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Welcome to the School Nurse Office

As school nurse, my goal is to help our students maintain optimal health so they can fully take advantage of the educational opportunities offered to them.  

The school nurse provides the following services:

  • Vision and hearing screenings at various grade levels. Parents will be contacted if their child does not pass any screening.
  • Dental screenings performed by a local dentist.   Parents will be notified of results of dental screenings.
  • Management of prescription medications and over-the-counter medications administered during school activities
  • Maintain individual health record for each student, including immunization records.
  • Notification of required immunizations for each school year.  Parents will be notified each spring of required immunizations for students. 
  • Injury and illness assessment.
  • Basic first aid measures for injuries..
  • Identification of health concerns and individualized health care plans as needed.
  • Baseline cognitive computerized testing for athletes prior to each sport season.
  • Health information resource for students, parents, and faculty
  • Health promotion activities.
  • Chronic disease monitoring.

Parents are encouraged to contact me with any health concerns that may affect your child during the school day.  I appreciate the opportunity to work with students and parents to provide a safe, healthy environment for learning. 

Jami Kuchar, RN

From Nurse Jami, School Nurse

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ILLNESS AT SCHOOL AND SCHOOL POLICY

It’s a new school year and spending time with classmates can mean viruses and head lice. Please review the information below regarding common school age viruses, policy guidelines for sending students home and returning to school, and prevention tips.

 

STUDENTS WITH FEVER: Any student with a fever of 100 or more will need to be picked up from school. The child is not to return to school until he or she has been fever-free for a minimum of 24 hours without the use of fever-reducing medication such as Tylenol (Acetaminophen) or Ibuprofen. If a parent discovers at home that a child has a fever, the same guideline applies.

HEAD LICE: Students will only be check for head lice if there is a concern or request by a teacher or the student’s parent. Per KDHE guidelines: only children with live lice will be sent home, and the parent requested to initiate lice removal treatment. I will request receipt or label information of the treatment with readmission to school. Kansas regulations no longer require children to be nit free before returning to school. Encourage your child to not share personal items or allow their hair to touch another child’s. Head lice are spread most commonly by direct head-to-head (hair-to-hair) contact.

FIFTH DISEASE: The first symptoms of fifth disease are usually mild and nonspecific and include fever, runny nose, and headache. After several days a distinctive red rash appears on the face called a "slapped cheek" rash. Some people will get a second rash a few days later on their chest, back, buttocks, arms, and legs that can vary in intensity, is itchy, and can come and go for several weeks. (KDHE Website) Children are not excluded from school unless temperature is over 100 due to nonspecific symptoms. Some children may just not feel well and symptoms mimic seasonal allergies. Children are most contagious prior to having a rash, are no longer contagious by the time the rash appears. The rash may last 1-3 weeks and come and go throughout that time. Hand washing and covering the nose and mouth during sneezing and coughing are the most effective ways to stop the virus from spreading. Exposed pregnant women should follow up with their doctor for any risk factors that may apply to them.

HAND FOOT, AND MOUTH DISEASE: Hand, foot, and mouth disease usually starts with a fever, reduced appetite, general discomfort, and sore throat. One to two days after the fever starts, painful sores can develop in the mouth. A skin rash, flat or raised red spots and sometimes blisters, will develop over one to two days. The rash usually appears on the palms of the hands and soles of the feet: it may also appear on the knees, elbows, buttocks or groin area. Children with a fever and rash should stay at home. Children should not return to school until they have been fever-free for 24 hr as the policy above states. Prevention: Washing hands often with soap and water, especially after changing diapers and using the toilet. Cleaning and disinfecting frequently touched surfaces and soiled items, including toys. Avoiding close contact such as kissing, hugging, or sharing eating utensils or cups with people with hand, foot, and mouth disease. 

Illness and School Attendance

Since the influenza season will soon be upon us, it is a good time to review and explain how illness and fever affect school attendance. In the fall of 2009, the school board approved certain ...more

Wellness - It is Important to All of Us!

10/20/16

 Allergies are always a major health concern in September.  Doctor’s offices have a huge increase in patients every September due to allergies.  Allergies can result not only in mild symptoms such as head congestion, runny nose, and itchy eyes but also lead to sinus infections and asthma attacks so it is important to provide treatment.  If your child is experiencing head congestion, itchy eyes, mild sore throat day after day, it is very likely that he/she is suffering from allergy symptoms.  Fall allergy triggers are different, but they can cause just as many symptoms as in spring and summer.

 

What Causes Fall Allergies?

Weed pollen grains that fill the air from August through October (up to the first frost). Ragweed is the biggest allergy trigger in the fall. Though it usually starts to release pollen with cool nights and warm days in August, it can last into September and October. About 75% of people allergic to spring plants also have reactions to ragweed. Even if it doesn't grow where you live, ragweed  pollen can travel for hundreds of miles on the wind..

In someone with hay fever (allergic rhinitis), inhaling these tiny particles triggers a cascade of biochemical reactions, resulting in the release of histamine, a protein that causes the all-too-familiar symptoms. In addition to sneezing, runny nose, congestion, and fatigue, histamine can cause coughing; post-nasal drip resulting in sore throat; itchy or watery eyes, dark circles under the eyes; and asthma attacks.

Mold is another fall trigger. You may think of mold growing in your basement or bathroom -- damp areas in the house -- but mold spores also love wet spots outside. Piles of damp leaves are ideal breeding grounds for mold.

Going back to school can also bring allergies in kids because mold and dust mites are common in schools.

 

Since it’s not realistic to stay totally inside to avoid allergens, here are some tips to help your child if he/she suffers from moderate to severe allergy symptoms listed above.

  • Whenever you come in from outside, wash your face and hands. If you’ve been exposed to outdoor air for quite a while, shower and change into fresh clothes.
  • sinuses -- can be very effective at curbing hay fever symptoms---it needs to be more than just a quick spritz.
  • Medical therapy may be in order. Nonprescription antihistamines, such Claritin,Zyrtec and Allegra are generally the first choice for mild to moderate symptoms (no need to pay extra for brand names, as generics cost less and work just as well).
  • If you’re bothered by congestion as well as sneezing and a runny, itchy nose, adding a decongestant such as Sudafed or Mucinex should help. There are also antihistamine-decongestant combinations available. These products generally include a “D” in the name, as in Claritin D or Allegra D. (If you havehigh blood pressure, ask your doctor if taking a decongestant is OK. Some cause a potentially dangerous rise in blood pressure.) These are usually only available behind the counter of pharmacies in stores like Walmart or Dillons.
  • For severe or persistent symptoms, asteroid nasal spray (FlonaseNasonex, and so on) may be helpful. 

Experts say the best approach may be to start treatment early and combine various therapies.   Whichever prevention strategies and medications you decide upon, don’t wait until the last minute to start using them.  If you know your child has seasonal allergy problems, start giving the allergy medicine as soon as you are aware of symptoms or high pollen counts.  Helping your child feel as healthy as possible will help him or her to do his best at school and minimize school absences.

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1/21/16
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Pertussis Information

Pertussis , a respiratory illness commonly known as whooping cough, is a very contagious disease caused by a type of bacteria called Bordetella pertussis. Pertussis can cause illness in babies, ...more

HAND, FOOT AND MOUTH DISEASE

Hand, foot, and mouth disease is a common viral illness that usually affects infants and children younger than 5 years old. However, it sometimes occurs in older children and adults. It usually ...more

CONCUSSIONS AND SPORTS

           A concussion is a traumatic brain injury!The Center for Disease Control estimates that 1.6 million to 3.8 million sports related traumatic brain injures (TBIs) occur each year. Estimates indicated that 85 % to 90 % of sports concussions are not recognized or reported.High school football players often do not report concussions for several reasons.

           The majority of concussions in competive sports were attributed to basketball, baseball, football and soccer. Girls competing in sports like basketball are more susceptible to concussions than boys are in the same sports. Female concussion rates in HS basketball are almost 3 times higher than boys rates.

           BRAIN INJURY CAN OCCUR EVEN IF THERE IS NO LOSS OF CONSCIOUSNESS.Loss of consciousness occurs in approximately only 10% of all concussions. Amnesia is 10 times more predictive than loss of consciousness predicting outcome following a concussion.

          Concussions are caused by a direct blow to the head, face, neck or elsewhere ti the body with a force transmitted to the head.

Research shows that it may take days, weeks, or even months to be symptom free following a concussion. Even when physical symptoms, such as headache, are gone, neurocognitive problems may remain!Fiction: The most pronounced symptoms following a concussion are usually seen within the first 24 hours following the injury. FACT: SYMPTOMS OFTEN INCREASE THE SECOND DAY FOLLOWING THE INJURY. Girls take longer than boys to recover from a concussion. An athlete with prior history of headaches or brain injury is more susceptible to concussion and a more prolonged recovery from concussion. Athletes with a previous concussion are more susceptible to another concussion.

Athletes who sustain a concusssion during play should never return to play during that game.

For more information on concussions and sports, please see the attached presentation given by Janet Tyler, PHD with the Kansas Instructional Support Network at the University of Kansas Medical Center. 

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VISION SCREENING

One of the most important tasks of the school nurse is vision screening.  By Kansas state law, schools are required to provide vision screening to all enrolled students every 2 years, as a minimum interval.   Vision screening guidelines for school nurses also emphasize the importance of doing such screening annually for all children 8 years and younger.  After the vision screening is done,  the person doing the screening is required to encourage  the parents of students who failed screening to have their child receive an eye examination by an optometrist or ophthalmologist---this is known as a vision referral.  The school nurse is also required to follow-up on referrals made.

An initial vision screening for a student 4 years and older at our school includes: 

  • Distance acuity (far vision)---each eye is tested separately and then with both eyes together
  • Near acuity (near vision))---each eye is tested separately and then with both eyes together 
  • Depth perception--using stereoptic glasses
  • Color vision
  • Fusion testing (only up to age 8)

* For preschoolers and kindergarteners new to the school, the screening also includes fixation, tracking, pupil response, corneal light reflection and near point of convergence.  

* Near acuity is not tested for preschoolers under the age of 4.

Each year, all students in preschool, kindergarten, 1st grade, 2nd grade, 3rd grade, 5th grade, 7th grade, 9th grade and 11th grade receive vision screening.  In addition, each student new to the school that year and all students receiving special services through special ed and the gifted program receive vision screening.   Vision screening is usually done in the fall before Christmas break to ensure that any child who has undetected vision problem will receive the necessary treatment to help him/her in his academic performance through the rest of the school year.   Although children's near acuity remains pretty much the same after the age of 8, distance acuity can begin to change for the worse around the age of 9--sometimes sooner.  

Criteria for referring to an optometrist or opthalmologist are as follows for children 4 years and older: 

  • Distance acuity (far vision) and/or near acuity  of 20/40 or worse (higher numbers indicate a worse condition such as 20/50, etc.) in one or both eyes.
  • Two or more lines difference between the 2 eyes in either distance or near acuity.  An example would be a child having 20/20  distance or near acuity in the right eye and 20/30 in the left eye.   The lines checked are 20/20, 20/25, 20/30, 20/40, 20/50, etc. going as high as needed to find where a child's vision is at.
  • With the Worth 4 dot test for fusion, the child counts an incorrect number of dots
  • Inability to track properly with eyes, inability to fixate on an object or fixation with one eye only----such as in 'crossed eyes'
  • With corneal light reflection, the reflection of a penlight does not appear in the same position in each pupil.
  • With the near point of convergence, there is poor fixation of eyes to object beyond 3 inches of nose or asymmetrical response between the eyes.
  • For depth perception, inability to detect butterfly in stereoptic book
  • For children 3 years old, the criteria for referring for distance vision is 20/50 in one or both eyes.

Vision screening at school should not replace having regular eye examinations for children.  There are eye conditions which can only be detected with the more sophisticated equipment and knowledge of an optometrist or opthalmologist.   At times, a child may pass the vision screening done at school but still have a vision problem.  Some examples of such vision problem areas are teaming of the eyes, ability of the eyes to remain focused,  and visual perceptive processing disorder.  In that situation, the eyes can see but the brain and eyes are not working properly together to process what the child is seeing. 

It is recommended that children begin having eye examinations at the age of 3 and in Kansas, all children age are eligible for free eye examinations under a program called See to Learn.  There are a large number of optometrists who participate in this program, including optometrists in Wellington and Arkansas City as well as other local communities.   Vision is crucial to all areas of academic learning so the sooner children have an eye examination, the better!  

For anyone who has questions about the See to Learn program or vision screening at school, you are welcome to contact our school nurse,  Jami Kuchar, R.N. at 620-892-5215 Monday through Friday between 9 AM and 3 PM.

 

Immunization Requirements for 2017-18

KANSAS IMMUNIZATION REQUIREMENTS FOR 2017-2018 SCHOOL YEAR

For Preschoolers 4 years and under:

4 doses DTaP (diphtheria, tetanus and pertussis)

3 doses IPV (polio)

2 doses MMR (measles, mumps, rubella)

1 ...more

Time to Get Flu Shots

The influenza season begins in October so it's time to get flu vaccine for both children and adults. Influenza (flu) vaccine is recommended for everyone ages 6 months and ...more

SCHOOL MEDICATION POLICIES

Over-the Counter Medications: Medications.jpg

Students are not allowed carry o ver-the- counter medications with them at school. The school nurse has a variety of over-the-counter medications on hand in her office w h ich ...more