School Nurse

Health Screening

Health Screenings include Height/Weight, Vision Screening, and Hearing Screening.  They are done annually, usually at the beginning of the school year. We complete the screenings on all students in the following grades:  K (or first entry into the school district), 1, 2, 3, 5, 7, 10. We also complete them on any new students or by parent/teacher request.

Parents are mailed a referral letter if their child fails the vision screening.  It recommends follow-up with an eye doctor for further evaluation. If parents don’t have vision insurance, they can contact us to get a Lion’s Club referral or Sight for Students application.  If accepted, both usually cover the cost of an eye exam and glasses if needed.

If a student doesn’t pass the hearing screening, we repeat the screening in about 6 weeks because colds and/or allergies can sometimes negatively affect the results of the screening.  If the student doesn’t pass the second hearing screening though, we contact the parent to recommend further evaluation of the child’s hearing. Parents can choose to follow-up with the child’s personal physician or to agree to accept our referral to LCSD #1’s Audiology department for further evaluation.  

Immunizations

Wyoming law requires that your child has received certain immunizations when they attend school.  It is the parent/guardian responsibility to provide a record of those immunizations. If the required documentation is not received within 30 calendar days of starting school, your child will not be able to attend until up-to-date on the required immunizations.

These requirements mainly affect those entering Kindergarten, 7th grade, or any newly enrolled students.

Please note that each state has different required vaccinations, so if you move to Wyoming your child may need additional vaccinations to meet our requirements.

If a parent/guardian chooses not to vaccinate their child, Wyoming does allow for parents to apply for a waiver to the mandatory immunizations, based on a religious objection or a medical contraindication.  There is a special form to complete that is submitted to the state and if the waiver is granted, the parent/guardian will receive an official notification by the state. The notification must then be provided to the school.  This process takes time, so should be completed before enrolling your child in school. Please note that if your child has an exemption from another state, it does not transfer to Wyoming - a Wyoming waiver is required. 

See Wyoming Immunization Requirements Or Requisitos de Wyoming Para Imunizaciones.

Medical Waiver Request Form


Religious Waiver Request Form

Emergency Seizure Medicines

If your student has a seizure disorder, he/ she will need to bring in the Emergency Seizure medication that has been prescribed in case of a seizure at school.

We will need to have a Medication Administration form completed to give us permission to administer it at school in case your child has a seizure.  Often the doctor will prescribe the emergency seizure medication for a seizure that lasts 5 minutes or longer or a series of cluster seizures.  Your child’s doctor will specify your child’s directions in the prescription. If it is administered, we may call 911 and then when able,the School Nurse and Parent(s) will be notified.

The Medical Administration form will need to be completed annually and the medication must not be expired.

Inhalers/Epipens may be stored at school in the nurse’s office in a locked cabinet. The Inhaler/Epipen needs to be in the original container with the prescription label including the child’s name, dosage, instructions on usage and the physician’s name. No expired inhalers/epipens will be accepted at school.  It is helpful to write the child’s name with permanent marker directly on the inhaler.

The parent will need to complete the Medication Authorization form with a parent signature and return to the school nurse.

Responsible student’s may self-carry an inhaler as well.  Parent will need to complete a Request for Student Self-Administration of Inhaled Asthma Medication form annually and return to the school nurse.

Medical Authorization Form

Student Self-Administration Form

If your child is diabetic, he/she will need to bring in Glucagon to be used in case of an Emergency at school.  

We will need to have a Medication Administration form completed to give us permission to administer it at school in case your child is found unresponsive or has a seizure which is an indication of extremely low blood sugar.  If it is administered, we will call 911 and then when able, the School Nurse and Parent(s) will be notified

The Medication Administration form will need to be completed annually and the Glucagon must not be expired.

Other Medications

Form(s)

Medication of any kind (including Acetaminophen, ibuprofen or other pain relievers) may not be administered to a student without written parental consent. 

Students are not permitted to keep any type of medication in their desks or in their possession during school hours or at any school function.

All medication will be stored in the school nurse’s office in a locked cabinet. Prescription medication will be dispensed upon receipt of the labeled bottle that includes: the students name, physician’s name, drug name and administration instructions.

No expired medications will be accepted. 

LCSD#2 accepts no responsibility for adverse effects of any medication dispensed. 

The parent must sign the Medication Authorization Form and return to the school nurse.

Special Dietary Needs

If a student requires a special diet or has specific allergies to food(s), parents need to let us know.  We will notify your child’s teacher and those staff members working with your child at school. There is also a form that needs to be completed for the kitchen, to ensure that the appropriate foods are served at lunchtime.  

There is a form that needs to be completed and turned in to us at school called Medical Statement to Request Special Meals, Accommodations, and Milk Substitutes in School Nutrition Programs to accommodate special diet needs or food allergies at school. Please complete the Special Dietary Needs form and return it to the school nurse. 

Symptoms include:
Frequent loose or watery stools, abdominal cramps and tenderness, fever, generally not feeling well and may have blood in the stool.

How is it spread?
Contact with feces (stool) of children who are infected.  Water or food contaminated by human or animal feces (eg, swimming pools).  Contact with raw or undercooked meat. Contact with animals in the child’s environment or during trips to sites with animals (eg, farms, pet stores, petting zoos).

How do you control it?
Good hand washing and proper surface disinfection.  Ensure proper cooking and storage of food.

Will my child be excluded from school?
YES, if the stool is not contained to the diaper for diapered student or diarrhea is causing “accidents” for toilet trained students.  Stool frequency exceeds 2 stools above normal during the time the child is at school. If there is blood, mucous or black stools.  

Symptoms include::
A temperature above 100.4 degrees fahrenheit  from any site is considered meaningfully elevated above normal. 

How is it spread?
Children with fever are usually less active and generally “don’t feel well”.  Children with fever are not always contagious. Non contagious causes of fever include urinary tract infections, ear infections and causes unrelated to infections.  The most common cause of fever is viral upper respiratory infections (the common cold). Although the common cold is contagious, it is not particularly harmful to others.

How do you control it?
Children with fever need to drink more to avoid dehydration.  Treating the fever is not necessary unless the child is uncomfortable.  Evidence suggests fever helps the body fight infection. Acetaminophen or ibuprofen may be considered for the child’s comfort if he/she feels ill.  Some young children younger than 6 years may have a brief seizure called a febrile seizure. They are frightening to witness but do not result in any kind of brain damage.

Will my child be excluded from school?
Only if fever is associated with behavior change or other signs of illness, the child is unable to participate in school, or the child has not completed the recommended vaccine series (until it is clear the child does not have a vaccine-preventable illness).  

Flu

Symptoms include:
Sudden onset of fever, headache, chills, muscle aches and pains, nasal congestion, cough, low energy, abdominal pain, nausea/vomiting.  Other symptoms may include: mild pinkeye, croup, bronchitis or pneumonia.

How is it spread?
Respiratory droplets from talking, coughing and sneezing.  Contact with respiratory secretions from or objects contaminated by children who carry the influenza virus.

How do you control it?
Annual immunization for all people 6 months and older.  Good hand washing, cover their nose and mouth when coughing or sneezing.  Antiviral medications that treat influenza infection are most helpful if given in the first 48 hours of the illness.

Will my child be excluded from school?
YES, until the fever has been absent for 24 hours after any fever-reducing medications have been given, the child is able to participate and staff members determine they can care for the child without compromising their ability to care for the health and safety of the other children in the group.

If your child gets injured and comes to school with a splint or cast, please provide a doctor’s note that outlines what kinds of activities are allowed at school:

• Is participation in PE and/or recess allowed?

• Are there particular activities that are not allowed (such as use of right arm if right arm is in cast)?

• How long will activities need to be restricted?

• Are crutches/wheelchair needed?  If so, parent needs to provide.

• Is your child able to walk?

• Can your child participate in all activities at school?

Symptoms include:
Children vomiting from an infection often have diarrhea and, sometimes, fever.  Prolonged or severe vomiting can result in children becoming dehydrated (dry mouth, no tears, no urine).

How is it spread?
Direct contact with vomit can result in the spread of certain infections.

How do you control it?
Use good hand-hygiene techniques.  Clean and disinfect surfaces that have been contaminated with body fluids.

Will my child be excluded from school?
YES, vomiting 2 times or more in 24 hours and vomiting not from a known condition for which the child has a medical condition.  Your child will be readmitted when the vomiting has resolved.

These are small insects that feed on human blood by biting through the skin.They travel 10 to 15 feet to feed and go without feeding for up to 6 months. Bites usually occur on exposed skin, such as the face, neck, arms and hands.  These are itchy bites, which often occur in a row, on areas of skin that are exposed during the night. 

Symptoms include:
A red dot where the bite occurred in the middle of a raised red bump. Look for specks of blood, rusty spots from crushed bugs, or dung spots the size of a pen point on bedsheets and mattresses or seams of bedding. 

How is it spread?
Bedbugs are not spread from one person to another. They bite humans at night and hide in cracks or crevices during the day.  They also hide in belongings and clothing that allow them to spread.

How do you control it?
Avoid overreacting. Nap mats and mattresses can be cleaned.  Clean up bedbug debris with detergent and water. Extermination involves vacuuming and using less toxic “bio-based” products.  Launder bedding and clothing in hot water and a hot drying cycle. Use of encasement covers around mattress, box springs and pillows to trap bedbugs is advised and can be found on the internet.

Will my child be excluded from school?
NO, unlike lice or scabies, bedbugs infest the living area and require extermination.  During the daytime, bedbugs do not stay on the affected person.

A concussion is an injury to the brain that results in temporary loss of normal brain function.  It usually is caused by a blow to the head. Often, there are no external signs of head injury. In many cases, a person with a concussion never loses consciousness.

People with concussions often cannot remember what happened immediately before or after the injury and may act confused.  A concussion can affect memory, learning, judgment, reflexes, speech, balance, and muscle coordination. Even mild concussion should not be taken lightly.  In most cases, a single concussion should not cause permanent damage. More than one concussion is even more concerning because there is an increased risk of permanent damage.

If a concussion is suspected, parent(s) will be called and a medical evaluation will be required before returning to school.  The doctor will need to send instructions for the concussion protocol to be followed at school that will outline any PE/sports/physical activity restrictions and schoolwork accommodations.

If a concussion is suspected while participating in a sports activity, the coach will call parent(s) and require a medical evaluation before returning to the sport.  The concussion protocol (as above) will still be required for return to school.

Head Lice are very small tan-colored insects that live on blood they draw from the scalp.  They crawl and do not hop and deposit tiny, gray/white eggs, known as nits, on a hair shaft.  As adult insects, they cannot live more than 48 hours away from the scalp. Head Lice do not carry disease. The cycle starts with an adult lice laying eggs, nits, that hatch in 7 to 12 days.  Lice can reproduce about 2 weeks after hatching.

Symptoms include:
Itching of the skin/scalp with visible nits behind the ears and near the nape of the neck.  Secondary infections may occur due to scratching of the scalp causing open sores and crusting.  

How is it spread?
Primarily through direct head-to-head contact with infected hair.  Shared objects (hats, headgear, and other objects) that contact the head are a possible but uncommon cause of spread of lice because the insects prefer to stay close to the blood supply on the scalp. Head Lice infestations occur in all socioeconomic groups and do not represent poor hygiene. 

How do you control it?
By using medicated shampoo that kills both lice and nits such as “RID” ( ask your pharmacy for recommendations).  Most medicated shampoos require 2 treatments approximately 7 days apart. All household member and close contacts should be checked.  All infected persons and bedmates should be treated at the same time. Please notify the school so classmates can be checked as well.  Herbal remedies or use of household products, such as mayonnaise, have not been shown to be effective.  

Nit (head lice egg) combs, often found in lice medicine packages, should be used to comb nits and lice from the hair shaft.  After each treatment, checking the hair and combing with a nit comb to remove nits every 2-3 days may decrease the chance of self-reinfestation.  Continue to check every 2-3 weeks to be sure all lice and nits are gone.

The following supplemental measures may help decrease the spread of Head Lice: 

• Launder articles that are in contact with the infested individual on the hot cycle in the washer and dryer or put in a plastic bag for 2 weeks.
• Floors, carpets, mattresses, and furniture can be vacuumed.
• Chemical treat ment of the environment is not necessary. 
• Discourage activity that causes head to head contact. 

Will my child be excluded from school?
At the end of the day, the child will need to start treatment before returning to school.   Most treatments need to be repeated in 7 to 10 days after the first treatment.

Impetigo is a skin infection caused by staph or strep bacteria.

Symptoms include:
Small red pimples or fluid-filled blisters with crusted yellow scabs, most often found on the face, but can also be found anywhere on the body.

How is it spread?
It is spread by direct contact with the sores of the infected person or from contaminated surfaces. This means that the parent needs to take the student to the doctor to get a prescription for the antibiotic treatment. 

How do you control it?
Cover lesions, after which infected individuals should be treated with an appropriate antibiotic regimen at the end of the day.  Good hand hygiene and clip fingernails to reduce further injury of tissue by scratching and then subsequent spread through contaminated fingernails.  Clean and sanitize surfaces. 

Will my child be excluded from school?
If impetigo is suspected at school, we will cover it if possible, the student can remain at school for the rest of the day, and we will call parent to inform of the need to take student to doctor for treatment.  If the antibiotic is started before the next day, the student may return to school. Students may be excluded until treatment has started. This is a common concern with those participating in wrestling and use of the wrestling mats.  Wrestling coaches won’t allow a student with impetigo to return to practices/meets until appropriate treatment has begun.

Staphylococcus aureus are bacteria that primarily cause skin infections.

Symptoms include:
Red bumps that progress to pus-filled boils or abscesses.  Boils may drain pus. Your child may feel tired, have a fever and/or pain and swelling of joints or bones.

How is it spread?
Close skin-to-skin contact and contact with toys or surfaces that have been contaminated with the bacteria.

How do you control it?
Use good hand hygiene, cover open or draining sores and parents/caregivers/staff that have skin conditions that may cause skin breaks (eczema, cuts, etc.) should wear gloves when caring for your child that involves touching of the skin.  Avoid sharing personal items.

Will my child be excluded from school?
NO, unless the lesions cannot be covered.  If suspected, Wrestler will need a doctor’s note before returning to practice/meets. 

If your child has an operation/surgery, please provide a doctor’s note that outlines what kinds of activities are allowed at school:

• Is participation in PE and/or recess allowed?

• How long will activities need to be restricted?

• Does your child require pain medication while at school?

• When can your child resume normal activities at school?

Symptoms include:
Red or pink, itchy, painful eye(s) that is sensitive to light.  More than a tiny amount of green or yellow discharge in which the eye(s) may be crusted shut in the morning.

How is it spread?
Hands become contaminated by direct contact with the discharge from the infected eye(s) or by touching other surfaces that have been contaminated.

How do you control it?
Consult your health care provider for diagnosis and possible treatment.  Careful hand hygiene before and after touching the eyes, nose and mouth. Clean/sanitize objects that are commonly touched by hands or faces, such as tables, doorknobs,cuddle blankets and toys.

Will my child be excluded from school?
NO, the School Nurse will notify parents but your child does not need to leave school.  Health care providers may vary on whether to treat this condition with antibiotics. 

Ringworm is a fungal infection of the skin. 

Symptoms include:
One or more circular-type patches of red, dry skin of the body or feet.  The scalp may have patchy circular areas of dandruff or hair loss. 

How is it spread?
It is contagious and spread by direct contact with the fungus from a person, animal (dogs/cats), or contaminated surface.

How do you control it?
Treatment is use of an oral or topical anti-fungal medication that can be obtained over-the-counter or with a doctor’s prescription.  

Will my child be excluded from school?
At school the ring worm needs to be covered to prevent spreading to others.  Athletes in sports with person-to-person contact can participate as long as treatment has been started and the affected area can be covered.  If the area cannot be covered, the student cannot participate until he/she has received 72 hours of treatment

Symptoms include:
Sore Throat, fever, stomachache, headache, swollen lymph nodes in the neck and decreased appetite.  The School Nurse can check for red tissue with white patches on the sides of the throat, at back of tongue and at the back wall of the throat upon request.  A throat culture or rapid strep test is the only way to be certain of the diagnosis of strep throat.

How is it spread?
Respiratory droplets from a child coughing, talking or sneezing.  Contact with respiratory secretions from or objects contaminated by children who carry strep bacteria.  Close contact helps the spread of the infection.

How do you control it?
Have a health care provider/ school nurse evaluate individuals with a severe sore throat with a rash and those who have only a severe sore throat that lasts longer than 24 hours.  If cough/runny nose are major symptoms, strep is unlikely. Use good hand-hygiene techniques at all times.

Will my child be excluded from school?
YES, your child can return to school after 12 hours of antibiotic treatment.