Working TogetherHealth Services and Health Education2008 ArkAHPERD Conference, Hot Springs, AR

Paula Smith, RNP, MNSc.

State School Nurse Consultant

Arkansas Department of Education

Why are we here?

Share information about select health topics: MRSAHIPAA/FERPARespiratory emergenciesHypoglycemiaSeizures

What is Staphylococcus aureus? A type of bacteria.

Known as “staph”

Very common cause of skin infections.

Found on the skin and in the noses of healthy

people. MRSA: “staph” resistant to

commonly used antibiotics.

What are the differences…Hospital Acquired -vs- Community Acquired?

• Sick

• Elderly

• Recent hospital stay

• Surgery

• Dialysis

• Patients undergoing an invasive medical procedure.

• Health People

• Young

• Athletes

• Children attending

daycare/school

• Intravenous drug

users

Potential Sites or Sources of Staph infections

Characteristics of CA-MRSA

Spreads quickly

Often looks like a “spider bite”

Can release very strong toxins that destroy tissue

Bacteria is mutating and becoming a more prominent infection worldwide

CA-MRSA Misdiagnosed Commonly misdiagnosed as:

Simple staph infectionSpider bite

Delayed proper treatment leads to:Increased chance of spreading

infection to others Increased severity of infectionIncreased risk of fatality

How Is MRSA Spread?

Direct physical contact with someone who has an open, infected sore

Direct physical contact with a contaminated personal item or a contaminated surface

Sharing needles, drug “works” or tattoo equipment are particularly high-risk activities

Signs and Symptoms of a Staph Infection

Small red bumps resembling pimples, boils or spider bites.

The site may be warm, red and painful to touch.

Can turn into deep, painful abscesses. Can cause potentially life-threatening

infections in bones, joints, surgical wounds, the bloodstream, heart valves and lungs.

Minor “Staph” InfectionTypical infection

is in the form of a boil or folliculitis.

Ulcerated wound

Arms and legs are common sites of infection.

Staphylococcus aureus Skin and Soft Tissue Infections

Stop the Spread of Stop the Spread of MRSAMRSA…… Wash your hands!Wash your hands! Wash Wash

often with soap and often with soap and warm water for 20 sec!warm water for 20 sec!

Wash your hands!Wash your hands! Wash your hands!Wash your hands!

Keep cuts and abrasions Keep cuts and abrasions coveredcovered

DO NOT share towels, DO NOT share towels, personal items, clothing personal items, clothing or equipment.or equipment.

Stop the Spread of MRSA Stop the Spread of MRSA ……Shower with hot

water and wash with soap.

Use pump soap, not bar soap.

Clean and disinfect items such as gym and sports equipment.

X

Avoiding Resistance to Antibiotic Therapy

Do not overuse antibiotics!Antibiotics will not help a virus

Take ALL of your antibiotics when on Antibiotics Therapy!Don’t save them for a later date

or for someone else!

HIPAA/FERPA

What is Personal Health Information (PHI)?

Who has a “legitimate educational interest”?

Who needs to know what?

All personally identifiable health information is considered personal and private and is protected by the U.S. Constitution, state constitutions and federal and state laws.

Confidential vs. Highly Sensitive

School officials MUST treat all personally identifiable student health information as confidential and sensitive and protect it accordingly.

All personally identifiable records are confidential, certain records must be considered “highly sensitive” and less easily accessed by school officials.

Highly Sensitive Records

Special EducationStudent healthThird-party medical and mental health

records released to the school for planning

Family information provided in counseling and social work settings.

What can I do?

Treat all students the sameDO NOT discuss any student with

anyone who does not have a “legitimate need to know”

Be careful where conversations about students occur. Maintain privacy!

Respiratory Symptoms

Wheezing (high pitched sound) Coughing Can’t speak/can’t cough Flaring nostrils Clutching throat/wild gestures Blueness around lips (late sign) Excessive drooling Agitation Loss of consciousness (late sign) Sitting up, leaning forward Head bobbing with each breath

Respiratory First Aid

Maintain CALMAsk if the student uses a rescue inhalerCall the school nurseMaintain ABCs

Airway, Breathing, CirculationIf experiencing late signs of respiratory

distress, call 911

Hypoglycemia

Causes: too much insulin, not enough food, unusual amount of exercise, delayed meal.

Hypoglycemia Symptoms

nervousness, headache,sweating, intense hunger, personality change,trembling, weakness,dizziness, difficult to awakenpalpatations, blurred vision, andoften have trouble speaking.

Hypoglycemia treatment

1/2 to 3/4 cup of orange or grape juice (a juice box is good when you're away from home)

2 glucose tablets or 2 doses of glucose gel 2–4 pieces hard candy 5 gumdrops 1–2 tablespoons of honey 6 oz. regular (not diet) soda (about half a can) 2 tablespoons of cake icing All of these are 10-15 grams Carbohydrates

Seizures

Treatment: Position patient on side Do not insert anything in patient’s mouth Prevent self-injury to patient, move

furniture Allow rest period after seizure subsides Notify parent & refer for medical care

when indicated Call 911 if seizure activity is continuous

or non-subsiding

Resources

Your School Nurse(s)Child Abuse Hotline

800-482-5964Poison Control

800-3POISON (376-4766)American Red Cross

501-748-1022

Coordinated School Health

Laura McDowell, Coordinator Debby Woods, PANT Coordinator Kathleen Courtney, HIV/AIDS Joy Rockenbach, Act 1220 Coordinator Paula Smith, State School Nurse

2020 W. 3rd St., Suite 320 Little Rock, AR 72205 501-683-3600 www.arkansascsh.org