Annual Staff In - service Lucie McCarthy, RN, BSN, PHN School Nurse MVUSD 894-5750 ext 6796
OVERVIEW- “First Responder” Survey Scene “Is it safe to respond?” Remain Calm – Call for Nurse (911, if appropriate) Check “ABC” –Call 911 if compromised (DON’T MOVE UNTIL IT IS DETERMINED THAT THERE IS NO HEAD, NECK OR BACK INJURY) Apply Direct Pressure to Bleeding – Use Barrier Immobilize any possible sprain or fracture STAY WITH VICTIM UNTIL HELP ARRIVES Notify Administration – Complete Accident Report
CPR Review C – A – B Compression, Airway, Breathing Chest compressions 30 to 2 (for all) PUSH HARD, PUSH FAST Give 2 slow breaths (watch chest rise) AED
UNIVERSAL PRECAUTIONS ALWAYS use gloves when coming in contact with any body fluid Wash hands after any contact, even after wearing gloves Exposure risks: blood to blood transmission, sexual contact, perinatal, shared needles, break in skin Report any exposure immediately “If it’s Warm, Wet and Not Yours, Don’t Touch It”!!
DIABETES Purpose: To recognize the symptoms of low blood sugar and provide treatment. Low Blood Sugar: Feels “shaky” or “low”, hungry, pale, may become disoriented, dizzy, combative. Treatment: have the student eat something (candy, sugar tabs) or drink juice. Call the health office. If you send the student to the health office, make sure to send the student with an escort Students may check blood sugars in the classroom and treat as necessary
SEIZURES Purpose: to protect student from injury Treatment: Notify office to send assistance (Health Office 6793) Ease student to the floor, loosen any clothing around the neck and protect student from hard or sharp objects in the area. Monitor airway. Do NOT force anything in the student’s mouth! Carefully time length of seizure – what time it starts and ends and be prepared to describe event. Roll student to side after seizure to drain secretions. Immediately notify parent, health tech, school nurse.
CONFIDENTIALITY Only Counselors, Psychologists and School Nurses have confidentiality If drug use, pregnancy or other confidential issues are shared with staff (other than those listed), you may not be protected by law if you keep the information confidential. Refer student to above staff to discuss issue. Look for changes in students (e.g. behavior, dress, weight, etc.) and refer for possible intervention.
CHILD ABUSE You must report if there is reasonable suspicion (someone with like training or experience would reasonably suspect abuse MAY have occurred) It is not our responsibility to determine if actual abuse occurred – only that there is reasonable suspicion. You must report as soon as you become aware of potential abuse If you have first hand knowledge (saw or heard potential abuse), you must report. Responsibility can not be transferred to another staff person. Referring the matter to another staff member does not excuse you from liability from failure to report. The law protects mandated reporters – not those who fail to report.
CHILD ABUSE REPORTING Call 1-800-442-4918 Make sure you have the student’s name, address, birth date, parents’ name and siblings’ names available Written report must follow within 36 hours or you may file online at http://dpss.co.riverside.ca.us/dpss/http://dpss.co.riverside.ca.us/dpss/ Let administration know ASAP (may need to involve SRO and Nurse)
INCIDENTS REQUIRED TO REPORT Physical Injury: Inflicted by other than accidental means on a child Exclusions: Reasonable and age appropriate spanking to the buttocks where there is no evidence of serious physical injury caused by reasonable and necessary force used by a peace officer or school administrator
PHYSICAL INJURY Exclusions to reporting Injuries caused by two children fighting by mutual consent Force used by a peace officer to stop a disturbance that threats the physical injury to a person or damage property, for purposes of self defense, to obtain possession of weapons or other dangerous objects within the control of the child, or to apprehend an escapee
PHYSICAL ABUSE Characteristics to determine non-accidental injuries – Location of the injury Pattern of the injury Correlation of the story to the physical injury Degree or extent of the injury
SYMPTOMS AND CHARACTERISTICS INDICATING PHYSICAL ABUSE Excessive wound pattern Bruises or welts with definitive shape or pattern Burns, fractures, or sprains, lacerations or abrasions, rope burns on wrists or ankles Neurological signs (whiplash, shaken infant syndrome)
PHYSICAL ABUSE Behavioral indicators: Extremes in behavior Easily frightened, or fearful Unusual injury for child’s age group Destructive towards others Inappropriate dress which may hide injuries
PHYSICAL ABUSE Parental Characteristics: Concealment of child’s injuries Inconsistent explanations for child’s injuries Verbal threats Irrational thought process
NEGLECT Neglect, General: Means the negligent failure of a parent or caretaker to provide adequate food, clothing, shelter, medical care, or supervision where no physical injury has occurred Neglect, Severe: Parent or caretaker willfully causes or permits the person or health of a child to be placed in a situation such that his or her person or health is endangered
PHYSICAL NEGLECT Physical indicators: Poor growth patterns (failure to thrive) Hunger, malnutrition Lacks appropriate clothing Unattended physical/medical indicators Absence of adequate and appropriate food
EMOTIONAL ABUSE AND WILLFUL CRUELTY Person willfully causes or permits any child to suffer, or inflicts on any child, unjustifiable mental suffering Behavior Indicators: Habit disorders Learning problems Destructive to self or others Poor self-esteem Sad Isolates in group settings
EMOTIONAL ABUSE Parent Characteristics: Unrealistic expectations of child Belittles, rejects, degrades, ignores Constantly threatens the child Describes child as bad, evil, or different Parent has low self-esteem
SEXUAL ABUSE Sexual assault includes sex acts with children and child molestation and does not require force or lack of consent. Includes child pornography and child prostitution
SEXUAL ABUSE Physical Indicators: STD’s Genital discharge Physical trauma Difficulty walking or sitting Stomach aches, headaches, or other psychosomatic symptoms
SEXUAL ABUSE Behavioral Indicators: Age appropriate sexual knowledge and/or sexual behavior Excessive compulsive masturbation Excessive curiosity about sexual matters or genitalia (with self or others) Usually seductive with classmates or teachers
SEXUAL ABUSE Behavioral indicators in preteen and adolescents: Withdrawal and depression Refusal to dress out in P.E., self-conscious or body beyond that expected for age Sudden acquisition of money, new clothing, or gifts with no reasonable explanation Suicide attempt or other self-destructive behavior
SEXUAL ABUSE Parental / Caretaker behavior characteristics: Extreme protectiveness toward minor Severe overreaction to child receiving any sex education in school setting Offender refuses to allow child to have normal boy/girl relationships Family isolated or withdrawn Parent shows sexually inappropriate behavior with child
Age Factors to consider in abuse cases: Preschool: Younger the child, higher risk for serious injury Younger child’s story generally truthful Preschool children don’t usually know abuse is serious Must consider normal child development stages (some behavior appropriate
FACTORS School age up to preteens: More prone to self report family abuse More aware of normal family behavior due to exposure to other children’s families Tend to be protective of substance abuse parents
FACTORS Teens Disclosure of abuse must be validated because of possible hidden agenda Sexual abuse disclosed by teens when family incest conflicts with normal teenage relationships Physical abuse allegations must be checked out to rule out mutual combative conflicts between parent and child