5340F - MEDICAL STANDING ORDERS
General Guidelines
Disposable gloves must always be worn while rendering first aid or cleaning injuries.
Wash hands with soap and water after removing and discarding disposable gloves.
Any unusual cluster of children with similar symptoms and/or unusual symptoms should be reported to the school nurse. The school nurse will consult with the Floyd County Health Department and coordinate notifying the parents to call their physicians, if necessary.
Students are sent home from school for the following reasons and require a doctor's statement for readmission:
Reddened eye(s) with possible drainage, matting, or discomfort. If questionable, contact school nurse.
Recurrent or persistent skin infections - including scabies.
Unexplained or undiagnosed rash. If questionable, contact school nurse.
Injury involving documented loss of consciousness.
Untreated drainage from skin. If questionable, contact school nurse.
Students are sent home from school for the following reasons:
Temperature of 100 degrees or over. Notify parent that student must be fever-free for twenty-four (24) hours before returning to school.
Temperature of 96.5 degrees or lower.
Lice (pediculosis) - school personnel checks for absence of lice (live bugs) to readmit.
Vomiting - contact school nurse if vomiting is a recurrent issue.
Diarrhea.
Instructions and/or care for health conditions
Abdominal pain - Take temperature. Send home if 100 degrees or above. Allow to rest if less than 100 degrees. Contact the parent if pain does not subside after rest and suggest the parent notify their physician.
Amputated parts - If a body part such as a finger or a toe is amputated in an accident, the amputated part should be sent with the student to the doctor of hospital. The part should not be cleaned in any way but should be wrapped in sterile gauze and packed in ice, if possible.
Bites (animal or human) - Clean with green soap and water, contact the parent, and suggest the parent notify their physician as soon as possible. All animal bites must be reported to the Health Department. For human bites at school, see blood exposure incident instructions ("E" below).
Bleeding - Apply pressure with a dressing. Contact the parent and suggest the family notify their physician if severe and/or wound may require stitches.
Blood exposure incident (student) - Clean the exposed area with soap and water and apply dressing as needed. Contact the parent and request that the parent contact their physician. Document the incident in the student log. Complete an accident report as directed by the school nurse if the student (exposed to blood) needs immediate attention by a physician. Identify the source, if possible. Report the incident to the principal.
Burns (Thermal, Chemical, or Electrical) - Cool with running water. Loosely apply sterile dressing. Contact the parent.
Choking - Use back blows and abdominal thrusts if person is unable to speak and is unable to cough. Suggest medical attention be sought if these measures must be taken. For an unconscious choking victim, call 911 and use modified CPR method.
Cough - Take temperature. Send home if 100 degrees or above. Call the parent and suggest the parent notify their physician if severe, persistent, or prolonged.
Cramps - Provide rest.
Cuts and scratches - Clean with green soap and apply band aid. Contact the parent and suggest the family notify their physician if severe and/or wound may require stitches.
Diabetes - Follow the individual Diabetic Management Plan. Never allow student to be alone if low or high (>400) blood sugar is suspected, or has altered mental status.
Draining sore/wound - Ensure doctor's statement has been received and that sore/wound is covered. No student with draining sore/wound may be allowed to participate in swimming.
Earache (or draining ear) - Check temperature. Send home if 100 degrees or above. Contact the parent and suggest the parent contact their physician. Do not place anything into the ear canal. May place cotton in the external ear.
Eye injury - Notify the parent immediately if student is having trouble seeing or if there is reason to believe injury is serious. Cover eye with sterile gauze, if necessary. If foreign object is in eye, flush with water or remove with twist of gauze. If unable to remove, contact the parent and suggest parent notify physician immediately.
Fainting - Have student lie down with feet elevated; loosen tight clothing. Contact the parent.
Foreign body - If object such as a staple or splinter, etc. is stuck in skin, it may be removed if protruding. If deeply embedded, contact the parent.
Fractures and dislocations - Immobilize part in position found if it does not cause further pain. Have student lie down, keep quiet and warm, and give nothing by mouth. Do not move if neck or back injury suspected. Observe for signs of shock. Contact the parent and suggest the parent notify their physician.
Frostbite - Re-warm frozen part by immersing it in warm water. Do not rub the part. Give victim a warm drink. Contact the parent and suggest the parent notify their physician.
Head injury - Watch for vomiting, confusion, dizziness, blurred vision, headache, and loss of consciousness. Apply ice to the injury. Contact the parent and suggest the parent notify their physician if any of the above symptoms are noted.
Headache - Take temperature. Send home if 100 degrees or above. Allow to rest if less than 100 degrees.
Heat exhaustion - Give sips of water, allow to rest and elevate feet, loosen clothing, apply cool, wet clothes. Contact the parent and suggest the parent notify their physician.
Insect bites/stings - Clean with green soap. Apply hydrocortisone cream if itching. Refer to Health History information for any reports of severe allergy to stings.
MRSA - Ensure doctor's statement has been received. If sore/wound is draining, ensure that it is covered. No student with draining sore/wound may be allowed to participate in swimming.
Nosebleed - Have student hold tissue at nostril, lean head forward while head is elevated, and pinch bridge of nose. Dispose of bloody materials in a plastic bag. Contact the parent and suggest the parent notify their physician if repeated or prolonged.
Puncture wounds - Clean with green soap and apply band aid. Check status of tetanus shot. Contact the parent and suggest the parent notify their physician if the wound is severe.
Rash - Notify the parents immediately if allergic or if infectious source is suspected. Refer to page 1 for exclusion criteria. May apply hydrocortisone cream if itching.
Ringworm - Cover area with band aid. Contact the parent and notify that the student may remain in school if under treatment with an antifungal medication. Request that the parent report name of product used.
Seizures - Note time that seizure started, ended, and what the seizure looked like (focal or generalized). Do not restrict movement, ease child to floor if sitting. Protect child from injury and clear area, if possible. Do not attempt to place anything in mouth. Loosen tight clothing. Allow to rest after recovery. Call 911 if seizure lasts longer than five (5) minutes, recurs repeatedly without time for recovery, an injury occurs as a result of seizure, or if the student has no history of a previous seizure.
Sore throat - Take temperature. Send home if 100 degrees or above. Allow to rest if less than 100 degrees.
Sprains and strains - Elevate injured body part and apply ice pack. Contact the parent and suggest the parent notify their physician if swelling or discoloration appears.
Ticks - If the tick is attached to the skin, remove it by pulling steadily and firmly by grasping the tick with tweezers as close to the skin as possible. Use gloves if no tweezers are available. Once the tick is removed, clean area with green soap. If you cannot remove the tick, or if parts of the tick stay in the skin, call the parent and suggest the parent notify their physician. If tick is fully removed, contact the parent and suggest the parent notify their physician if flu like symptoms or rash appears in the next three (3) to four (4) weeks.
Tooth (permanent) loss - Wrap tooth that has been knocked out in a moist sterile gauze or immerse in milk for transport to the dentist. Call parent and explain that treatment should be obtained within an hour of the injury.
Tooth (primary) loss - Place in a sealed container or plastic bag. Rinse mouth with water and control bleeding, if necessary.
Toothache - Call the parent and suggest the parent notify their dentist.