Health Office Protocols

1. Parents/Guardians will notify the school of their child's allergy when they register on Infinite Campus or when an allergy is diagnosed. 

2. For medication (prescription or over the county) to be on school campuses, the Medication Authorization Form - Anaphylaxis must be completed and signed by the Health Care Provider and parent/guardian. 

3. It is recommended that parents/guardians provide at least two sets of prescribed emergency medications to the school. If a child is cleared to carry and self-administer, it is recommended that one back up set should be provided to the school.

4. All medications must be provided in the original container. Prescribed medications must have a current prescription label. All medications must have a visible expiration date, which should be current for the entire school year. 

5. Parents/Guardians may provide their teacher extra snacks safe for their student to be used for special occasions. They may also provide extra snacks safe for their child to be kept with disaster supplies. 

6. Parents/Guardians should work with the teacher regarding any activities involving food before the activity is scheduled. Teachers or persons responsible for the activity are encouraged to provide notice to anyone who may contribute food to the activity to refrain from providing foods containing nut products or other known allergens from the classroom. 

7. It's recommended that parents/guardians should educate their student in the self-management of their food allergy including:

   1. Safe and unsafe foods: bring food from home or check online food service food options.

   2. Not to accept food unless it is from the teacher/designated person.

   3. Strategies for avoiding exposure to unsafe foods.

   4. Student may bring a disposable paper placemat on which to place their food.

   5. Symptoms of an allergic reaction. 

   6. How and wen to tell an adult they may be having an allergy related problem.

8. Students should not be excluded from school activities solely based on their allergy.  

1. Parents/Guardians will notify the school or Health Services Department when their student is diagnosed with Type 1 Diabetes. 

2. The Health Services team will work with the parents/guardians to create a management plan for the school setting. 

3. Parents/Guardians will provide an updated Diabetes Medical Management Plan each school year and with any changes during the school year. 

4. For students who are not deemed independent in their diabetes management, a trained staff member or licensed nurse will support the student at designated times and as needed.  

5. If student is independent, student is still encouraged to check in with the health office when experiencing hypoglycemia or hyperglycemia.

6. All staff members working with a student with Diabetes will be trained on signs and symptoms of hypoglycemia and hyperglycemia. 

7. District Nurse will work with the school to identify staff members willing to be trained in low blood glucose treatment and emergency glucagon administration.

8. Extra snacks or supplies provided by the parent/guardian may be stored with the disaster supplies when requested. 

9. Students should not be excluded from school activities solely based on their health condition. 

10. Parents/Guardians are recommended to provide enough supplies for daily use and extra in case of a disaster. Please refer to the Diabetes Supplies for School document. 

1. Parents/Guardians will notify the school of their child's seizure condition when they register on Infinite Campus or when the condition is diagnosed. 

2. For medication to be on school campuses, the Medication Authorization Form - Anti-Seizure must be completed and signed by the Health Care Provider and a parent/guardian. 

3. It is recommended that parent/guardian provide at least two sets of prescribed emergency medication to the school if possible. 

4. The District Nurse will work with the school to identify staff members willing to be trained in emergency anti-seizure medication administration. 

5. Students should not be excluded from school activities solely based on their seizure condition. 

1. All student medications kept in the health office and the Emergency Care Plan are sent with the teachers on all field trips. The medication will be kept with a PAUSD staff member, unless the student is cleared to carry and self-administer, a parent/guardian is attending, or the parent/guardian has identified a designee and filled out the required form.
   • Designee: a non-PAUSD employee for whom the student's parent/guardian has provided the school with written authorization to respond to an emergency. The designee must accept in writing.
2. For students with emergency medications, unless cleared to carry and self-administer, a trained staff/parent/guardian/designee must accompany the student at all times during the field trip, including riding to and from the field trip location. 
3. On overnight trips, parent/guardian is encouraged to participate or to provide a designated person to go with the child. If this is not possible, the school will schedule a meeting with parents, teacher and a District Nurse for the purpose of developing an alternative plan.

Injuries to the head can range from a minor bump, blow, or jolt to the head to a serious brain injury. A concussion (also known as a mild traumatic brain injury) changes the way the brain normally works. Symptoms of a serious brain injury can occur immediately or their onset can be delayed for several hours. Following an injury to the head, students should be observed closely for 48 hours after the injury. 

Students are observed for a head injury when:

• Student sustains a head injury on the campus or during PE. Student is sent to the health office, if able, with a buddy.
• The school staff is notified by the parent or student self-reports an instance of a head injury. 
• School sponsored after-school activities staff reports an incident during their after school hour activities to the health office staff. 

Health Office personnel, shall follow the head injury procedures below, unless a 911 call has been deemed necessary. 

• School staff will provide appropriate first aid and monitor the student for at least 20 minutes. 
• Staff will complete the Report of Head Injury Form for each head injury. A copy will be given to the parent/guardian.
• Staff will contact parent/guardian to notify them of the head injury. 
• Students who are allowed to remain at school will be cautioned about over-activity and advised to return for worsening symptoms. 

After-School Sports Head Injuries and Returning to Sports/Play

Athletics will communicate to the health office the names of students removed from play or sent home with a head injury.

PAUSD AR 6145.2 - Athletic Competition provides specifics regarding injuries sustained during athletic activity. 

California Education Code 49414 requires school districts to provide emergency epinephrine for students suffering, or reasonably believed to be suffering, from anaphylaxis.  Anaphylaxis is a rapid, severe allergic response triggered by foods, insect stings, medications, latex materials, exercise, or in rare cases by unknown causes.  This is a life-threatening allergic condition, requiring immediate treatment.  Administering epinephrine to students during a medical emergency may help ensure the student’s health and safety at school.  PAUSD has adopted a policy for standing orders to provide emergency medical care for anaphylaxis.

This emergency treatment is considered to be first aid and part of the requirement to give diligent care to the health of students (EC 49400 and 49407).  All students suffering, or reasonably believed to be suffering, from a severe life-threatening allergic reaction will be administered emergency epinephrine in the form of an epinephrine auto-injector by a licensed nurse or by a trained unlicensed school staff.  If epinephrine is administered under the guidelines of EC 49414, staff members are required to activate Emergency Medical Services (EMS) 9-1-1.  In the event that a nurse or trained unlicensed school staff is not immediately available, staff will call 9-1-1.

If a student has a health condition that contraindicates the use of epinephrine, parent/guardian must notify the school in writing.

In PAUSD, each elementary school has at least 1 junior EpiPen and 1 adult EpiPen. Each secondary school has at least 1 adult EpiPen. The high school athletics offices have also been given at least 1 adult EpiPen.

California Education Code 49414.3 allows school districts to provide emergency naloxone for students suffering, or reasonably believed to be suffering, from opioid overdose.  An individual suffering from an overdose may be unresponsive, have slow, shallow or no breathing, cold or clammy skin, pinpoint pupils, be difficult to wake, have heavy gurgling or snoring sounds, or blue or gray skin, lips, or nails.  This is a life-threatening situation, requiring immediate treatment.  Administering emergency naloxone to students during a medical emergency may help ensure the student’s health and safety at school.  PAUSD has adopted a policy for standing orders to provide emergency medical care for opioid overdose.

This emergency treatment is considered to be first aid and part of the requirement to give diligent care to the health of students (EC 49400 and 49407).  All students suffering, or reasonably believed to be suffering, from a severe life-threatening overdose will be administered emergency naloxone in the form of a nasal spray by a licensed nurse or by a trained unlicensed school staff.  If naloxone is administered under the guidelines of EC 49414, staff members are required to activate Emergency Medical Services (EMS) 9-1-1.  In the event that a nurse or trained unlicensed school staff is not immediately available, staff will call 9-1-1.

In PAUSD, emergency naloxone is available in each Health Office, each automated external defibrillator (AED) box, and in the high school athletics offices.