Handwashing is one of the most important steps in keeping students healthy.

Our goal is to maintain a happy, healthy educational environment. Regular attendance is an important part of your child’s educational stability and success. However, elementary school is a time when our children are building up their immune systems by being exposed to the many different common childhood pathogens (viruses/bacteria). We understand that children will frequently “catch” these illnesses and that it may be difficult to decide when to keep them home from school for a few days. In order to help you determine when they should stay home please refer to the following.

When a student presents any one of the following symptoms during the night or in the morning, he/she should be kept home: 

• Fever (100 or greater): can return once fever free for 24 hours without the use of medications.
• Persistent coughing (coughing that disrupts learning for student and peers): can return when cough is controlled with sips of water or limited cough drops.
• Vomiting (within the last 24 hours): can return when free from vomiting for 24 hours and after successfully eating 2 solid meals.
• Diarrhea (within the last 24 hours): can return when free from diarrhea for 24 hours.
• Rash (body rash with itching and/or fever): can return when free from itching and/or has been evaluated by a doctor. 
• Head lice (itching active head lice): can return after appropriate lice treatment.
• Eye infections (redness, itching, crust and/or drainage from eye): can return once evaluated and cleared by doctor, must have a note from doctor.

The length of time that children must remain home with the following diseases, providing there are no complications, is: 

1. Chickenpox – must remain out until all lesions are dried or crusted.
2. Strep Throat/Tonsillitis – must remain out 24 hours from the time antibiotic from a health care provider is started. 
3. Scarlet Fever/Scarletina – must remain out 24 hours from the time an antibiotic from a health care provider is started. 
4. Conjunctivitis (pink eye) – must remain out until there is no discharge from the eye, but at least 24 hours after antibiotic eye drops are started. 
5. Impetigo – must remain out 24 hours from the time appropriate treatment has begun. 
6. Hand, foot, and mouth – fever free for 24 hrs, lesions dry/ scabbing, no new lesions for 24hrs. 
7. Scabies – must remain out until completion of appropriate treatment as ordered by a health care provider. 
8. Ringworm – must remain out until appropriate medical treatment has begun. 
9. German/3 Day Measles (Rubella) – 4 days from onset of rash x. Mumps – until temperature and swelling disappears 
10. Measles – four days from onset of rash 
11. Whooping Cough (Pertussis) – three weeks from onset or 5 days from institution of appropriate antimicrobial therapy. 
12. Influenza – until fully recovered.

Please understand that we are sympathetic to how difficult it may be to keep a child home for a few days or to visit their pediatrician. However, when children are not feeling well, they have a harder time focusing on school and they would benefit most from a few days of rest. Our goal is to make sure that your child is provided with the best environment for learning. Thank you for partnering with us to create a happy, healthy learning environment.

Asthma is the most common cause of illness among children and adolescence, and the leading cause of absenteeism.

What is asthma?

Asthma is a condition affecting the lungs in which the airways narrow and swell and may produce extra mucus. This can make breathing difficult and cause repeated episodes of coughing, a whistling sound (wheezing) when you breathe out, chest tightness, shortness of breath, and nighttime or early morning coughing. 

What is the treatment for asthma?

If your child has been diagnosed with asthma, you and their doctor will come up with a treatment plan that involves a blend of medications and avoiding asthma triggers. It is also a good idea to develop an Asthma Action Plan to help manage the condition at home.

What are asthma triggers?

Asthma triggers are various allergens that can cause asthma flare ups. It is important to recognize and minimize these triggers in order to effectively manage your child’s asthma. Different people have different triggers. Here are a list of the most common asthma triggers:

• Tobacco Smoke – tobacco smoke is not good for anyone but can be especially dangerous for those with asthma. If your child has asthma you should make your home a “smoke-free” zone and avoid smoking around them in general. The best thing to do for both your child’s health and your own, is to quit smoking.
• Dust Mites – dust mites are microscopic bugs that can live in your home. To minimize their occurrence make sure you are vacuuming regularly, washing bedding weekly, avoiding down filled comforters/pillows/quilts, and  keep your home at a relatively low humidity level (around 30-50%).
• Outdoor Pollution – air pollution can come from many sources including factories, vehicles, wildfires, etc. Pay attention to air quality in your community when planning activities and be aware of when your child might be more susceptible to asthma exacerbations. Ideally, outdoor activities should be planned for when pollution levels will be low.
• Seasonal Allergies – The same substances that trigger your hay fever (allergic rhinitis) symptoms, such as pollen, dust mites and pet dander, may also cause asthma signs and symptoms. In some people, skin or food allergies can cause asthma symptoms. This is called allergic asthma or allergy-induced asthma.
• Pests (cockroaches, mice, etc.) – To control pests in your home: 

• Remove as many water and food sources as you can.
• Clean dishes, crumbs, and spills right away.
• Store food in airtight containers.
• Keep trash in a closed container.
• At least every 2 to 3 days, vacuum or sweep areas that might attract cockroaches or mice.
• Keep counters, sinks, tables, and floors clean and free of clutter.
• Seal cracks or openings in cabinets, walls, baseboards, and around plumbing.
• Use pesticide baits and traps in areas away from children and pets, following manufacturers’ instructions.
• Avoid using sprays and foggers as these can cause asthma attacks.

• Pets – Furry pets can trigger an asthma attack if you are allergic to them. If you can’t or don’t want to find a new home for the family pet, decrease your exposure by: keeping pets out of bedrooms, washing furry pets, using an air cleaner with HEPA filter, and using allergen-proof mattress and pillow covers.
• Molds – Breathing in mold can trigger an asthma attack whether or not you are allergic to mold. Indoor mold growth is often found in damp areas; bathrooms, basements, kitchens, and water damaged areas.
• Cleaning and disinfecting products – These products should always be used in well ventilated areas. Children with asthma should have limited exposure to these products.
• Scents/fragrances – certain scents and fragrances might trigger an asthma response, avoid exposure to these items to prevent exacerbations.
• Illnesses – certain illnesses that affect your respiratory system can make asthma worse. Make sure to avoid exposures and to get your child’s annual flu vaccine.
• Exercise – Exercise sometime triggers asthma. Exercising is an important aspect of healthy living. Please make sure your child’s action plan accounts for recess and gym activities if this is a trigger for your child.
• Emotions/Stress – strong emotions and stressful situations can lead to very fast breathing, called hyperventilation, that can also cause an asthma attack. 

What is an Asthma Action Plan?

An asthma action plan is an individualized plan that outlines how to manage your asthma. This plan will be developed by you and your child’s provider and shared with the school nurse. It will be important to make sure that this form is completed and returned to school as well as any medications that your child may need during the school day. The best way to prevent an asthma attack/complication is to follow the treatment plan. Many people live healthy lives with asthma if it’s managed well. Asthma Action Plans often contain the following information:

• A list of triggers 
• Symptom tracking
• A list of asthma medications and instructions on when and how to take them 
• When to call the healthcare provider or seek emergency medical care 
• Emergency phone numbers

Your child’s Asthma Action Plan will be renewed each school year.

https://www.cdc.gov/asthma/action-plan/documents/asthma-action-plan-508.pdf

Allergies and School

Managing allergies in schools is a collaborative effort between students, families, staff, administrators, and the school nurse. The goal for effective management is to reduce and/or eliminate potential allergens. The keys to meeting this goal is prevention, education, awareness, communication, and rapid emergency response. 

An allergy occurs when your immune system reacts to something – such as pollen, bee sting, pet dander, or food – that does not usually cause a reaction in most people. The severity of a reaction can range from mild irritations, such as rash/itching/swelling, to anaphylaxis.

Anaphylaxis is a severe and life threatening reaction which can occur within seconds or minutes after exposure to an allergen. The symptoms of anaphylaxis are as follows:

• Skin reactions, including hives and itching and flushed or pale skin
• Low blood pressure (hypotension)
• Constriction of the airways and a swollen tongue or throat, which can cause wheezing and trouble breathing
• A weak and rapid pulse
• Nausea, vomiting or diarrhea
• Dizziness or fainting

Food allergies, specifically, are a growing concern among school children. It is the most common trigger, accounting for 60% of the reactions is a school setting. The CDC estimates that approximately 1 in 13 children have a significant food allergy that may result in anaphylaxis. The most common food allergies in children are: milk, eggs, wheat, soy, peanuts, tree nuts.

Insect stings are another common allergy in school age children. Insects that can trigger allergic reactions include honeybees, yellowjackets, hornets, wasps, and fire ants. When they sting, they inject venom into the skin. Allergic reactions to stings usually don’t happen when a child is stung for the first time. Most happen when the child is stung for a second time, or even later.

If your child has an allergy please contact the school nurse so the appropriate accommodations can be made and documented. If your child has a history of an anaphylactic reaction the school nurse, in collaboration with you and your child’s doctor will create and Emergency Action Plan (EAP). An EAP is a plan that gives specific steps for school professionals to take if your child has a medical emergency. 

https://my.clevelandclinic.org/health/diseases/8610-allergies

https://kidshealth.org/en/parents/sting-allergy.html

https://downloads.aap.org/AAP/PDF/AAP_Allergy_and_Anaphylaxis_Emergency_Plan.pdf

Schools are accountable to provide safe, legal, and appropriate care for students. This includes the administration of medications necessary during the school day in order for the student to attend school and take full advantage of his or her educational program. Both federal and state laws guide the administration of medications to children during the school day. The school nurse provides for the safe administration of medications in the school setting.

Standing Order Medications: Standing orders are written, reviewed, and signed by the school‘s physician. These orders authorize administration of specific over-the-counter (OTC) medications to students according to a defined protocol. Although parent/guardian approval (consent) is not needed for the administration of medications during a life threatening emergency, consent is required for the administration of over-the-counter medications. Permission to administer these medications to students must be signed and returned to the school health office yearly. Standing order medications include the following:

• CHILDREN’S TYLENOL (age/weight based)
• CHLORASEPTIC SPRAY 
• BACTINE SPRAY 
• BACITRACIN ANTIBIOTIC OINTMENT 
• CALAMINE OR ZIRADRYL LOTION
• STING-KILL SWAB
• DACRIOSE/SALINE EYE IRRIGATING SOLUTION
• BENADRYL (oral or topical)
• Mentholyptus COUGH DROPS
• TUMS
• Oragel/Anbesol 

Prescription MEDICATIONS:  If your child requires any additional medication in school (Prescription or over-the-counter), you will need your child’s medical doctor to complete a Medication Administration Form. Provide the form with a sealed labeled bottle of the matching medication to the school nurse.  OVER THE COUNTER MEDICATIONS and PRESCRIPTION MEDICATIONS both require a Completed Medication Administration Form indicating the following: 

• Student’s name 
• Name of the medication(s) 
• Reason for medication(s) 
• Dosage of medication 
• Frequency or time(s) of administration 
• MD stamp and signature 
• Parent signature 
• This form needs to be completed annually for each school year

Bullying, although not a new problem in and around schools, has increasingly become a bigger issue with children, having negative impacts for all involved. With the increase in online formats (social media, gaming, etc.) this can feel like an issue that is difficult to get ahead of. The Centers for Disease Control and Prevention (CDC) define bullying as” any unwanted aggressive behavior(s) by another youth or group of youths…. that involves an observed or perceived power imbalance, and is repeated multiple times or is highly likely to be repeated.” Bullying can come in the following forms:

• Physical such as hitting, kicking, and tripping
• Verbal including name-calling and teasing
• Relational/social such as spreading rumors and leaving out of the group
• Damage to property of the victim
• Online (Cyber-bullying) which includes verbal threats and harassment over online platforms (cell phone, text messages, social media, gaming, emails)

Bullying can produce long term effects for children, resulting in physical injury, social and emotional distress, self-harm, and even death. It also increases the risk for depression, anxiety, sleep difficulties, lower academic achievement, and dropping out of school. 

Talking about bullying can be difficult for everyone. However, research suggest that children often look to parents/guardians for advice/help on difficult decisions. Spending even 15 minutes a day talking with your child can reassure them that they can talk to you if they have a problem. Start conversations about daily life and feelings with questions like these:

• What was one good thing that happened today? Any bad things?
• What is lunch time like at your school? Who do you sit with? What do you talk about?
• What is it like to ride the school bus?
• What are you good at? What would do you like best about yourself?

It is important to talk to your child about bullying so that they understand what it means to bully someone and what to do if it happens to them. If you suspect that your child is being bullied at school or on the bus, please contact the school. If you suspect that your child is being bullied somewhere outside of school please consider discussing the following tips/options with your child:

Don’t give the bully a chance. As much as you can, avoid the bully. You can’t go into hiding or skip class, of course. But if you can take a different route and avoid the mean kid, do so.

Stand tall and be brave. When you’re scared of another person, you’re probably not feeling your bravest. But sometimes just acting brave is enough to stop a bully. How does a brave person look and act? Stand tall and you’ll send the message: “Don’t mess with me.” It’s easier to feel brave when you feel good about yourself. See the next tip!

Feel good about you. Nobody’s perfect, but what can you do to look and feel your best? Talk to your child about ways to increase self-esteem.

Get a buddy (and be a buddy). Two is better than one if you’re trying to avoid being bullied. Plan to walk with a friend or two on the way to school, recess, lunch, or wherever you think you might meet the bully. 

Ignore the bully. If you can, try your best to ignore the bully’s threats. Pretend you don’t hear them and walk away quickly to a place of safety. Bullies want a big reaction to their teasing and meanness. Acting as if you don’t notice and don’t care is like giving no reaction at all, and this just might stop a bully’s behavior.

Stand up for yourself. Pretend to feel really brave and confident. Tell the bully “No! Stop it!” in a loud voice. Then walk away, or run if you have to. 

Don’t bully back. Don’t hit, kick, or push back to deal with someone bullying you or your friends. Fighting back just satisfies a bully and it’s dangerous, too, because someone could get hurt. You’re also likely to get in trouble. It’s best to stay with others, stay safe, and get help from an adult.

Don’t show your feelings. Plan ahead. How can you stop yourself from getting angry or showing you’re upset? Try distracting yourself (counting backwards from 100, spelling the word ‘turtle’ backwards, etc.) to keep your mind occupied until you are out of the situation and somewhere safe where you can show your feelings.

Tell an adult. If you are being bullied, it’s very important to tell an adult. Find someone you trust and talk about what is happening to you. 

Remember, children often learn by watching adults. When adults treat others with kindness and respect,  it demonstrates to children that there is no place for bullying. Children watch how the adults in their lives manage stress and conflict, how they treat those around them and how they allow others to treat them. For more information regarding bullying, the effects of bullying, and how to make a positive impact in our communities, please visit the following websites:

https://www.stopbullying.gov/bullying/what-is-bullying

https://www.stopbullying.gov/prevention/how-to-prevent-bullying

https://kidshealth.org/en/kids/bullies.html