Asthma Diabetes Seizures Anaphylaxis Concussion

ASTHMA

Asthma  is a lung condition caused by an increased reaction of the airway to various stimuli.  An asthma attack is a series of events that narrows the breathing tube, and causes an overproduction of mucus which restricts the airway.

Signs of an asthma attack include coughing, shortness of breath, wheezing, bluish colored nailbeds, and/or nostrils flaring.

Interventions include administer medications as prescribed.  Remove any possible triggers(perfumes, extremes in temperatures, etc.).  Rest and calm the student, call the school nurse/first responder, call the parent and/or 911 if respiratory distress does not improve or worsens.  Lips turning blue is considered a medical emergency as it is a sign of severe respiratory distress.


SEIZURES

Seizures are the result of mixed electrical signals in the brain.  Some people have been diagnosed with epilepsy and take medication to treat the seizures.  However, if a person should have a seizure following a head injury, is pregnant, or has no prior history of seizures; it is considered a medical emergency.  Call 911.

Signs of seizures include twitching/jerking movements, staring or eyes rolling back, incontinence, stiffness, and/or loss of responsiveness.

Interventions include protecting the student from injury removing all hazardous objects and putting something soft under the head.  Never put anything in the mouth. Do not restrain the student; allow them to seize.  Monitor and document the activity(duration, symptoms, precipitating factors).  Reorient student after seizure subsides.  Call school nurse/first responder and parent.  If seizure lasts longer than 5 minutes call 911. 


DIABETES

Diabetes is a condition in which the pancreas produces too little or no insulin or the result of insulin resistance.  There are two types of diabetes(type I and type II).  Without insulin, the body's cells cannot utilize glucose for energy.

Signs of low blood sugar(hypoglycemia) include weakness, sweaty, shaky, confusion, and/or change in behavior.
Signs of high blood sugar(hyperglycemia) include increased thirst, increased hunger, increased urination, irritability, change in behavior, and if extremely high could have nausea/vomiting.

Treatment for low blood sugar includes check blood sugar, give simple sugar(cup of juice/soda, 4-8 pieces hard candy/jelly beans, half of candy bar, oatmeal cake, etc.).  Recheck blood sugar in 10-15 minutes, if still low give another simple sugar.  Follow all lows with a complex sugar(pack of nabs, cheese, sandwich, etc.)  Call school nurse and/or parent, do not leave student unattended.  If no blood sugar machine available to check blood sugar; always treat as low if unsure.
Treatment of high blood sugar includes check blood sugar, administer insulin as prescribed, give water or diet soda to drink, call school nurse and/or parent, do not leave student unattended; follow student's emergency action plan.

ANAPHYLAXIS

A sudden severe life threatening allergic reaction caused by an allergen such as but not limited to (latex, nuts, insect stings, medications).  Signs include swelling of the throat/tongue/lips and difficulty breathing.  Treatment includes administration of an epinephrine pen asap, contact 911, contact parent, and school nurse/first responder.
Milder allergies(caused by some of the above mentioned allergens) may cause itching, hives, diarrhea, nausea/vomiting,; call nurse or first responder and parent; may require oral or topical medications as prescribed by doctor and parent. 
All food allergies require diet orders from MD for school cafeteria to modify diet at school. 

CONCUSSION
Any student that experiences a head injury at school should be evaluated by the school nurse or first responder asap using the concussion checklist available at all schools.  The students parent should be contacted and referred to their primary provider as deemed necessary. There are guidelines to follow regarding returning to play should the head injury occur during activity/athletics.  There are also guidelines to follow regarding return to learn in the classroom following the injury. There should be a collaboration between the parent, school nurse, athletic personnel, teachers, doctors and parents regarding recommendations treatment for the injured student. This is mandated via NC State Law.  Contact your school nurse for further information.