Life-Threatening Health Conditions Fall 2005 sponsored by Nursing Services.

Life-Threatening Health Conditions

Fall 2005sponsored by

Nursing Services

This self-paced module

Designed to meet the state law requirements in RCW 28A.210.320 – education to all who work with students diagnosed with a life-threatening condition.

Press the space bar to continue and the backspace bar to move back to a previous frame.

Life-Threatening Health Condition

A life-threatening health condition means a condition that will put the child in danger of death during the school day if a medication or treatment order providing authority to a registered nurse and a nursing plan are not in place.

Life-Threatening Health Conditions

Prior to attendance at school, each child with a life-threatening health condition shall present a medication or treatment order addressing their health condition.

•Following submission of the medication or treatment order, an Individual Health Plan (IHP) shall be developed for the student.

Life-Threatening Health Condition

RCW 28A.210.320 states that………..

Students who have a life-threatening health condition and no medication or treatment order presented to the school shall be excluded from school.

Who are these Children with Medical Needs?

Students with known medical

conditions such as:

Severe Asthma

Life-threatening Allergies

Diabetes

Unstable Seizures

504 Accommodations must be established for all these medical conditions!

Section 504

Prohibits discrimination against any individual because of a disability.

Requires schools to make reasonable accommodations for the disability.

Students with health care needs have the right to attend school.

So, What Will This Student Look Like?

Many times classrooms will have students with various health care needs.

It is likely that a student with severe asthma maybe sitting next to a student with life-threatening allergies, and in the next row there may be a student with a seizure disorder.

Allergies

Let’s discuss the impact of allergies on the student that you may have in class.

What is an Allergy?

An allergy is an abnormal response to a “normal” substance (allergen).

The allergic person has an altered immune response to substances which normally are not harmful to most people.

A reaction may be mild or severe.

What Causes Allergic Reactions?

Substances “allergens” that cause allergies can vary from child to child.

Potential allergens:–Substances used to diagnose and treat disease–Medications–Latex–Foods (cross contamination)–Stings or insect bites–Snake venom

Food Allergies

Food is the leading cause of anaphylaxis in children.

Eight foods cause 90% of food allergy reactions:

– Milk– Peanuts– Soybeans– Eggs

– Wheat – Tree Nuts– Fish and Shellfish

Anaphylaxis

Anaphylaxis is a sudden, severe allergic response that produces breathing difficulties, circulatory problems and possible death.

Anaphylaxis is always considered a medical emergency.

Symptoms of Anaphylaxis

Tingling lips, mouth or tongue Flushing of the face and body Itchy eyes, nose, face Eyes and face swelling Hives Diarrhea Wheezing

Treatment

Allergy symptoms are controlled by a licensed health care provider through:– An individually tailored routine of medications

Diphenhydramine HCL (Benadryl) Fexofenadine HCL (Allegra) Loratadine (Claritin)

– Dietary manipulations– Allergen-free area by environmental control

Emergency Medication

Epinephrine is the medication to treat severe allergic reactions.

Epinephrine’s effects will last for only about 15 minutes.

Symptoms of the reaction can recur 4 to 8 hours after the initial reaction.

How to Use the Epi-Pen®

1. Pull off gray safety cap.2. Place black tip on outer thigh.

Stabilize the thigh. You may inject through clothing.

3. Press forcefully to active mechanism. Hold pen in place for 10 seconds.

4. Dispose of Epi-Pen ® as a contaminated sharp.

5. Massage the injection area for 10 seconds.

6. NOTE: You must demonstrate this skill using the Epi-Pen Trainer to your School Nurse.

Where is the Epi-Pen Kept?

There is always one available in the Health Room.

The student may be wearing/carrying one. Review each student’s Individual Health Plan

(IHP) to identify the exact location of the medication.

Asthma Basics

What is asthma?– Chronic lung condition that causes breathing

problems (asthma attacks)– Manageable disease

Who has asthma?– 4.8M US, 150K (1 in 10) Washington

children– Level of severity varies from student to

student

Normal Breathing Process

Inhalation causes air to travel through the nose &/or mouth through the trachea.

• From the trachea air enters a series of smaller airways that branch off the trachea, called bronchi and then divide into even smaller airways – bronchioles.

• It is in the bronchi and bronchioles that asthma has its effect.

Asthma Basics (cont.)

What happens during an asthma attack?– Airways in the lungs become smaller; extra mucus

in airways can further block air– Symptoms include: coughing, wheezing, chest

tightness, shortness of breath What can trigger an asthma attack?

– Respiratory illness, allergens, weather, irritants, emotions, exercise

– Students may have different triggers

Asthma Basics (cont.)

What Causes an Attack?

Respiratory Illness Allergens Weather Irritants Emotions Exercise

Symptoms of Asthma

Shortness of breath Coughing Wheezing Chest Pain Chest Tightness

Management of Asthma

Management of asthma uses two basic approaches:– Minimizing contact with triggers – Use of medications

Medications

Rescue Meds provide quick relief by relaxing the muscles around the bronchial tubes

– bronchodilators

Long-term control medications reduce inflammation of the airways

– Reduce inflammation

Where is the Asthma Medication Kept?

Student medication is kept Health Room in the elementary schools.

The student may be wearing/carrying an inhaler in the secondary schools.

Review each student’s Individual Health Plan (IHP) to identify the exact location of the medication.

Note: if the student has an inhaler and no IHP, please notify the school nurse.

Diabetes

Another medical condition on the rise!

Diabetes

A chronic illness that results from failure of the pancreas to make the hormone called insulin.

Without insulin, sugar accumulates in the blood stream and will cause symptoms.

Diabetes is a Chronic Illness

Most children have Type 1 Diabetes (requires Insulin)

– Diabetes is not contagious– Diabetes cannot be cured, but can be managed and treated– Treatment includes:

Frequent blood testing Administration of insulin Dietary control School Accommodations

Diabetic Training

In-service Training: as required by RCW 28A.210.320

– In schools attended by diabetic students, all school employees must undergo an in-service training on symptoms, treatment, and monitoring of students with diabetes and any additional observations that may be needed during the school day.

Diabetic Training

Specific Training as required by

RCW 28A.210.320– All school employees who have responsibility for diabetic

students must complete training in proper procedures for care of students with diabetes. Such training must include information of individual student’s IHP requirements, as well as information on symptoms, treatment, and monitoring of student with diabetes.

Blood Sugar Testing

Hypoglycemia – too much insulin & too little glucose

Hyperglycemia- too little insulin & too much glucose

Hypoglycemia

Too much insulin and too little glucose– Causes: too little glucose, missed food, too much exercise,

and/or growth spurts– Symptoms: hunger, shakiness, paleness, headache,

behavior change, blurred vision, dizziness, seizures

Treatment: Prescribed by medical care provider and parent to self-treat with juice, soda, glucose, snacks

Accommodations: may be needed related to lunch, snacks and/or physical exercise

Hyperglycemia

Too little insulin and too much glucose

• Treatment: Prescribed by medical care provider and parent to self-treat with water, and diet soda

• Accommodations: frequent bathroom privileges, extra water

– Causes: too little insulin, infection/illness, injury, undiagnosed diabetes

– Symptoms: increased thirst, frequent urination, nausea, blurry vision, fatigue

Insulin

Taken by injections

Lower blood sugar

Different types of insulin have different peaks or onset of action

Another Medical Condition…

…for you to know and understand.

Seizures

Seizures

Epilepsy is a chronic disorder of the brain characterized by the tendency to have recurrent seizures.

• There are over 30 different types of seizures.

• Seizures are sudden uncontrolled episodes of excessive electrical discharges in some nerve cells in the brain, with associated sensory, motor, and/or behavioral changes.

Types of Seizures

Generalized Seizures– Tonic/Clonic (grand

mal) seizures– Absence (petit mal)

seizures

Partial Seizures– Complex Partial– Simple Partial

Treatments

Medications-often students will be on 2-4 different medications.

Ketogenic Diet-foods high in fat and low in carbohydrates and protein.

Surgery Vagus Nerve Stimulator

First Aid for Seizures

1. Stay Calm

2. Protect person from injury

3. Do not restrain person

4. Do not put anything in mouth

5. Roll person to their side

6. Allow person to rest once seizure is over.

Call 911

IF:• The seizure is a first time seizure or you

don’t know if the person has epilepsy.

• The person is pregnant.

• There are signs of breathing difficulty.• The seizure is followed by another seizure.

• The seizure lasts more than 3-5 minutes.

One More Thought …

If you have a student with any of the previously discussed medical conditions, and the student complains of illness – always accompany the student to the Health Room.

• The School Nurse is your resource,

support and a friend. Refer to them!

• Provide care and notify the nurse.

Test Time

There are five test questions for you to answer. Please print out the test, identify the correct answer

and submit your completed test to your administrator.

Make sure your name and employee number are on the test.

Good Luck!