Dear Parent/Guardian:

This handbook has been designed to acquaint you with some of the functions and duties of the school nurse and to inform you of some of the health procedures we follow. The goal of the school nurse is to maximize each childs potential to learn and grow by providing the best possible health care. The school nurse is also a resource for health education in the school, either by direct teaching or by providing materials for the classroom teacher to use.

Vermont State law requires that certain grades be screened for blood pressure, vision and hearing. We are also required by Vermont State law to follow a certain guideline regarding immunizations.

The nurse will see students on a scheduled basis for screenings. When available in the building, the nurse will also see students for illness/injury either through teacher or self-referral. Currently, the nurse is here three days per week. On days when she is not in the building, the principal and office staff will see students.

The nurse will administer basic first aid measures. Any illness/injury that requires a physician's diagnosis will be referred to the parent/guardian. The parent/guardian will be called if the student needs to go home.

We ask you to read this booklet carefully and to keep it for future reference. Attached to this booklet are permission forms for medication. Additional copies of these forms can be obtained at your school office.

We encourage you to contact the nurse with questions or concerns throughout the school year.

1. GENERAL ILLNESS OR INJURY

A. If your child is ill or appears to be ill, PLEASE keep him/her at home. This can prevent the spread of infection to others.

B. If a child comes to school ill or becomes ill while at school, the parent or guardian will be contacted at home or work to come for him/her. Students will not be permitted to leave unless accompanied by a parent or with parental permission, or with another adult for whom the parent has given permission.

C. It will be the responsibility of the parent or guardian to provide transportation. Please be sure that we have a telephone number where you can be reached at all times.

D. Any child attending school must participate in physical education and outside activity. If there is to be extensive indoor recess, or absence from physical education, we MUST HAVE a statement from the doctor or parent. No notes will be issued from the health office.

E. All injuries occurring at home are parent's/guardian's responsibility.

F. In the event of a medical emergency at school, the following procedure is used;

1. The parent/guardian is notified as soon as possible after the emergency occurs.

2. If the injury appears to be serious, the child is transported by ambulance directly to the nearest hospital emergency room.

3.Every attempt is made to have the nurse present but if this is not possible, any adult present on the scene will follow this procedure.

4. The school does make every effort to contact parents either at home, work or otherwise. If we do not find you on our first try, we continually call until we reach you.

5. If a child must be taken to the emergency room at the hospital, please note that no treatment can be administered unless A PARENT IS PRESENT. They have a form you will be required to sign for treatment. However, if the emergency is life threatening, it will be treated while awaiting your arrival.

2. HEALTH SCREENINGS

A. Health screenings are performed according to STANDARDS OF PRACTICE FOR SCHOOL HEALTH SERVICES. Be aware, however, they are not foolproof. Occasionally the results are not consistent with student complaints. Since our tests do not pick up every type of problem it is wise to check with your child's doctor if you still have concerns. For example: if our vision screening shows that your child's vision is normal according to our guidelines, but they still complain about difficulty seeing the blackboard or reading a book, you should obtain a more thorough eye exam. Conversely, your child may fail one of our screenings, but pass the test at the doctor's office afterwards.

It is an unfortunate, but inevitable fact that there will be some "false positives" and "false negatives" during the screening process. We try to keep them to a minimum by performing a second screening before we refer you for a doctor's exam.

3. VISION SCREENINGS

A. Vision screenings are required for students in grades 1, 3, 5 and for children receiving special services. Other students are screened if referred by teacher, parent or physician.

B. Children are screened and retested if necessary. Any child failing retest will be referred. The parents/guardians will be contacted by written note and/or by telephone.

C. We do request a report from the health care provider on their findings.

4. HEARING SCREENINGS

A. Hearing screenings are required for students in grades 1, 2, 3, 5 and for children receiving special services. Other students are screened if referred by teacher, parent, or physician.

B. Children are screened and retested if necessary. Any child failing retest will be referred. The parents/guardians will be contacted by written note and/or by telephone.

C. We do request a report from the health care provider on their findings.

OPTING OUT OF HEARING TESTS

16 V.S.A. 1422 requires schools to annually test the hearing of students in grades 1, 2, 3, 5, 7, and 9. Parents are permitted to opt their children out of such tests and presumable parents should be given notice of the procedure for opting-out.

5. MEDICATIONS

A. Prescription medications will be given in school only with a written doctor's order AND written permission from the parent/guardian.

B. Non-prescription medications will be given in school only with written permission from the parent/guardian. The following is a list of those non-prescription medications which can be given in school when sent in with instructions from parents:

1.Tylenol/Ibuprofen (or generic substitute) - i.e., toothache, headache, other minor aches

2. Cold/Allergy medications - i.e., Sudafed, Allerest, Benadryl, etc.

3. Cough Syrup - i.e., Robitussin, Triaminic, etc.

4. Dramamine (or generic substitute) - for preventing motion sickness on field trips bus rides, boat rides, etc.

Tylenol is available in the nurse's office. Please note, due to the association with Reye's Syndrome, aspirin or any product containing aspirin will not be given in school without a physician's order.

C. All medication (prescription and non-prescription) must come to school in its original container, pharmacy bottle or labeled as follows from the prescribing physician: child's name, doctor's name, medication name and directions for giving. If you are filling a prescription, ask the pharmacist for two bottles so that one can come to school with the student. Medications will not be given if sent in a baggie, envelope or unlabeled container.

D. All medication will be kept in the health office.

E. Doctor and parental permission is required for students to carry their inhalers.

F. We urge that medication be given at home if possible, especially if only given 2-3 times per day, unless ordered during school hours by the doctor or if the medication must be given with a meal.

G. Permission forms need to be updated at the start of each school year.

6. BEE STINGS

A. If your child has a history of any allergic reactions to bees, wasps, etc. and is required to have an epi-pen or other medication in school, please notify the school nurse at once. It is advisable that an epi-pen be sent to school for your child.

7. FOOD ALLERGIES

A. If your child has a history of Food Allergies, please notify the school nurse. If they are required to carry emergency medication in school, an Emergency Health Care Plan will be completed. If your child will be eating the school's lunch or breakfast, a note from your physician stating the allergy and what foods need to be avoided will be required. Accommodations will be made in the classroom and lunchroom to help prevent exposing your child to the food they are allergic to.

8. IMMUNIZATIONS

A. Vermont State law requires all students who enter Vermont State Schools to have the following by age 5:

Please see the chart in the appendix.

B. If your child, according to his/her health record is in need of boosters, you will be sent a notice.

C. Children may be exempted from immunization requirements for either medical, religious or moral reasons if the following is

provided to the school:

1. For medical exemptions - A signed statement from a physician that immunizations are contraindicated, which includes the reason and the period of time the exemption is in effect.

2. For religious or moral exemptions - A signed statement from the parent or guardian that immunization is against their religious or moral beliefs. (Exemption forms are available at school).

D. According to Vermont Law, children can be excluded from school if immunizations are not up to date or if an exemption is not on file.

9. RECORDS

A. A health record is kept on all students Preschool-6 grade.

B. Health History - new students (kindergarten or transfer) will be asked to complete a detailed health history. Yearly, all students will be given an emergency/health update to be filled out and returned ASAP after the start of the school year. Filling out the health history is an important way to help us keep your child safe and healthy in school. A copy of the most recent physical would be very helpful to include in the students health record.

10. CONFERENCES

A. Conferences are held with parents when deemed necessary.

11. COMMUNICABLE DISEASE

A. GENERAL INFORMATION

1. Children with an elevated temperature and/or other signs of illness will be excluded from school. Children should be fever free, without medication, for 24 hours before returning to school. If children are put on medication (for example, an antibiotic), they should be on medication 24 to 48 hours before returning to school. It will be generally accepted that children well enough to attend school will participate in all activities unless a note from the physician indicates otherwise. Children in whom there is a failure/deficiency of the immune system's defenses to fight infection will be notified of the occurrence of a high risk disease (for example, chicken pox).

B. CONJUNCTIVITIS (PINK EYE)

1. If suspected, the child will be referred to the parent and excluded from school until under treatment by a physician. The eyes must be clear of drainage.

C. FEVERS

1. A student may return to school after being fever free for 24 hours, without being medicated.

D. FIFTH DISEASE

1. The child with diagnosed "fifth disease" may return to school when fever free and feeling well. The rash may still be present. Please notify the school nurse if your child has been diagnosed with this illness as it can pose a health problem for pregnant women.

E. HEAD LICE

1.Children with head lice will be excluded from school until there is no evidence of lice or viable eggs (live nits). Treatment, at home, with an appropriate medicated shampoo or rinse and combing out of dead nits will be necessary.

a. We urge parents to check their children's hair periodically for signs of head lice. If you do not know what to look for, please contact the school nurse. If you do find signs of head lice, please contact the school.

b. Head checks will be done in a classroom where a case has been identified. If your child is found to have signs of head lice, you will be notified by note and/or telephone. The child must be treated with an appropriate shampoo or rinse and every effort made to remove all nits. With the cooperation of the parents and school, this problem can be kept at a minimum level.

F. HERPES SIMPLEX (COLD SORES, FEVER BLISTERS)

1. The child may attend school if feeling well and fever free. The child should avoid direct contact with lesion. Frequent hand washing is strongly encouraged.

G. CHICKENPOX

1. The child will be excluded from school until all lesions are dry and crusted (approximately 6-8 days following eruptions). Please notify the school nurse if your child has been diagnosed with this illness.

H. IMPETIGO

1. The child will be excluded from school until the child is under a physician's care, on medication, and there is no longer any sign of drainage. Frequent hand washing with soap is strongly encouraged.

I. SCABIES

1. The parent of a child suspected of having scabies will be notified by note and/or phone call. The child may return to school after diagnosis by a physician and appropriate treatment.

J. STREP THROAT, SCARLETINA, SCARLET FEVER

1. The child with physician diagnosed strep throat, scarletina or scarlet fever may return to school when fever free, has been taking a prescribed antibiotic for 24 hours and feels well. The student should take all the prescribed medication even if feeling better.

K. STY

1. The child with a sty may attend school if there is no drainage from the sty. Hand washing is strongly encouraged.

L. HEAD INJURY

1. Minor head injuries will be examined and treated in school with rest and an ice pack.

2. If more serious, the parent will be notified.

3. All students with head injury should be watched for the following signs for the next 24 hours: nausea, severe headache, dizziness, blurred vision, excessive drowsiness or unsteadiness. If any develop, contact your physician immediately.

4. If the head injury appears to be serious, the student will be transported to the nearest hospital by ambulance.

M. UPPER RESPIRATORY INFECTION (COMMON COLD, FLU)

1. May remain in school when fever free, nasal drainage is clear, and is not a threat to the health of others in the classroom.

2. If your child has been out, they may return to school when fever free and feeling well.

N. TOOTH INJURIES

1.The parent is notified immediately if the injury causes bleeding, a break in the tooth, pain or if the fall/blow was severe. It is recommended that the student's dentist be notified. He may wish to check for injury above or below gum line.

2. If the tooth has been knocked out it may be possible to replant if the student is seen by a dentist promptly.

O. RASHES

1.Rashes are indicative of many different diseases. If a rash develops in school, it will be examined by the school nurse. The nurse will most likely refer the student to a physician for diagnosis. If the rash is accompanied by fever and/or other signs of illness, the parent will be notified to take the student home.