement from the doctor is on file in the Health Services office.
It is the parent/guardian’s responsibility to take outdated/unused medication home. Written parent permission is required for student to carry medication home. After notification outdated/unused medication will be destroyed if not picked up. Parents are strongly encouraged to pick up the medication.
MEDICATION FOR FIELD TRIPS
Students may NOT carry or self-administer medications on field trips. Teachers/staff members will be responsible for carrying and administering medications (except if letter of medical necessity signed by the physician is on file in the Clinic).
BACTERIAL MENINGITIS
What is meningitis?
Meningitis is an inflammation of the covering of the brain and spinal cord. It can be caused by viruses, parasites, fungi, and bacteria. Viral meningitis is most common and the least serious. Bacterial meningitis is the most common form of serious bacterial infection with the potential for serious, long-term complications. It is an uncommon disease, but requires urgent treatment with antibiotics to prevent permanent damage or death.
What are the symptoms?
Someone with meningitis will become very ill. The illness may develop over one or two days, but it can also rapidly progress in a matter of hours. Not everyone with meningitis will have the same symptoms.
Children (over 1 year old) and adults with meningitis may have a severe headache, high temperature, vomiting, sensitivity to bright lights, neck stiffness or joint pains, and drowsiness or confusion. In both children and adults, there may be a rash of tiny, red-purple spots. These can occur anywhere on the body.
The diagnosis of bacterial meningitis is based on a combination of symptoms and laboratory results.
How serious is bacterial meningitis?
If it is diagnosed early and treated promptly, the majority of people make a complete recovery. In some cases it can be fatal or a person may be left with a permanent disability.
How is bacterial meningitis spread?
Fortunately, none of the bacteria that cause meningitis are as contagious as diseases like the common cold or the flu, and they are not spread by casual contact or by simply breathing the air where a person with meningitis has been. The germs live naturally in the back of our noses and throats, but they do not live for long outside the body. They are spread when people exchange saliva (such as by kissing; sharing drinking containers, utensils, or cigarettes).
The germ does not cause meningitis in most people. Instead, most people become carriers of the germ for days, weeks or even months. The bacteria rarely overcome the body’s immune system and causes meningitis or another serious illness.
How can bacterial meningitis be prevented?
Do not share food, drinks, utensils, toothbrushes, or cigarettes. Limit the number of persons you kiss.
While there are vaccines for some other strains of bacterial meningitis, they are used only in special circumstances. These include when there is a disease outbreak in a community or for people traveling to a country where there is a high risk of getting the disease. Also, a vaccine is recommended by some groups for college students, particularly freshmen living in dorms or residence halls. The vaccine is safe and effective (85-90%). It can cause mild side effects, such as redness and pain at the injection site lasting up to two days. Immunity develops within 7 to 10 days after the vaccine is given and lasts for up to 5 years.
What you should do if you think you or a friend might have bacterial meningitis.
Seek prompt medical attention.
For more information
Your school nurse, family doctor, and the staff at your local or regional health department office are excellent sources for information on all communicable diseases. You may also call your local health department or Regional Texas Department of Health office to ask about meningococcal vaccine. Additional information may also be found at the web sites for the Centers for Disease Control and Prevention: www.cdc.gov and the Texas Department of Health: www.tdh.state.tx.us.
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