BEYOND BANDAIDS

Welcome to another publication of BEYOND BANDAIDS, the school health newsletter written by the Ashburnham-Westminster School Health Department. The purpose of the newsletter is to keep you informed about current topics/concerns in school health.

The Ashburnham-Westminster School Health Program was awarded grant funds again last year from the Massachusetts Department of Public Health. With this grant we are required to support the assurances recommended which include strengthening the infrastructure to include a school nursing leader, implementing a plan to link students with health care providers and prevention programs, developing a management information system, establishing a continuous quality improvement program, collaborating and consulting with other school districts’ nurses…just to name a few. We are all working within these frameworks along with providing the daily care and maintaining the health records according to the Massachusetts laws.

In collaboration with our school physician, Dr. Lisa Rembetsy-Brown and the school nurses in our district, we look forward to providing you with an optimum school health program. Always know that we are available by phone or email if you have any questions at all.

Marcia Sharkey, RN BS

Nurse Leader

Infectious Mononucleosis

By Susan Lofquist, RN BSN

Oakmont High School

Every year I get a number of calls from parents seeking information about mononucleosis, often referred to as the “kissing disease”. Well, relax mom and dad…it’s not just from kissing!

Mononucleosis (or just “mono”) is an illness caused by the Epstein-Barr virus. While it is commonly seen in the high-school-aged population, especially between the ages 15 and 19, mono can occur in any age group. Interestingly, by the age of five, more than 50% of the population has been infected with mono, with 90-95% of the population being infected by age 40!

The illness usually presents with the classic symptoms of fever, fatigue, swollen glands and a sore throat. In most cases, the person has had the infection for 4-8 weeks before the symptoms appear. Because of the long incubation and recovery period, it can be difficult to control transmission of the virus. It is usually recommended that a student stay home from school as long as the fever and extreme fatigue persist. While there is no cure for mono, symptoms should be treated with plenty of rest. Smoothies or shakes (think: cold Carnation Instant Breakfast!) can be used to provide adequate nutrition and soothe sore throats. NEVER give aspirin to a student with mono because of the risk of Reyes Syndrome, a rare but severe complication that can occur in teens.

The student should be excused from contact sports and gym until receiving clearance from his/her health care provider, because of the potential for spleen rupture.

While it IS true that the virus is spread through kissing via saliva, it can also be transmitted through sharing food utensils or drinks. Mono is not an illness of casual contact, and it almost exclusively spread through saliva-to-saliva contact. Therefore, the best ways to avoid spreading the virus are the usual common sense and basic hygiene measures: avoid sharing food, drink (think: water bottles!) and eating utensils and wash hands with soap and water frequently throughout the day. This will not only prevent the transmission of mononucleosis, but also prevent the spread of many other common respiratory and gastrointestinal illnesses.

Additional resources:

www.healthyontario.com

health.theolympian,com/ContitionFactsheet.aspx?id=75

Ear Infections

By Krista Penning, RN BSN

JR Briggs Elementary School

Ear infections are a common childhood illness which results in millions of office visits and antibiotic prescriptions annually.

Acute Otitis Media includes intense signs and symptoms and inflammation and is the most common bacterial illness in a child where an antibiotic would be prescribed in the United States.

Otitis Media (OME) with effusion is even more common and about 90% of children will have OME before school age; often between 6 months to 4 years. One will usually see OME following a cold and/or viral infection or actual ear infection; and will usually clear up on its own without treatment.

Common Signs & Symptoms or Ear Infections are:

Pain: An older child will usually tell you, where a younger child may only seem irritable and cry. One may notice

tugging on ears, or child may not eat as well or be fussy at feedings, because sucking and swallowing may cause painful pressure changes in middle ear.

Loss of Appetite

Trouble Sleeping

Fever: Can range from 100-104 degrees

Ear Drainage: Yellow or white fluid; possible blood tinged. Fluid may have foul odor and will look different from normal ear wax. Pain and pressure often decrease after drainage begins, but this does not necessarily mean the infection has gone away. If this happens it is NOT an emergency, but your child will need to be seen by a physician.

Trouble Hearing: During and after a child has had an ear infection he/she may have trouble hearing for several weeks. This occurs because the fluid behind the ear drum gets in the way of sound transmission. This is usually temporary and clears up after the fluid from the middle ear drains away.

Other Causes of Ear Pain:

Swimmer’s Ear-which is an infection of the skin in the ear canal.

Blocked or plugged Eustachian tubes from colds or allergies.

Sore throat

Teething or sore gums

For more information please refer to American Academy of Pediatrics and American Academy of Family Physicians

Health Office Screenings and BMI

Marcia Sharkey, RN BS

Nurse Leader

Meetinghouse School

Students in grades Kindergarten through 9 are screened by the Health Office for vision, hearing and postural. Referrals for students who failed any of these screenings were/will be sent home and we ask that you please remember to follow through with our recommendations and send the referral form back to the school after your child’s evaluation. We want to be sure the physician’s recommendations are being followed.

Students are also screened for height and weight which is another requirement by the state. Measuring and monitoring growth over time in all children is an important indicator of health and development (US Preventive Services Task Force, 2005). The goal of the Massachusetts Department of Public Health’s (MDPH) Comprehensive Growth Screening Program is the improvement in health and well-being of school-age children in Massachusetts so that they are healthy and ready to learn. Consistent with this goal, schools are now required by law to provide height and weight screenings and Body Mass Index calculations in certain grades and report these finding to families and health care providers.

Body Mass Index (BMI) is a number calculated from a child’s weight and height using the Centers for Disease Control (CDC) calculations for BMI-for-Age charts. Please note that many factors other than height and weight (such as participation in sports or family history) influence your child’s growth. The BMI is simply a screening tool, not a diagnosis of the presence or absence of health risk. And the purpose of the Growth Screening Program is to provide you with information about your child’s growth pattern and to increase awareness of the importance of healthy eating and active living.

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We ask that you please share the results of all the screenings with your child’s health care provider. If you do not have health insurance or your child does not have a regular health care provider, please contact your school nurse for information about obtaining health insurance coverage or finding a provider.

Concussion

What every parent should know…

By Ann Lee Fredette, RN

Overlook Middle School

Concussions are among the most difficult sports injuries. They are jolts or blows to the head, contact between two players or a player and a solid surface that will cause an immediate dazed feeling. Concussions are injuries to the brain, and can often be very difficult to recognize. Many athletes never lose consciousness, or are symptoms apparent immediately. Many students will hide or minimize their symptoms and ask to return to play too soon.

Two of the most common signs are loss of consciousness and amnesia; however nausea, fuzzy vision, headache, grogginess, personality changes, dizziness and sensitivity to light are very often present and less obvious. Sometimes symptoms can show up days or weeks after the injury, usually around 5-10 days.

So what should a parent do? Tell your child’s coach, get a medical exam, and most of all give your child time to recover. If your child has had a concussion, his/her brain needs time to heal. Second concussions can cause permanent brain injury if the athlete returns too soon.

The worry isn’t just another bump. An injury causes the brain to undergo metabolic changes that will affect energy levels, meaning that physical and mental exertion might add more stain.

The treatment outcome depends on seeking medical attention right away, and to remind your teen that missing one or two games is better than missing the entire season. If in doubt, check it out.

Massachusetts Booster Seat Law Revision

By Nancy Taylor, RN BSN

ESHS Grant Nurse

Beginning July 10, 2008 a child restraint is required by law for children 5-7 years of age or until they reach 4’9” in height in our state. Children who have outgrown their child safety seat are now required to use a booster seat until they reach the allowable age of height.

A booster seat helps the child fit correctly in the vehicle’s safety belt. It positions the lap belt on the hips and the shoulder belt across the chest, providing the greatest amount of protection.

Children younger than 5 years old and less than 40 pounds are still required to ride in a federally approved child passenger restraint. Children who are 8-12 years old or taller than 4’9” must be protected by a safety belt.

If children are improperly restrained, the driver may be stopped by the police and fined $25.

For further information about this law visit:

http://www.mass.gov/legis/laws/seslaw08/sl080079.htm

For information on where to get free or discounted booster seats, call the Care Safe Line at 1-800-CAR-SAFE (1-800-227-7233) or visit

http://www/mass.gov/childsafetyseats