1. From the Health Room 2015-2016 JOYCE KELLEY-KRAMER, RN, BSN, NCSN, MS 704 591 6705 WORK CELL J.KRAMER@CMS.K12.NC.US

2. School Nurse Role Employed by the Mecklenburg County Health Department One of 100 + BSN prepared nurses covering CMS schools One nurse to every school Butler and Levine Middle College & schools as assigned Acute event care, chronic disease or medical support and management, access to health care (including vision wear), immunization surveillance, and population health promotion Nurse Referrals Breathing problems Chest pain Dizziness Falls or injuries on campus Head injury complaints Bleeding, large wounds Blood sugar issues Fever Change in usual level of consciousness or baseline Severe allergy

3. First Responders & Health Care Designees First Responders Diabetes Medication Administrators Rob AponteDot Flaherty Dot Flaherty Coach BarkleyRob Aponte Barb Fesler Judy Fruth

4. Asthma EQUIPMENTSTEPS Emergency Action Plan; Sit/ Rest, Assist, Call

5. Asthma Action Plan

6. Epi Pen and Severe Allergy Medicine and Storage of CMS Supply Signs and Symptoms of Severe Allergic Reaction Tightness in throat Hoarseness/ hacking cough Hives /itchy rash Swelling of tingling in face, tongue, throat, or extremities Drooling Difficulty breathing, shortness of breath, wheezing Nausea, cramps vomiting, diarrhea

7. Heimlich When student con not cough, speak or breath… Ask :  “Are you choking?”  Call 911  Explain what you are going to do  Perform Heimlich  Follow with ER assessment

8. Blood Borne Pathogens

9. Diabetes: Legally mandated student services 2003 State Board Guidelines http://www.ncpublicschools.org/docs/sbe-archives/meetings/2009/10/hrs/10hrs02.pdf

10. Each Diabetic student will have an individualized diabetes care plan developed by the parent/guardian and child’s diabetes team

11. All staff trained in generalized care: Recognizing high and low blood sugar

12. At least 2 school personnel intensively trained to provide direct care to students School nurse will give in-depth training to at least 2 CMS staff members that will assist and/or provide care for individual students with diabetes: Dot Flaherty Rob Aponte

13. Diabetes Training for all School Staff Done the school 504 coordinator annually School nurse present as a resource

14. Diabetic students are allowed to: have a care plan in place (retrievable & secured) monitor their blood sugar anywhere in school or during school activities snack anywhere in school or during school activities to prevent or treat hypoglycemia (low blood sugar) use the restroom and access to fluids as necessary have immediate access to supplies at all times self- medicate with the appropriate permission Diabetic equipment

15. Seizure Different types of seizures : Present with varying changes in level of consciousness If the student shows a change in level of consciousness:  Observe & if possible take notes  Time  Call for help  Monitor  Notify nurse or first responder If loss of consciousness: Lower to floor in recovery position (side lying) Monitor breathing Do not put anything in the mouth Call for help Common Triggers  Specific time of day or night  Sleep deprivation – overtired, not sleeping well, not getting enough sleep  At times of fevers or other illnesses  Flashing bright lights or patterns  Alcohol or drug use  Stress  Associated with menstrual cycle (women) or other hormonal changes  Not eating well, low blood sugar  Specific foods, excess caffeine or other products that may aggravate seizures  Use of certain medications

16. CMS Mandated : Asthma, Epi, Heimlich, Seizure CMS Coordinated School Health Health Awareness Videos http://www.cms.k12.nc.us/cmsdepartm ents/csh/Pages/EducationalVideos.aspx

17. Standard First Aid Information at Butler Store all information in retrievable, but HIPPA complaint, secure area in Red Emergency folder available for substitutes: Quick Emergency Information Emergency Action Plans Diabetes high and low blood sugar guidelines Role of the School Nurse and info. for referrals Teacher referral to the school nurse (for chronic and longer term problems (attendance, vision, sleeping in class after parent has been called). Access all forms and resources at : Butler High School Home page to School Nurse page link (to be updated by Thursday, 8/20/15). I will post a prototype on the White Board in the mailroom. Email requests for Band-Aids, etc. Email requests for verification of student visit

18. As a thank you from the Health Room – Health Passes 2015-2016 JOYCE KELLEY-KRAMER, RN, BSN, NCSN, MS 704 591 6705 WORK CELL J.KRAMER@CMS.K12.NC.US