Health Training for School Personnel
Autumn Slote, BSN, RN
Mountain Valley JPA
School Nurse
Topics
Anaphylaxis & EpiPen Administration
What is Anaphylaxis?
Anaphylaxis is a life-threatening allergic reaction that affects millions of Americans every year. Anaphylaxis can be caused by a variety of allergens, with the most common being foods, medications, insect venom, and latex.
The definitive treatment for anaphylaxis is epinephrine. All patients at risk for experiencing anaphylaxis are urged to carry self- injectable epinephrine such as EpiPen epinephrine auto-injectors.
Symptoms of an Allergic Reaction
Recognize and Respond to Anaphylaxis
Per FARE (Food Allergy Research & Education) For a suspected or active food allergy reaction:
1- Administer EpiPen IMMEDIATELY
2- CALL 911
request ambulance with epinephrine
If student has an IHP for allergy, follow that for additional meds prn
POSITIONING
lay person flat and raise legs (helps return blood flow and oxygen to the heart). If breathing is difficult or they are vomiting, let them sit up or lie on their side.
NEXT STEPS
if symptoms do not improve, or symptoms return, more doses of epinephrine an be given about 5 minutes or more after the last dose.
Transport to and remain in ER for at least 4 hours because symptoms may return.
When in doubt, give EPIPEN and call 911.
For ANY of
the following
SEVERE Symptoms
LUNG:
HEART:
THROAT:
MOUTH:
SKIN:
GUT:
OTHER:
Short of breath, wheezing, repetitive couth
Pale or bluish skin, faintness, weak pulse, dizziness
Tight or hoarse throat, trouble breathing or swallowing
Significant swelling of the tongue or lips
Many hives over body, widespread redness
Repetitive vomiting, severe diarrhea
Feeling something bad is about to happen, anxiety, confusion
For MORE THAN ONE
MILD Symptoms
NOSE:
MOUTH:
SKIN:
GUT:
Itchy or runny nose, sneezing
Itchy mouth
A few hives, mild itch
Mild nausea or discomfort
EpiPen Administration
If signs/symptoms arise:
Direct office to call 911
Direct office to call parent
Direct an adult to get the AED
Get EpiPen from office
Remain with student and observe for respiratory distress
Initiate CPR if necessary
Blue to the sky
Orange to the thigh
Go through clothing
EpiPen Video Demonstration
~2:23 minutes
Red Cross EpiPen Video
~1:22 minutes
EpiPen Administration PRACTICE
REMEMBER:
Blue to the SKY
Orange to the THIGH
Green is Jr= LESS than 66lbs
Yellow is Adult= MORE than 66lbs
If you use an EpiPen,
CALL 911
EPINEPHRINE INDEMNITY ACKNOWLEDGEMENT
*Required form to complete*
This notification is provided annually to all staff to inform them that they are protected from civil liability brought on as a result of their actions serving as a volunteer in administration of EMERGENCY EPINEPHRINE in a suspected anaphylaxis at school.
Please complete the EPINEPHRINE INDEMNITY ACKNOWLEDGEMENT form handed out to you and submit it to office manager.
Notification of Volunteer Agreement for training in Administration of Epinephrine auto-injector
*OPTIONAL*
Current law (SB 1266) now requires schools to provide emergency epinephrine for individuals who may be experiencing anaphylaxis.
Legislation allows for a school nurse or a trained volunteer to administer an epinephrine auto-injector to an individual who is showing symptoms of anaphylaxis.
Staff members who volunteer to be trained are protected under the law and will be provided defense and indemnification by the school district for any and all civil liability.
This notification is provided annually to all staff. If you are willing to be identified as a volunteer in the administration of an EpiPen, please complete the NOTIFICATION OF VOLUNTEER AGREEMENT FOR TRAINING IN ADMINISTRATION OF EPINEPHRINE AUTO-INJECTOR form handed out to you and submit it to office manager.
*Reminder: you will not harm a student if you administer an EpiPen to a student showing symptoms of anaphylaxis that is NOT actually having an anaphylactic reaction.
** Please contact me if you need additional training: aslote@mvjpa.com
Where are EpiPens stored?
STOCK EpiPens are stored: know the location at your school
STUDENT EpiPens are stored: know the location at your school
Post Test
Seizures
What are Seizures?
Sudden, abnormal electrical activity in the brain.
When people think of seizures, they often think of convulsions in which a person's body shakes rapidly and uncontrollably.
Not all seizures cause convulsions. There are many types of seizures and some have mild symptoms.
Types of Seizures
Seizures fall into two main groups.
seizures, happen in just one part of
the brain. This includes absence seizures.
abnormal activity on both sides of
the brain.
Signs & Symptoms of absence seizures: short period of “blanking out” or staring into space can include eyelid fluttering
Signs & Symptoms of tonic-clonic/grand mal seizures: stiffening of the body, losing consciousness, convulsing
First Aid for Seizures
If student is having a seizure:
Tonic-Clonic Seizure VIDEO
**Note: immediately place unconscious victim on side**
(this video shows the teacher placing student on side after the seizure ends. I like this video to show what a tonic-clonic seizure looks like, how calm the teacher is, her demonstrating timing the seizure, and how she talks calmly reassuring student)
~1:20 minutes
Focal Seizure VIDEO
~1:10 minutes
Administration of Valtoco VIDEO
~3:30 minutes
Where are Emergency Seizure Medications stored?
STUDENT Emergency Seizure Medications are stored:
know the location at your school
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Asthma
What is Asthma?
Signs & Symptoms of Asthma Attack
Asthma symptoms can include:
narrow passages)
Asthma Medications
Types of Medications (Inhaled)
• Controllers (also called prevention or maintenance)
• Relievers (also called rescue or fast acting)
Controllers (Anti-Inflammatory)
To be most effective, preventive medication must be used every day.
CAUTION: Controller medications DO NOT provide rapid relief of asthma symptoms.
Examples of common corticosteroids (controllers) are:
Aerobid, Azmacort, Beclovent, Flovent, Pulmicort, Quvar, Vanceril
Relievers (Bronchodilator) These medications relax the muscle bands around the breathing tubes, and breathing becomes easier within minutes.
Examples of short acting bronchodilators (relievers) are:
Albuterol, Breathaire, Maxair, Proventil, Ventolin, Xopenex
NOTE: If a student is experiencing an asthma attack in the classroom or on school grounds, make sure he/she uses a reliever (rescue) inhaler and not a controller inhaler.
VIDEO on Inhalers
~1:05 minutes
~1:00 minutes
~2:30 minutes
Where are Asthma Medications stored?
STUDENT Inhaler’s are stored:
know the location at your school
Unless the student has an order from their MD that states that student is allowed to self carry and self administer their inhaler.
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Diabetes
What is Diabetes?
~2:00 minutes
Signs & Symptoms of Diabetes
HYPOGLYCEMIA
(Low blood sugar)
HYPERGLYCEMIA
(High blood sugar)
Where are Diabetic Medications stored?
STUDENT Diabetic Medications and Supplies are stored:
know where these would be stored if you have a diabetic at your school.
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AEDs
AEDs
Our School uses the Philips HeartStart OnSite AED
~1:45 minutes
~6:00 minutes
~4:00 minutes
Where is AED located?
AED is located:
know the location(s) at your school. Some schools have more than one onsite.
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Individualized Healthcare Plans
What are Student Individualized Healthcare Plans?
Student Individualized Healthcare Plans are located:
know where these are located at your school
Student’s Individualized Healthcare Plan (IHP) is a formal document, developed by a licensed school nurse often in collaboration with the student’s physicians and/or parents, that explains the students medical concern and how to safely care, and support, the student at school. They are reviewed annually, or updated throughout the school year as needed for any changes.
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Medication Administration
Student Medication Administration
Schools are allowed to administer prescription and over-the-counter medications to student’s as long as specific criteria are met.
Who can administer student medication?
Storage
Field Trips
Medication Authorization Forms
Schools must have a COMPLETED Medication Authorization Form signed by a MD, NP, PA, or DO before administering medication that includes:
**The medication authorization form is valid for 1 year or until there is a change.
**ALL medication MUST HAVE a complete Medication Authorization Form!
Including: tylenol, ibuprofen, cough drops, saline eye drops, neosporin, calamine lotion, hydrogen peroxide, etc.
“Rights” to Medication Administration
RIGHT STUDENT
RIGHT MEDICATION
RIGHT DOSE
RIGHT ROUTE
RIGHT TIME
RIGHT DOCUMENTATION
Watch for side effects and report anything unusual
Where are Student Medication’s located?
Student Medication’s are located:
know where student medications are located at your school
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Opioid Overdose & Narcan
Fentanyl
Fentanyl is an opioid pain killer in the same class as codeine, morphine & oxycodone.
California’s I5 and other southern interstates rank highest in the country for routes used to traffick Fentanyl throughout the US.
Fentanyl is often added to other drugs without the users knowledge: cocaine, meth, marijuana, and pills.
Fentanyl has been found in vape pens, oral medications, nasal sprays, eye drops, and candy.
The U.S. Drug Enforcement Administration is alerting the public of a sharp nationwide increase in the lethality of fentanyl-laced fake prescription pills. The DEA Laboratory has found that, of the fentanyl-laced fake prescription pills analyzed in 2022, six out of ten now contain a potentially lethal dose of fentanyl.
Narcan
Immediately use narcan if drug overdose is suspected.
Narcan is not harmful if administered to someone not having an overdose.
If someone is having an overdose, once narcan is administered, they may become very agitated from the quick withdrawal.
Signs and Symptoms of an Overdose
Symptoms of an overdose can vary from drowsiness to a coma to death.
Early signs of an overdose include:
If overdose is suspected:
*Cardiac arrest from fentanyl can happen as soon as 2-5 minutes from use*
**If CPR is indicated, only perform chest compressions. Do not give rescue breathing to prevent risk of exposure to the opioid. Effective compressions will help pump blood to vital organs decreasing the risk for neuro deficits**
How to administer Narcan VIDEO
VOLUNTEER OF NONMEDICAL SCHOOL PERSONNEL AFFIDAVIT
*OPTIONAL*
Assembly Bill 1748 (Mayes) added Education Code section 49414.3, effective January 1, 2017 authorizes unlicensed school employees to administer emergency naloxone hydrochloride or another opioid antagonist medication to students who suffer an opioid overdose at school.
Each year, the school requests volunteers to administer emergency naloxone hydrochloride or another opioid antagonist medication to pupils suffering, or reasonably believed to be suffering, from an opioid overdose, in the absence of a school nurse.
Employees who volunteer to administer emergency naloxone hydrochloride or another opioid antagonist medication will be provided a defense and indemnification by the school district, county office of education, or charter school for any and all civil liability, in accordance with, but not limited to Government Code section 810 et seq.
This notification is provided annually to all staff. If you are willing to be identified as a volunteer in the administration of narcan, please complete the form handed out to you and submit it to office manager.
*Reminder: you will not harm a student if you administer Narcan to a student showing symptoms of an opioid overdose that is NOT overdosing.
** Please contact me if you need additional training: aslote@mvjpa.com
Where is Narcan located?
STOCK Narcan is located:
know where Narcan is located at your school
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Heimlich
Symptoms of Choking
Heimlich Review & VIDEO
The Heimlich maneuver is the first choice for helping a choking victim. It is performed by wrapping your arms around a person, making a fist with one hand and clasping it with the other. You place your fists between the person's rib cage and belly button and thrust your fists into their abdomen in an inward and upward motion until the object is freed.
Immediately begin CPR as trained if the victim loses consciousness.
~2:50 minutes
~1:40 minutes
~4:15 minutes
~1:25 minutes
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LifeVac
What is LifeVac & how does it work?
or cannot be administered (wheelchair, medical conditions etc).
**The LifeVac anti-choking device is not FDA approved. While it is registered with the FDA as a Class II medical device, the FDA does not approve over-the-counter anti-choking devices. The FDA recommends following established choking rescue protocols, like the Heimlich maneuver, as they have a high success rate and can be performed immediately. The FDA states that using anti-choking devices like LifeVac could potentially delay the use of these established methods.
LifeVac VIDEO
1st video is ~34 seconds
2nd video is ~4:23 minutes
Where is LifeVac located?
LifeVac is located:
know where the location of the LifeVac is at your school
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CPR
Cardiopulmonary Resuscitation
CPR Review
Early recognition and initiation of CPR can double and even triple the chances of survival after sudden cardiac arrest.
Why is CPR Important?
Keeping the blood flow active- even partially- extends the opportunity for a successful resuscitation once trained medical staff have arrived on site.
Why Learn CPR?
Learning how to perform CPR properly takes just a few short hours, but it can change a life forever. Sudden cardiac arrest can happen to anyone and anywhere. In these emergencies, the heart stops beating too ineffectively to circulate blood to the brain and other vital organs.
About High-Quality CPR
High-quality CPR should be performed by anyone. There are 5 critical components:
You must get recertified every 2 years.
Adult CPR
Cardiopulmonary Resuscitation
Adult CPR Review & VIDEO
For those trained: conventional CPR using chest compressions and mouth-to-mouth breathing at a ratio of 30:2 compressions-to-breaths. For an adult:
Perform 30 compressions
Give 2 breaths
**Repeat this cycle until victim has obvious signs of life or emergency personnel arrive and take over care**
Immediately have someone get AED & call 911.
~8:50 minutes
Use PPE
Child CPR
Cardiopulmonary Resuscitation
Child CPR Review & VIDEO
For those trained: conventional CPR using chest compressions and mouth-to-mouth breathing at a ratio of 30:2 compressions-to-breaths. For a child (aged 1-puberty):
Perform 30 compressions
Give 2 breaths
**Repeat this cycle until victim has obvious signs of life or emergency personnel arrive and take over care**
Immediately have someone get AED & call 911.
Use PPE
~2:00 minutes
~31 seconds
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Basic First Aid
Bleeding
Call 911 if:
Bleeding
Stop Bleeding
Nose Bleeds
Broken Bones
What Are the Signs & Symptoms of a Broken Bone?
The signs of a fracture depend on the type of break and the bone affected. It always hurts to break a bone.
What to Do…
Do Not Move Your Child and Call 911 Right Away If:
Basic Splint
What is a splint and why is it important with broken bones?
Splinting a possible broken bone helps provide pain relief and supports bone ends of the fracture site. Bone ends of the fracture site are very sharp. A splint helps prevent bone protruding through the skin, soft skin, and tissue damage, as well as bleeding.
The general rule for splinting is that the joint above and below should be immobilized to protect the fracture site. Example: if the forearm is broken, you would want the splint to include the wrist and the elbow.
Use a small board, cardboard, or something similar to brace site and wrap gently, but securely, with gauze or an ace bandage, to hold the splint in place until parents and/or EMS arrives.
**Make sure splint is not too tight where it cuts off circulation to the body part**
~2:50 minutes
~56 seconds
PPEs
Personal Protective Equipment
Types of PPEs
PPE’s help to minimize your exposure to hazards and bodily fluids. This helps to decrease your risk of exposure to communicable diseases.
Examples of PPE’s are:
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FINAL Questions
How to Contact Me
Autumn Slote, BSN, RN
best option for questions: aslote@mvjpa.com
(530) 921-3982- text will elicit a quicker response VS a phone call