1. Student Health – Welcome to NRMPS! Bloodborne Pathogens First Aid/First Responders Diabetes Asthma/Seizures EpiPens Medications School Nurse Referrals

2. Bloodborne Pathogens Exposure Control Plan Locations Main office Website Carol Eatman, RN Bloodborne Pathogens Coordinator Your guide to safety!

3. Bloodborne pathogens Organisms in blood and other body fluids that can cause disease Examples: HBV  HCV  HIV AIDS Universal Precautions Treat all blood/body fluid as if infected. Protect yourself! Wear gloves Wash Hands HBV Vaccine Call Custodian

4. Hepatitis B Vaccination Series Series of 3 vaccinations Offered to all employees identified as “at-risk” for exposure to bloodborne pathogens Covered 100% by State Health Plan & most insurance plans Required for all children born on/after July 1, 1994.

5. Other Ways to Protect Yourself Sharps Containers Syringes, needles, broken glass Never re-cap needle! Dust pan & broom Use for broken glass Band-aids Cover open wounds Other PPE School Nurse’s office

6. Exposure at Work Direct Transmission From one person to another through open cut, abrasion, sore, or membranes of nose, mouth, eyes Indirect Transmission Touching a contaminated object or surface

7. I’m exposed! What now? Wash immediately Notify principal, nurse, or Carol Eatman Complete Exposure Report & WC Form 19 Carolina Quick Care

8. At-Risk Jobs Nurse Athletic Trainer Custodian How do I know if my job is at-risk? Contact Nurse, Carol Eatman, or Principal to Complete Exposure Determination Questionnaire

9. Red Bag/First Aid Kit In each classroom  Assigned to room, not teacher.  Accessed only by teachers Contents Gloves  Band-Aids  First-aid Supplies  Emergency Action Plans and Emergency medications  Asthma Inhalers  Epi-pens  Diabetic Supplies, medications, and snacks Take with you at all times when with students - fire drills, playground, cafeteria, field trips, etc.

10. First Responders Employees trained to respond in the case of an accident or illness if the school nurse is not on campus. (Please stand.) Automatic External Defibrillators Located: ____________________________

11. Glucometer, snacks, insulin Students allowed to carry items at all times, to check blood sugar anytime they feel symptomatic, and have a snack when needed Definition: The body does not use Glucose properly due to insulin problems. Emergency Action Plans  Provides medical directions for care  Kept in red first-aid bag  Student keeps copy in book-bag  If no care plan is provided, contact school nurse or parent/guardian to come and handle.  May need to call 9-1-1

12. Diabetic Care Managers School staff members -- trained by school nurse to handle diabetic care of students at school ( Please stand.) How to check blood sugar How to count carbohydrates How to recognize signs of distress

13. Low Blood Sugar If in doubt, Treat as low blood sugar. Sweatiness Nervousness Pallor Early Signs & Symptoms

14. Low Blood Sugar Sleepy  Stubborn  Irritable  Sad  Angry  Uncoordinated  Pass out  Seizure Late signs & Symptoms

15. Treating low blood sugar 2-4 glucose tablets 4 ounces of apple or orange juice 4-6 ounces of regular soda 2 tablespoons of raisins 3-4 teaspoons of sugar or syrup 1 cup of low fat milk 1 tube of cake gel or 2 packets honey (if unable to swallow or unconscious) Students will carry a juice with them at all times. Parents are responsible for providing snacks/supplies. Always keep a snack in red first-aid bag. Preparedness for lock-down.

16.  Recheck blood sugar after 15 minutes, if still low give another snack. Check again in 15 minutes. If does not come up to normal - call parent.  Follow with carbohydrate/protein snack (peanut butter crackers, meat, cheese, etc.)

17. High Blood Sugar Thirst  Frequent urination  Blurred Vision  Drowsy  Nausea Mood Changes Signs & Symptoms

18. High Blood Sugar Treatment 1. Check care plan for orders. 2. Insulin per doctor’s orders. 3. If no care plan is in place, contact parent/guardian. 4. Offer student clear non- calorie liquids. 5. Do not exercise if the blood sugar is over 300. Insulin is the only way to  the blood sugar. Exercise will not decrease the blood sugar!

19. Diabetic Emergency! Loss of consciousness  CALL 9-1-1  Stay with student  Send for nurse, DCM, 1 st Responder  Give Glucagon, if ordered  Call parent/guardian

20. Medications at School Medication form Required for staff to give meds Medication log Completed at time med is given Audited by school nurse Secure meds Lock box or drawer w/lock Self-medication Parent permission form required Controlled substances not allowed Rx Medication labels required Refer to School Nurse

21. Asthma Inhaler  Must be easily accessible and available (especially for PE, exercise, outside)  Must never deny access to student  Kept with student or in red first-aid bag  EAP indicates where inhaler is kept  Administer as ordered, e.g., before exercise Case Management by School Nurse – Refer students with:  Frequent Absences  Severe/many episodes  Chronic cough  Sits out PE/recess  Abuse, misuse, overuse, and/or frequent use of inhaler  Student who has no inhaler

22. Seizure Emergency Emergency Action Plan Lets you know what to look for and what to do. Notify School Nurse and Parent  First time seizure  More than one seizure in a day Call 9-1-1  Seizure lasts more than 5 minutes  Student doesn’t arouse after a seizure Always call 9-1-1 first Then the parent, nurse, 1 st Responder

23. Severe Allergies & EpiPens Emergency Action Plan - Refer to plan for care - Kept in red first-aid bag EpiPen Video Video Auvi-Q VideoVideo Call 9-1-1, immediately after using EpiPen Life threatening symptoms  Immediate swelling  Tightening of throat, hoarseness, hacking, repetitive cough  Shortness of breath or wheezing  Weak pulse, fainting, pale or blue color to skin

24. School Nurse Referrals Communicable diseases  Rash  MRSA  Conjunctivitis  Meds & Substance Abuse  Child Abuse  Mental Illness  Fractures  Squinting & Other Vision Problems  Hearing problems  Referrals to Healthcare Provider

25. School Nurse Referrals Carol Eatman, RN 462-2825 Office 903-0391 Cell cheatman@nrms.k12.nc.us

26. Staff Training Modules NRMPS Website School Nurse

27. Have a Great Year!Questions?