Lifethreatening Health Conditions and Personal Safety

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Life-threatening Health Conditions and Personal
Safety

• Fall 2006
• sponsored by
• Nursing Services

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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.
• Annual blood borne pathogen review.
• Press the space bar to continue and the
  backspace key to move back to a previous frame.

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Life-Threatening Health Condition

• RCW 28A.210.320 states
• life-threatening condition means a health
• condition that will put the child in danger of
• death during the school day if a medication
  
• or treatment order and a nursing plan
• are not in place.

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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.
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Who Are These Children With Medical Needs?

• Students with known medical
• conditions such as
• Asthma
• Life-threatening Allergies
• Diabetes
• Unstable Seizures

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Allergies

• Lets discuss the impact of allergies.

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What Causes Allergic Reactions?

• Substances allergens that cause allergies
  can vary from person to person.

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

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Food Allergies

• Food is the leading cause of anaphylaxis in
  children.

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Anaphylaxis

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

Anaphylaxis is always considered a
medical emergency.
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Symptoms of Anaphylaxis

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

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Treatment

• Allergy symptoms are controlled by a licensed
  health care provider through
• Medications
• Diphenhydramine HCL (Benadryl)
• Fexofenadine HCL (Allegra)
• Loratadine (Claritin)
• Diet
• Allergen-free area

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Emergency Medication

• Epinephrine is the medication to treat severe
  allergic reactions.

Epinephrines effects will last for only about 15
minutes.
Symptoms of the reaction can recur 4 to 8 hours
after the initial reaction.
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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.

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Where Is The Epi-Pen Kept?

• There may be one available in the Health Room.
• The student may be carrying one.
• Review each students Individual Health Plan
  (IHP) to identify the exact location of the
  medication.

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Asthma Basics

• What is asthma?
• Chronic lung condition that causes breathing
  problems (asthma attacks)
• Who has asthma?
• 4.8M US, 150K (1 in 10) Washington children
• Level of severity varies from person to person

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Normal Breathing Process

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

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

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

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Asthma Basics (cont.)

• What happens during an asthma attack?
• Airways in the lungs become smaller and extra
  mucus can block air flow
• Symptoms include coughing, wheezing, chest
  tightness, shortness of breath

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What Causes an Attack?

• Triggers for Asthma attacks include
• Respiratory Illness
• Allergens
• Weather
• Irritants
• Emotions
• Exercise

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Symptoms of Asthma

• Shortness of breath
• Coughing
• Wheezing
• Chest Pain
• Chest Tightness

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Management of Asthma

• Minimizing contact with triggers

• Management of asthma uses two basic approaches

• Use of medications

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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

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Where is the Asthma Medication Kept?

• Student medication may be kept in the Health
  Room.
• Some student may be carrying an inhaler.
• Review each students 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.

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Diabetes- another medical condition

• 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.

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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

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Blood Sugar Testing

• Hypoglycemia too much insulin too little
  glucose
• Hyperglycemia- too little insulin too much
  glucose

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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

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Hyperglycemia

• Too little insulin and too much glucose

• Causes too little insulin, infection/illness,
  injury, undiagnosed diabetes
• Symptoms increased thirst, frequent urination,
  nausea, blurry vision, fatigue

• Treatment Prescribed by medical care provider
  and parent to self-treat with water, and diet
  soda
• Accommodations frequent bathroom privileges,
  extra water

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Insulin

• Taken by injections
• Lowers blood sugar
• Different types of insulin have different peaks
  or onset of action

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Seizures

• Epilepsy is a chronic disorder of the brain
  characterized by the tendency to have 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.
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Types of Seizures

• Generalized Seizures
• Tonic/Clonic (grand mal) seizures
• Absence (petit mal) seizures

• Partial Seizures
• Complex Partial
• Simple Partial

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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

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First Aid for Seizures

• Stay Calm
• Protect person from injury
• Do not restrain person
• Do not put anything in mouth
• Roll person to their side
• Allow person to rest once seizure is over.

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Call 911

• IF

• The seizure is a first time seizure or you dont
  know if the person has epilepsy.

• The seizure lasts more than 3-5 minutes.

• The seizure is followed by another seizure.

• There are signs of breathing difficulty.

• The person is pregnant.

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One More Thought

• If you have a student with any of the previously
  discussed medical conditions, and the student
  complains of illness
• Send the student accompanied to the Health
  Room or call the office for assistance.

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Protecting Yourself from Bloodborne Pathogens

• Keep in mind follow the rules!
• Infection Control
• Universal Precautions
• Hand Washing
• Use of Disposable Gloves
• District Procedures/Guidelines

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Universal Precautions

• Refers to a method of infection control in
  which all blood or certain bodily fluids anyone
  comes in contact with is assumed to be
  potentially infectious.

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Guidelines

• The following guidelines are meant to provide
  simple and effective precautions against
  transmission of disease.
• Do not eat, or touch your mouth or eyes, while
  giving first aid.
• Avoid contact with another persons blood or
  bodily secretions.
• Wash hands after bathroom use or contact with
  body secretions.
• Wash your hands before and after eating.
• Use gloves if contact with body fluids is
  anticipated.
• Wash your hands after glove use.

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Body Fluids

• The body fluids of all persons should be
  considered to contain potentially infectious
  agents.
• Blood
• Semen
• Feces
• Urine
• Vomit
• Respiratory secretions
• Saliva

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When To Use Gloves

• If care provider has an open wound on his/her
  hands
• Handling contaminated disposable items
• Direct hand contact with body fluids is
  anticipated
• Cleaning up body fluid spills
• Diapering/toileting

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Hand Washing Procedure

• Ensure that each sink is supplied with
  dispensable soap and disposable paper towels
• Wet hands thoroughly under warm water
• Dispense soap into wet hands
• Vigorously rub hands together for one minute,
  paying particular attention to nails, cuticles,
  spaces between fingers, and under jewelry
• Thoroughly rinse hands
• Dry hands with a disposable towel.
• Use towel to turn off the water
• Dispose of towel

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Hand Washing

• Hand washing is the single most important
  practice preventing transmission of infectious
  organisms!

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Use of Disposable Gloves

• Gloves reduce the risk of contact with bodily
  fluids.
• Gloves protect the caregiver as well as control
  the spread of infection from person to person.

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Disposable Glove Procedure

• Maintain a supply of gloves in readily accessible
  locations.
• Do not reuse gloves.
• Dispose of used gloves in a lined waste
  container.
• Wash hands thoroughly, following hand-washing
  procedure.

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Exposure Incident District Procedures

• Exposure incident means that an employee is
  exposed to another persons blood or other
  potentially infectious body fluid.
• Exposure means direct contact to the employees
  eye, mouth, and other mucous membrane or open
  wound.

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Steps To Take After An Exposure

• Wash exposed area immediately.
• Report to Supervisor immediately.
• Complete an employee accident report
• Contact Risk Management Office to report the
  incident and for specific procedures to follow.
• Post-exposure medical evaluation and follow-up
  needs to be completed.

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Clean Up Procedure

• Disinfecting environmental surfaces is important
  in minimizing the spread of infection
• Clean environmental surfaces with an approved
  cleaning solution.

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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!