From the desk of Nurse Donna ....

November is ending on a healthier note...

noreply@blogger.com (Donna) — Fri, 20 Nov 2009 12:19:00 +0000

It is extremely nice to see the closing of November ending with a huge decline in absentee's. At this time I am happy to state our absenteeism is 1-2% in the BREC which is a far cry from what we began the month with. This should make us all feel a sigh of relief. Clearly the students are doing what we asked of them in regards to hand washing, coughing into their arm and utilizing the paper cups as opposed to drinking straight from the fountains. From what I have heard Black River has had far less absenteeism than many of the surrounding school districts, so parents you should all be proud of the proactive measures this school has taken since the beginning of the school year.

With this said; I want you to be aware that we are still seeing a few cases of Influenza A, head lice and most recently a few cases of scabies (rash caused by a mite). Please pay attention to your children's complaints regardless of what they might be. One never knows when a complaint may just be an early warning sign of what's to come.

For now there is not much else to report health wise, so I will close wishing everyone a very happy Thanksgiving and a healthy Christmas Season to all.

Nurse Donna

November-Absenteeism on the Rise

noreply@blogger.com (Donna) — Mon, 02 Nov 2009 15:25:00 +0000

As the new month begins I note an increase in student absenteeism. Especially on the Elementary School side of the BREC. Having said this, I will continue to preach the need for parents and teachers to work together to promote and monitor for excellent hand washing techniques and proper respiratory etiquette with ALL children.

We are still seeing the occasional case of Chicken Pox but nothing I am concerned about (less than 1/2 dozen cases in total since the beginning of the school year). The Flu viruses and Strep Throat seem most prevalent at this time. Having said this; Do note that our rate of absenteeism on its worse day has NOT been any where near high enough to warrant parents wondering why we have not closed the schools. Folks, the numbers just are not there! Yes, we are seeing more illnesses than norm for this time of year, but then again so are all the other school districts near and far.

My belief is if we continue to work together promoting good hygiene habits here at Black River School District, we will see far less illnesses over the winter months ahead. Not allowing drinking from the water fountains, hand sanitizers in all the classrooms, teachers/students wiping down desks regularly are ALL excellent preventative measures be taken daily here at Black River.

Wishing everyone a safe and healthy holiday season....

Nurse Donna

New month...how about an update?

noreply@blogger.com (Donna) — Thu, 01 Oct 2009 11:40:00 +0000

In an effort to keep parents current on what we are seeing health-wise in school I will share monthly the variety of illness's coming through the clinic.

As usual as it is we have had several students with Chicken Pox during the month of September. We have also seen strep throat (Scarlet fever if rash presents) on the elementary side as well. Some have had a stomach virus and yes a couple cases of influenza A for which the children were treated per H1N1 protocol by their physicians since they are only testing for H1N1 if the person become hospitalized.

It is important that we all understand and educate ourselves in regards to the huge media hype on the H1N1 influenza virus. Such information is readily available through your county health department website and/or by googling the CDC web page. H1N1 is being treated the same as the yearly influenza virus and the best defense is still proper eating, good hand washing techniques and last respiratory etiquette. Teaching your children to cough into the arm rather than their hands will prevent that hand to hand contact of any virus.

Remember children need to get plenty of rest, set a specific bedtime and adhere to it. Students need at least 8 hrs of sleep per night to function at their best. And parents certainly need a bit of adult time after each workday as well.

With the cold weather creeping in, please make sure your child is dressed appropriately for the weather. Coats, hats, gloves, boots, etc. Weather and temperatures permitting our students do go outside for a bit of fresh air and the opportunity to play and release a bit of bottled up energy. They need to be dressed for such!

Well, this is it for now. Know that Black River School District continues to do its part in preventative measures towards keeping all your children healthy and safe. Together we can make this district one of the healthiest in this area. But it does take a joint effort.

To your families health,

Nurse Donna

Welcome back...FYI- How We Are Preparing for Flu Season

noreply@blogger.com (Donna) — Wed, 02 Sep 2009 13:16:00 +0000

Welcome back. I hope everyone enjoyed their summer break. I know I did!

Keeping you current.

With the abundance of information circulating in regards to the upcoming flu season and the continued spread of the "Swine" or H1N1 flu virus I thought I should share with you the
steps that we are taking at Black River Local School District this year.

All students will be sent home if they present to the clinic with a fever of 99 degrees or higher. They may not return till they have been fever-free for 24 hrs without the assistance of fever reducing medication.

Though to some this may sound a bit harsh, it is our responsibility to recognize and remove ill students from the school setting. It is our main defense in providing the highest medical protection to our student & staff population.

Tips we are utilizing to educate the students at school:

Proper hand hygiene (frequent hand washing vigorously for 15-20 seconds with soap) As we tell the children, singing Happy Birthday to yourself twice is the preferred time we are striving for.

Respiratory Etiquette "coughing/sneezing into your forearm/elbow area.

Avoid letting your hands/fingers touch your mouth and nose area. This will decrease the spread of germs one may have touched throughout the day.

Utilizing disposable paper cups at water fountains. We have placed cup dispensers at all Elementary drinking fountains to deter mouth contact on the fountain nozzles.

Teachers are wiping down desks at the end of the class day with disinfectants. This is above and beyond the nightly custodial cleaning.

Hand sanitizer Dispensers Placed in all classrooms within reach for students to use throughout the school day.

So as you can see, we ARE taking as many precautionary measures as feasibly possible within the school buildings and are asking for your support in keeping your ill children home when symptoms present. All children need to remain home until they have been fever free for 24 hours without fever reducing medications.

Should you have any questions, please feel free to call my office at 419-736-2161, ext. 403.

Nurse Donna

Hope you are all enjoying Summer Break....

noreply@blogger.com (Donna) — Wed, 08 Jul 2009 21:56:00 +0000

Just a quick note to say I am thinking of all of you and hoping your Summer Break is going well. I am keeping busy this summer as a Camp Nurse for the Society of the Handicapped at Camp Paradise in Seville. What a great camp this is!

I have met some wonderful new friends and hope you are doing the same. See you in August.

Nurse Donna

Summer Safety

noreply@blogger.com (Donna) — Tue, 19 May 2009 11:27:00 +0000

For many Americans, summer means fun in the sun. The kids are out of school, adults are on vacation and it's time for outdoor activities like riding bikes and hosting barbecues. However, the U.S. Consumer Product Safety Commission (CPSC) warns that summer also is the time of year consumers are most likely to be injured.

So that everyone can enjoy summer activities lets keep safety in mind by brushing up on ways to avoid injury to our children.

One of the best ways to stay safe this summer is to wear a helmet and other safety gear when biking, skating and skateboarding, and when riding scooters, all-terrain vehicles, and horses. Studies on bicycle helmets have shown they can reduce the risk of head injury by as much as 85 percent.

Use layers of protection to prevent a swimming pool tragedy. This includes placing barriers completely around your pool to prevent access, using door and pool alarms, closely supervising your child and being prepared in case of an emergency.

Never bring charcoal grills indoors. Burning charcoal produces deadly carbon monoxide

When cooking outdoors with a gas grill, check the air tubes that lead into the burner for any blockage from insects, spiders, or food grease. Check grill hoses for cracking, brittleness, holes, and leaks. Make sure there are no sharp bends in the hose or tubing. If you ever detect a leak, immediately turn off the gas at the tank and don't attempt to light the grill until the leak is fixed. Newer grills and propane tanks have improved safety devices to prevent gas leaks.

Make sure your home playground is safe. Falls cause 60 percent of playground injuries, so having a safe surface is critical. Concrete, asphalt or packed dirt surfaces are too hard. Use at least 9 inches of wood chips or mulch.

Make sure your home playground is safe. Falls cause 60 percent of playground injuries, so having a safe surface is critical. Concrete, asphalt or packed dirt surfaces are too hard. Use at least 9 inches of wood chips or mulch.

Use softer-than standard baseballs, safety-release bases and batting helmets with face guards to reduce baseball-related injuries to children.

If you are a soccer mom or dad, beware that movable soccer goals can fall over and kill children. Make sure the goal is anchored securely at all times and never allow anyone to climb on the net or goal framework or hang from the cross bar. Remove nets when the goals are not in use.

To prevent serious injuries while using a trampoline, allow only one person on at a time, and do not allow somersaults. Use a shock-absorbing pad that completely covers the springs and place the trampoline away from structures and other play areas. Kids under 6-years-old should not use full-size trampolines.

Don't allow a game of hide-n-seek to become deadly. There have been many reports of numerous suffocation deaths involving children who crawled inside old cedar chests, latch-type freezers and refrigerators, iceboxes in campers, clothes dryers and picnic coolers. Childproof old appliances, warn children not to play inside them.

If summer plans include camping and you want heat inside your tent or camper, use one of the new portable heaters that are equipped with an oxygen depletion sensor (ODS). If oxygen levels start to fall inside your tent or camper, the ODS automatically shuts down the heater before it can produce deadly levels of carbon monoxide (CO). Do not attempt to use alternative sources of heat or power to warm a tent or camper. Traditional camping heaters, charcoal grills, camping lanterns, and gas generators also can cause CO poisoning.

Install window guards to prevent children from falling out of open windows. Guards should be installed in children's bedrooms, parents' bedrooms, and other rooms where young children spend time. Or, install window stops that permit windows to open no more than 4 inches. Whenever possible, open windows from the top - not the bottom. Also, keep furniture away from windows to discourage children from climbing near windows.

Summer also means yard work. When mowing, keep small children out of the yard, and turn the mower off if children enter the area. If the lawn slopes, mow across the slope with the walk-behind rotary mower, never up and down. With a riding mower, drive up and down the slope, not across it. Never carry children on a riding mower.

Have a safe and healthy summer!!!

Nurse Donna

Swine Flu? Do you know what it is? If not, read on.

noreply@blogger.com (Donna) — Wed, 29 Apr 2009 14:10:00 +0000

For those who like to follow my web page, I wish to clarify first and foremost that there have been NO CASES of Swine Flu at Black River Local School District as of this posting date. As of this posting Ohio only has one (1) confirmed case of the Swine Flu.

If you would like additional information please visit the CDC's Swine Flu website by clicking on the following link: http://www.cdc.gov/swineflu/.

Remember your best defense is proper "hand washing" which is the #1 preventative measure according to the CDC. Teach your children and family members to sing "happy birthday " twice in their heads while washing hands to afford the recommended amount of time needed for proper washing with soap and warm water.

If a family member develops any of the following symptoms by all means do seek medical attention to assure that you do not have the influenza virus. The symptoms are as follows:

Fever
Cough
Sore throat
Body aches
Headache
Chills
Fatigue

Note that some people have reported diarrhea and vomiting associated with swine flu.

Remember that the Swine flu is thought to be spread the same as all other flu viruses which are spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose. (Hence, why hand washing is the #1 preventative measure).

Lastly, remember if in doubt regarding sending your child to school use your parental instinct; if they are not feeling well keep them home. Do not risk others to exposure at this time. Every one's cooperation is essential as we all do our part in and out of the school setting to assist in keeping this virus at bay for our families, friends and neighboring communities.

Nurse Donna

Spring Health & Safety Tips

noreply@blogger.com (Donna) — Tue, 21 Apr 2009 12:14:00 +0000

Spring time is now here. For most children, this means more outdoor activities (swimming, camping, bike riding, etc.). For all parents, this means being extra vigilant to keep your child safe and healthy.

I found an article that discusses some tips to keep your child safe and healthy this spring, including:

Avoiding and Treating Spring Allergies, which can cause your child to have a lot of sneezing, plus a clear runny or stuffy nose, itchy and watery eyes and a cough, especially when he has spent a lot of time outside.

Water Safety to protect your children when they are swimming or boating. Most importantly, always supervise your children around the water.

Sun Safety to prevent damage from too much exposure to the sun. Regular use of sunscreen in children can lower their risk of skin cancer by almost 78%. But remember that sunscreen only works if you use it correctly and it does not substitute for limiting too much sun exposure. Many parents make the mistake of using sunscreen and then allowing unlimited sun exposure.

Using Insect Repellents Safely to prevent bites from mosquitoes, etc. which can make your child miserable.

Help your child enjoy Spring by following the basic health and safety tips that are described in the rest of this article.

Spring Time Seasonal Allergies and Children

Allergic rhinitis, or hay fever, is a common problem in infants and children. The most common symptoms include a stuffy or runny nose with clear drainage, sneezing, itchy eyes and nose, sore throat, throat clearing and a cough that may be worse at night and in the morning. These symptoms usually occur during certain times of the year for people with seasonal allergies, corresponding to being exposed to outdoor allergens, such as tree pollens, grasses and weeds. Other people may have perennial allergies, with problems occurring year round from exposure to indoor allergens, such as dust mites, pets, second hand smoke and molds.

Other signs of having allergic rhinitis include the 'allergic salute,' a common habit of children which consists of rubbing their nose upward. This is usually because the nose is itchy and this practice can lead to a small crease in the skin of the lower part of the nose. Children with allergic rhinitis also commonly have 'allergic shiners,' which are dark circles under the eyes caused by nasal congestion.

Allergic rhinitis does run in certain families and are more common in children that have asthma or eczema. It is also more common in children that are exposed to second hand smoke, air pollution and pets.

Having uncontrolled allergies can put your child at risk for getting a secondary sinus infection, ear infections, and for having poor concentration at school. It can also make asthma symptoms worse.

The best treatment for allergic rhinitis is to avoid what your child is allergic to by following prevention and environmental controls. For seasonal allergies, this includes keeping windows closed in the car and at home to avoid exposure to pollens and limit outdoor activities when pollen counts are highest (early morning for tree pollen in the spring, afternoon and early evening for grasses in the summer, and midday for ragweed in the fall).

The medications that are used to control the symptoms of allergic rhinitis include decongestants, antihistamines and steroids. If symptoms are mild, you can use over the counter medications as needed. Avoid using topical decongestants (such as Afrin) for more than 3-5 days at a time or frequent use of over the counter allergy medicines with antihistamines, as they can cause drowsiness and poor performance in school.

Prescription allergy medications include the newer, non-sedating antihistamines, such as Claritin and Zyrtec (usual dose is 1-2 teaspoons or 1 pill once a day), and topical steroids, such as Nasonex, Flonase, and Nasacort Aqua (usual dose is 1-2 squirts in each nostril once each day). If your child's symptoms are well controlled, then you can decrease the dose of the nasal steroid that you are using for 1-2 weeks and then consider trying your child off of it and see how they do. Continue the antihistamine for 1-2 months or until your child's allergy season is over. Allegra is another antihistamine that is commonly used in older children because it is only available in a pill form.

To be effective, your child should be using these medications every day. They will not work as well if just used on an as needed basis. They are in general very safe with few side effects, but the nasal steroids have been associated with growth suppression when used in high doses. This is however rare, and your pediatrician will monitor your child's growth to make sure this does not happen.

If your child's symptoms are not improving with the combination of the antihistamine and steroid, then we may also use a decongestant, such as Sudafed, AH-CHEW D, or as a combination (Claritin D).

For seasonal allergies, it is best to start using these medications just before your child's season begins and then continue the medicines every day all through the season. For perennial allergies, your child may need to take these medicines year round.

Your child may also benefit from nasal irrigations using saline nose drops 1-3 times a day. This will help the sinuses drain.

If your child does not improve with these interventions, then we will consider having him see an allergy specialist for skin testing to figure out what he is allergic to and to possibly start immunotherapy injections (allergy shots).

Water Safety and your Children

To ensure that your children are safe, never leave them unsupervised around water. Here are some tips to keep your child safe around water:

Teach your child to swim, but remember that younger children shouldn't be left unsupervised around water even if they know how to swim. The AAP recommends that children under age four not be given formal swimming lessons, especially as a primary means to prevent the risk of drowning.

Always wear a safety approved life jacket when on a lake, river or ocean while boating, water skiing, jet skiing or tubing.

Warn your children about playing in canals or other fast moving water.

Do not let your child play around any water (lake, pool, ocean, etc.) without adult supervision (even if he is a good swimmer).

Don't allow running or rough play around the water.

Childproof your swimming pool with a fence around your backyard and a fence (at least 4 feet high) around the pool, with a self-closing, self-latching gate. Also consider having a phone poolside and learning CPR in case of emergencies.

Sun Safety for your Children

It is now well known that exposure to sun puts people at risk for skin cancer and premature aging and that most of that exposure comes during childhood (80% of a person's lifetime sun exposure occurs before they are 21). Regular use of sunscreen in children can lower their risk of skin cancer by almost 78%.

There are many sunscreens available for safe use in children over six months old. Pick one that offers UVA and UVB protection and that has a SPF of 15 or higher (especially if your child has light skin). Apply the sunscreen in a thick coat at least 30-45 minutes before going outside and reapply every two hours (or more often in he is swimming or perspiring heavily).

Here are some other tips to protect your child from the damaging effects of the sun.

Wear protective clothing, including a hat and long sleeve shirt and long pants. Keep in mind that most clothing only has a SPF of 5-9, so you can still get sun damage with a shirt on.

Limit exposure to the sun when it is at its strongest (10am-4pm).
Protect your child's eyes with sunglasses that protect against UVA and UVB radiation.

Use sunscreen daily, even if it is cloudy, since most of the sun's radiation penetrates clouds and can still cause sunburn.

Consider using a sunscreen with ingredients (such as zinc oxide or titanium dioxide) that physically block the sun's radiation if your child has sensitive skin.

Deet lowers the effectiveness of sunscreens, so use a higher SPF if you are using a combination product that has both a sunscreen and an insect repellant.

Insect Repellents for Children

Insects (mosquitoes, gnats, chiggers, ticks, etc.) commonly bite children and can make them miserable. There are many safe and effective insect repellents that you can use to protect your child, including those that use deet, citronella, or soybean oil. Remember to only use products that are approved for children, follow the manufacturer's instructions and wash off the insect repellents when you return indoors.

Insect repellents with deet are probably the best and most commonly used. Although it is absorbed through your child's skin, it is generally safe as long as the product has less than 10% deet. You should apply the deet product to all exposed skin, except near the eyes, mouth, open cuts or hands of small children (who may rub their eyes or put their fingers in their mouth). Deet is absorbed through the skin, so you may want to limit how much you put on younger children, wash it off as soon as possible, and apply it more to clothing than skin.

Although deet insect repellents are effective for several hours, they do wash off with water and sweat, and you may have to reapply them to be most effective (follow the product's instructions to be safe).

Other insect repellents that are generally safe in children include those made with Citronella (Avon's Skin-So-Soft) and soybean oil (Bite Blocker).

Remember that insect repellents do not protect against most stinging insects, including wasps, bees and fire ants.

To keep your children safe from insect bites, you can also:

Make sure to keep as much of her skin covered with clothing as possible, including long sleeve shirt, long pants, socks, and a hat.

Wear light colored clothing, so as not to attract bugs.

Avoid using any scented soaps or other products on your baby, since the fragrances can also attract insects.

Apply insect repellents to clothing instead of to skin so that it won't be absorbed.
Wash off insect repellents as soon as possible.

Avoid areas with insects nest.

** Remember to always follow the instructions, including age restrictions on any insect repellent you are considering using.

Nurse Donna

What does Pertussis sound like?

noreply@blogger.com (Donna) — Tue, 07 Apr 2009 15:50:00 +0000

If you have never heard "whooping cough" (Pertussis) click on the link below.

http://www.pertussis.com/hear.html

Nurse Donna

What is pertussis?

noreply@blogger.com (Donna) — Mon, 09 Mar 2009 12:30:00 +0000

What is pertussis?
Pertussis, or whooping cough, is a highly contagious respiratory infection caused by the bacteria Bordetella pertussis.

Who gets pertussis?

Pertussis can occur at any age. Although most of the reported cases occur in children under five years, the number of cases in adolescents and adults is increasing, probably due to waning of vaccine immunity. Adolescents and adults and those partially protected by the vaccine may have milder disease which is not diagnosed as pertussis. Pertussis is thought to account for up to 7% of cough illnesses per year in adults.

How is pertussis spread?

Pertussis is primarily spread by direct contact with the discharges from the nose and throat of infected individuals. Frequently, older siblings or other adult household members who may be harboring the bacteria in their nose and throat can bring the disease home and infect an infant in the household.

What are the symptoms of pertussis?

Pertussis begins as a mild upper respiratory infection. Initially, symptoms resemble those of a common cold, including sneezing, runny nose, low-grade fever and a mild cough. Within two weeks, the cough becomes more severe and is characterized by episodes of numerous rapid coughs followed by a crowing or high-pitched whoop. A thick, clear mucous may be discharged with the coughing. These episodes may recur for one to two months, and are more frequent at night. Young infants, adolescents, and adults do not have these typical coughing spells. Older people or partially immunized children may have milder symptoms.

How soon after infection do symptoms appear?

The incubation period is usually 7 to 10 days, with a range of 4 to 21 days.

When and for how long is a person able to spread pertussis?

A person can transmit pertussis from the onset of symptoms to three weeks after the onset of coughing episodes. The period of communicability can be reduced to five days after appropriate antibiotic therapy is begun.

Does past infection with pertussis make a person immune?

One attack usually confers immunity comparable to that provided by vaccine.

What are the complications associated with pertussis?

Young infants are at the greatest risk for complications. Serious complications of pertussis include pneumonia, seizures, encephalopathy (disorders of the brain), and death. Less serious complications include ear infections, loss of appetite, and dehydration.

*The child needs to complete 5 full days of antibiotic treatment before returning to school.

Thank you..

Nurse Donna

The Scoop on Step Throat

noreply@blogger.com (Donna) — Fri, 27 Feb 2009 13:11:00 +0000

"It could be strep throat." Have you ever heard a doctor or your mom say that when you're sick and you have a sore throat? I think we all have at one time or another.

Strep throat is a disease caused by tiny egg-shaped bacteria (say: bak-teer-ee-uh) called Group A streptococci (say: strep-toe-kah-kye). These bacteria cause 15% to 20% of all sore throats and are found in your throat and on your skin.

If a child has strep throat, the doctor will probably give him or her medicine called antibiotics. These kill the strep bacteria. That's good news because sometimes strep throat can get worse and cause problems with other parts of a kid's body. In rare cases, untreated strep can cause arthritis (say: arth-rye-tus) or heart problems from a disease called rheumatic (say: roo-mah-tik) fever.

Most of the time children get the medicine they need and recover from strep throat very quickly. After taking the medicine for 24 hours, you will feel a lot better and will no longer be contagious. However, it is really important to take all 10 days of the medicine to make sure you have treated the infection.

How Do I Get It?

If someone in your family or at school has strep throat, there is a chance you may get it. Strep throat is spread when healthy people come into contact with people who have it. When a person with strep throat sneezes or blows his or her nose and you are close by, or if you share the same forks, spoons, or straws, the bacteria can spread to you.

If you get strep throat, you will start to feel sick within 5 days after you have been around the person who gave it to you.

What Will the Doctor Do?

Your doctor will look into your mouth to see if your throat is red and your tonsils are swollen and covered with white or yellow spots. He or she will also look for small red spots on the roof of your mouth. Most of the time, strep will give you a sore throat, headache, stomach ache, and fever. Typically strep will not give you a runny nose or cough, and occasionally it won't give you any specific symptoms.

To prove that what you have is strep throat, your doctor may do one or two tests. First he or she can do a rapid strep test to check for strep bacteria. He or she will rub a cotton swab over the back of your throat. With this test, the doctor may be able to find out in less than 1 hour if you have strep throat.

If the first test doesn't prove anything, then your doctor may do a longer test called a throat culture. A swab from your throat will then be rubbed on a special dish and the dish will be left to sit for two nights. If you have strep throat, streptococci bacteria will usually grow in the dish within the next 1 to 2 days.

How Can I Get Better?

If you have strep throat, your doctor will give you an antibiotic (say: an-tye-bye-ah-tik), a medicine that kills bacteria. Usually the antibiotic used for strep throat is a form of penicillin (say: peh-nuh-sih-lun). You will take penicillin as a pill, a liquid, or a shot.

To make sure the bacteria go away completely and don't spread to other parts of your body, you must finish all of the medicine. Your doctor will have you take the pills or liquid for about a week.
Your mom or dad may give you acetaminophen (say: uh-see-tuh-mih-nuh-fun) to get rid of aches, pains, and fever. You'll want to have soothing drinks, like tea and warm chicken soup. It's best to avoid spicy and acidic foods, such as orange juice, because they could irritate your tender throat.

Your doctor will tell you to stay home from school until you have been taking the antibiotic for at least 24 hours. This way, you won't spread the bacteria to others.

How Can I Prevent Strep Throat?

If someone in your house has strep throat, you might get it. But you can take these steps to prevent it:

* Make sure the person with strep throat covers his or her mouth when sneezing and coughing.
* Don't handle used tissues or other germy items.
* Wash your hands regularly, especially before cooking and eating.
* Wash dishes, drinking glasses, knives, forks, and spoons in hot, soapy water.
* Keep sores and cuts clean because strep can get in there and cause problems, too.
* Strep throat is no fun, but after feeling sick for 2 or 3 days, most kids start feeling better. In other words, they feel less streppy and more peppy!

Nurse Donna

noreply@blogger.com (Donna) — Mon, 23 Feb 2009 12:14:00 +0000

Hello Parents....

Someone sent a comment over the weekend in which they shared a website with us that our younger children might find of interest. If it prevents the kids from passing thier germs from child to child it may be worth our taking a moment to check it out.

Thank you Maggie Brown.

http://www.germywormy.com/

Nurse Donna

The Importance of Establishing a Bedtime Routine

noreply@blogger.com (Donna) — Thu, 19 Feb 2009 17:34:00 +0000

With more and more activities competing for your child’s waking hours, it is not surprising to hear that most kids are sleep deprived. A recent estimated that 62 percent of kids ages 9-13 do not get enough sleep and 70 percent wish that they could get more sleep. Of those children who are sleep-deficient, most required an additional hour or more of sleep per night to meet the recommended amount for children their age.

Experts recommend that school-age children receive 9.5 to 10.5 hours of sleep each night.What can parents do to make a difference in their child’s sleep habits? There is strong evidence in support of establishing a bedtime routine. Kids who reported having a bedtime routine were:

•more likely to get the recommended amount of sleep.
•less likely to be tired at school.
•less likely to wish for “much more sleep” than they usually get.

Part of establishing a bedtime routine is setting a time for your child to go to bed. Take the lead in setting your child’s bedtime: Children who reported that their parent “decides what time to go to bed” were more likely to get an adequate amount of sleep. In fact, they averaged 45 minutes more sleep nightly than children who chose their own bedtime.“One of the most troubling things in recurrent sleep deprivation is the effect on the immune status,” explains Kate Cronan, M.D., pediatrician and medical editor for KidsHealth. “One or two nights of poor sleep is not the issue— it is those children who repeatedly receive too little sleep.

What many parents do not realize is that without proper sleep, kids’ bodies are not able to fight infection as effectively. In addition to forsaking their physical health, sleep deprivation can also affect their outlook on life. “A tired adult understands why they may have a tough day when they are sleepy— and they soldier on,” she continues. “We cannot expect the same from our children. Parents need to help their children get the proper amount of sleep. In the end, it really will make a huge difference for the whole family.”

Tips for Establishing a Bedtime Routine:

Is it too late to start a bedtime routine if my child is elementary age? Not at all. KidsHealth.org, the most-visited Web site about children’s health, shares simple tips for establishing (or re-establishing) a bedtime routine with your child.

•Bedtime: Set a bedtime for school nights and stick to it.
•Prioritize: Make sure homework (or any other task your child needs to finish for the next day) gets done first to ensure your child can get to bed on time.
•Wrap it up: Thirty minutes before bedtime, encourage your child to finish any projects or activities, and begin the bedtime routine (wash face and hands, brush teeth, etc.).
•Unwind: Include activities in the routine that will help your child slow down and relax (like taking a shower or reading a book).
•Time together: Spend a few minutes recapping the day together. Not only is this a great chance to catch up with your child, but your voice and presence will help your child to relax.
•Good night: Say good night and remind your child to stay quiet and in bed.

Nurse Donna

* For more information about KidsHealth, please visit www.KidsHealth.org.

Fifth Disease IS Common in Children

noreply@blogger.com (Donna) — Wed, 14 Jan 2009 12:50:00 +0000

Especially common in kids between the ages of 5 and 15, fifth disease typically produces a distinctive red rash on the face that makes the child appear to have a "slapped cheek." The rash then spreads to the trunk, arms, and legs. Fifth disease is actually just a viral illness that most kids recover from quickly and without complications.

Fifth disease (also called erythema infectiosum) is caused by parvovirus B19. A human virus, parvovirus B19 is not the same parvovirus that veterinarians may be concerned about in pets, especially dogs, and it cannot be passed from humans to animals or vice versa.

Studies show that although 40% to 60% of adults worldwide have laboratory evidence of a past parvovirus B19 infection, most of these adults can't remember having had symptoms of fifth disease. This leads medical experts to believe that most people with a B19 infection have either very mild symptoms or no symptoms at all.

Fifth disease occurs everywhere in the world. Outbreaks of parvovirus tend to happen in the late winter and early spring, but there may also be sporadic cases of the disease any time throughout the year.

Signs and Symptoms
Fifth disease begins with a low-grade fever, headache, and mild cold-like symptoms (a stuffy or runny nose). These symptoms pass, and the illness seems to be gone until a rash appears a few days later. The bright red rash typically begins on the face. Several days later, the rash spreads and red blotches (usually lighter in color) extend down to the trunk, arms, and legs. The rash usually spares the palms of the hands and soles of the feet. As the centers of the blotches begin to clear, the rash takes on a lacy net-like appearance. Kids younger than 10 years old are most likely to get the rash.

Older kids and adults sometimes complain that the rash itches, but most children with a rash caused by fifth disease do not look sick and no longer have fever. It may take 1 to 3 weeks for the rash to completely clear, and during that time it may seem to worsen until it finally fades away entirely.

Certain stimuli (including sunlight, heat, exercise, and stress) may reactivate the rash until it completely fades. Other symptoms that sometimes occur with fifth disease include swollen glands, red eyes, sore throat, diarrhea, and rarely, rashes that look like blisters or bruises.

In some cases, especially in adults and older teens, an attack of fifth disease may be followed by joint swelling or pain, often in the hands, wrists, knees, or ankles.

Contagiousness
A person with parvovirus infection is most contagious before the rash appears — either during the incubation period (the time between infection and the onset of symptoms) or during the time when he or she has only mild respiratory symptoms. Because the rash of fifth disease is due to an immune reaction (a defense response launched by the body against foreign substances like viruses) that occurs after the infection has passed, a child is usually not contagious once the rash appears.

Parvovirus B19 spreads easily from person to person in fluids from the nose, mouth, and throat of someone with the infection, especially through large droplets from coughs and sneezes.

In households where a child has fifth disease, another family member who hasn't previously had parvovirus B19 has about a 50% chance of also getting the infection. Children with fifth disease may attend childcare or school, since they are no longer contagious. Once infected with parvovirus B19, a person develops immunity to it and won't usually become infected again.

Parvovirus B19 infection during pregnancy may cause problems for the fetus. Some fetuses may develop severe anemia if the mother is infected while pregnant — especially if the infection occurs during the first half of the pregnancy. In some cases, this anemia is so severe that the fetus doesn't survive. Fortunately, about half of all pregnant women are immune from having had a previous infection with parvovirus. Serious problems occur in less than 5% of women who become infected during pregnancy.

Prevention
There is no vaccine for fifth disease, and no real way to prevent spreading the virus. Isolating someone with a fifth disease rash won't prevent spread of the infection because the person usually isn't contagious by that time.

Practicing good hygiene, especially frequent hand washing, is always a good idea since it can help prevent the spread of many infections.

Incubation
The incubation period (the time between infection and the onset of symptoms) for fifth disease ranges from 4 to 28 days, with the average being 16 to 17 days.

Duration
The rash of fifth disease usually lasts 1 to 3 weeks. In a few cases in older kids and adults, joint swelling and pain because of fifth disease have lasted from a few months up to a few years.

Diagnosis
Doctors can usually diagnose fifth disease by the distinctive rash on the face and body. If a child or adult has no telltale rash but has been sick for a while, a doctor may perform blood tests to see if the illness could be caused by parvovirus B19.

Treatment
Fifth disease is caused by a virus, and it cannot be treated with antibiotics used to treat bacterial infections. Although antiviral medicines do exist, there are currently none available that will treat fifth disease. In most cases, this is such a mild illness that no medicine is necessary.

Usually, kids with fifth disease feel fairly well and need little home treatment other than rest. After the fever and mild cold symptoms have passed, there may be little to treat except any discomfort from the rash itself. If your child has itching from the rash of fifth disease, ask the doctor for advice about relieving discomfort. The doctor may also recommend acetaminophen for fever or joint pain.

Complications
The majority of kids with fifth disease recover with no complications. By the time the rash appears and while it's present, they usually feel well and are back to their normal activities.

However, some children with weakened immune systems (such as those with AIDS or leukemia) or with certain blood disorders (like sickle cell anemia or hemolytic anemia) may become significantly ill when infected with parvovirus B19. Parvovirus B19 can temporarily slow down or stop the body's production of the oxygen-carrying red blood cells (RBCs), causing anemia.

When a child is healthy, this slowdown of red blood cell production usually goes unnoticed because it doesn't affect overall health. But some kids who are already anemic can become sick if their RBC production is further affected by the virus. The RBC levels may drop dangerously low, affecting the supply of oxygen to the body's tissues.

When to Call the Doctor
Call the doctor if your child develops a rash, especially if the rash is widespread over the body or accompanied by other symptoms.

If you're pregnant and develop a rash or if you've been exposed to someone with fifth disease (or to anyone with an unusual rash), call your obstetrician.

Nurse Donna

Winter Safety Tips..

noreply@blogger.com (Donna) — Mon, 05 Jan 2009 14:51:00 +0000

Sled Safely

Sledding is a great way to have fun in the snow, but being careful is essential. According to the Consumer Products Safety Commission, approximately 46,000 sledding injuries are seen in hospital emergency rooms every year. Most are children under the age of 15 with head injuries

1. Choose a hill for your children to sled on that is away from trees, rocks and other obstacles.
2. Make sure there is no street traffic or frozen water anywhere near the bottom of the sledding hill - a sled may not always come to a stop exactly where you want it to.
3. Check your child's sled to make sure it is in good condition with secure handholds and steering that works.
4. Tell your child to never ride on a sled that is being pulled by a car or snowmobile.
5. Remind your child to always sled while sitting up with his feet forward. Lying on a sled increases the chance of head injuries.
6. Have your child wear a helmet while sledding.

Prevent Winter Sports Injuries

Children should wear helmets and eye protection while skiing, snowboarding and snowmobiling.

1. Make sure your child's helmet is specifically designed for the activity he is participating in.Helmets should be well-fitted to prevent shifting or jostling of the helmet.
2. Make sure children know to stay on marked trails while skiing, snowboarding or snowmobiling.
3. Child According to recommendations from the American Pediatric Association, children under 16 years old should never operate snowmobiles. Children younger than 5 should never ride on a snowmobile, even with an adult.
4.Keep Free from Frostbite and Hypothermia
5. Children are more susceptible to frostbite and hypothermia than adults. Be aware of the symptoms and know how to treat your child if either occurs.
6. Frostbite is when soft tissue, usually in fingers or toes, freezes. There are several stages of frostbite. If severe enough, frostbite can require amputation, but most often no permanent damage will occur if skin is warmed up carefully.

Symptoms:
� Numbness
� Blisters
� Soft or frozen doughy feeling to exposed skin
� Tingling and burning of frostbitten area upon re-warming
� Aching or throbbing pain upon re-warming
� Redness, swelling upon re-warming
� Blackness

What to do: If a child complains of numbness or pain in her fingers, toes, nose, cheeks or ears while playing outdoors, check to see if her skin is blistered, hard to the touch, or glossy. If so:
� Have her come inside immediately.
� Have the child move the numb part of her body to increase blood supply.
� Do not rub the skin to warm it up, as this can cause tissue damage.
� Immerse the frozen skin in warm water. (Make sure the water is warm but never hot so the tissue isn't further damaged.
� Get medical help if the area stays numb after warming.

Hypothermia occurs when too much heat escapes from the body and body temperature drops lower than its normal 98.6 degrees F to 95 degrees F or lower. While severe hypothermia can cause internal organ damage or lead to death, it is generally not something to be concerned about unless a person is trapped outdoors or in cold water for an extended period of time without proper protection.

Symptoms:
� Shivering
� Numbness
� Muscle weakness
� Drowsiness
� Incoherence
� Lowered body temperature
� Slow pulse

What to do:

� Call 911 for help.
� Bring your child to a warm place.
� Wrap your child in blankets to retain body heat.
� Don't expose your child to any direct heat sources like hot water bottles, heating pads, radiators or fireplaces.

Why Winter Safety is Important
Winter can be a fun season for children, but hospital emergency rooms and their doctors see too many children with head injuries, broken bones and other serious winter injuries.

According to the National SAFE KIDS Campaign, in 2007 there were:
17,000 estimated injuries among children from skiing and snowboarding
24,500 estimated injuries from sledding
1,500 estimated injuries from snowmobiles and equipment
According to the U.S. Consumer Product Safety Commission:
Each year there are approximately 5,740 emergency room visits due to snow thrower-related injuries. Don't let your child be a statistic. Avoid visits to your local emergency room by helping your child stay safe while having fun during.

Please keep in mind that the text provided is for informational purposes only and is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health professional before starting any new treatment or making any changes to existing treatment.

Nurse Donna

Congratulations Nathaniel.

noreply@blogger.com (Donna) — Tue, 25 Nov 2008 18:52:00 +0000

Nathaniel Brantley now sees a much more colorful world, thanks to groundbreaking eye surgery that literally changed the 7-year-old's sight from black and white to color. (See story by clicking on the link below)
http://abclocal.go.com/kgo/story?section=news/health&id=6523160

Nurse Donna

Preparing Your Children for Winter Safety

noreply@blogger.com (Donna) — Tue, 11 Nov 2008 12:23:00 +0000

Types of Winter Safety Tips for Children
Not every type of winter hazard is applicable to every child, but understanding the basic risks and how to minimize them can help parents protect their children from the ravages of winter.

Playing Outside
The cold temperatures and biting winds are the most obvious hazards when children play in the snow. Children who are not prepared for winter climates can suffer frostbite, hypothermia and severe chills that can lead to illness, poor judgment and even permanent injury. To avoid the dangers of cold weather:
Dress in multiple layers to play outside, including extra layers for legs, feet and hands.
Always wear hats and gloves when playing outdoors in cold weather; the biggest proportions of body heat are lost through the head and hands.
Limit the amount of time spent playing outdoors to safe intervals, and bring children inside periodically to warm up.
Remove all wet clothing immediately and change to dry clothes if going back outdoors.
Wear sunscreen on all exposed skin to guard against burns from bright sunlight and snow glare.
Do not permit children to play outdoors in poor weather such as snowstorms, extreme cold or high winds.
Wear brightly colored outer clothing that is easily seen from a distance.
Do not dress children in winter wear with drawstrings – they can cut off circulation and make frostbite a greater threat, and loose drawstrings may present a strangulation hazard.
Teach children to avoid playing near snowplow areas.
Do not permit children to dig snow tunnels or forts that may collapse and bury them.
Avoid snowball fights that can lead to injuries from dangerous projectiles.
Keep roofs, gutters and awnings free from snow and icicle buildup that could collapse and injure a child. Similarly, do not permit children to pull icicles from the roof.
Teach children never to touch or lick exposed metal (fences, flagpoles, etc.) in winter.
Do not allow children to eat snow. It may contain pollutants, dirt, fecal matter or other contaminants, and the cold snow can chill a young child’s body to dangerous levels.
Regularly de-ice or sand sidewalks, driveways, patios and other areas where children may play.

Winter Sports
Winter sports can be a great way for children to stay active and enjoy colder temperatures, but each sport presents it own unique hazards. These winter safety tips for children can help them enjoy sports safely and comfortably.
Always use proper safety equipment and gear, including sports goggles and helmets, while playing winter sports.
Engage in safe sports behavior such as following the rules of the game and eliminating horseplay that can lead to accidents and injuries.
Enroll children in lessons from a qualified professional for advanced winter sports such as figure skating, skiing and snowboarding to ensure they learn safe techniques.
Only play winter sports in safe, approved locations rather than using seemingly frozen ponds, unknown hillsides or other potentially dangerous locations.

Staying Healthy
The long days of winter often keep children indoors, which can lead to hours of inactivity. Furthermore, children are more likely to contract illnesses during the winter months because they are in more confined spaces. To stay healthy during the winter, consider these safety tips:
Eat a healthy, balanced diet that includes fruits and vegetables.
Teach children proper hand-washing techniques to kill germs and bacteria or use hand sanitizer if necessary.
Keep children home from school and other public places if they are sick.
Ask a pediatrician about the necessity for flu vaccines for young children.

Holiday Safety Tips
The holidays are a time of fun and excitement, but they can also be dangerous. Inappropriate toys, indulgent foods and unsafe decorations can create hazards that may cause injuries to children of all ages. These safety tips can help avoid the greatest risks:
Do not use “candy” style ornaments or holiday decorations that may fool young children.
Limit the amount of holiday sweets and treats children are allowed to eat.
Choose unbreakable ornaments for safe tree decorations, and be sure no ornaments are small enough to be swallowed.
Only give age-appropriate toys and gifts to children.
Check toy recall notices for any holiday gift items.

Heating Tips
The natural reaction to falling temperatures is to raise the heat, either through external, supplemental heaters or by turning on a fireplace or other open flames. These safety tips can keep away the winter chill without risk:
Keep candles, kerosene lamps, and other open flames out of reach of children at all times.
Do not put a space heater in a child’s room.
Teach children fire safety procedures, including how to spot potential hazards.
Do not allow children to play in fires such as roasting marshmallows in a fireplace.
Practice family fire drills to reinforce safe behavior.
Do not use electric blankets for young children.

In Conclusion
By following the proper winter safety tips for children, parents can ensure that their sons and daughters will be warm, happy, and safe during the coldest months of the year, and seeing them enjoy winter safely will warm any parent’s heart.

Nurse Donna

Are your children dressed for "Winter" weather?

noreply@blogger.com (Donna) — Mon, 27 Oct 2008 12:05:00 +0000

DRESS WARM FOR WINTER

1. Dress warm and in layers before going outdoors.
2. Natural fibres will draw moisture away from the skin.
3. A nylon shell will keep wind out.
4. Wear a hat! 30% of body heat escapes through the head.
5. Carry extra socks and gloves and change if your current pair get wet.
6. Wear insulated, properly-fitting boots.

RECESS BREAKS

Unless the weather is too severe (high wind chill factors due to low temperatures and wind speed) students will be expected to go outside at recess times. We will monitor the weather to determine if outdoor recess will proceed as normal. Parents are urged to speak to your children about dressing properly for the weather. Remind your child to wear the clothing you send with them at every recess.

Thank you for your cooperation in this matter.

Nurse Donna

Thanksgiving comes early..thanks to the Black River Comedy Club & Homer(ville) Ruritan's.

noreply@blogger.com (Donna) — Tue, 21 Oct 2008 13:28:00 +0000

Thanksgiving comes early in the school nurses office.

I would like extend my personal "thank you" to both the Black River Comedy Club and the Homer(ville) Ruritan's for their generous donation to the nurses clinic in the amount of $275.00 each for 2 new recovery couches (pictured above).

So in the spirit of Thanksgiving, I ask all Black River families to join me in taking a moment over the upcoming holiday to convey your personal thanks to both organizations for the ongoing support this special gift represents to our students and this school system. If not for organizations such as these, community kindness would become a thing we only read about in our history books.

It is simple acts of kindness and random donations such as this that define a community. And there is not doubt as to how blessed Black River Local School District IS to have both these organizations in their midst.

Happy Thanksgiving to all.......

Nurse Donna

The Importance of Breakfast

noreply@blogger.com (Donna) — Fri, 10 Oct 2008 14:46:00 +0000

The most important meal of the day is a title that breakfast just can't escape. When you feel yourself thinking about skipping this all-important part of your morning, put these pearls of wisdom back in your mind:

Planning
A sausage, egg, and cheese croissant sandwich at the Drive-Thru is better than no breakfast at all, right? Not necessarily. If you make the effort to eat breakfast, why not do it right? And while you are at it, do it at home. The likelihood of eating a healthy, well-balanced breakfast drops dramatically once you walk out the front door. To get in the habit of eating breakfast at home, try these tips:
· Make yourself a pot of oatmeal at the beginning of the week and heat up a small portion each day.
· Buy five nonfat yogurts and cut up enough fruit for a work-week's worth of breakfast.
· Keep nonfat milk and high-fiber, high-protein dry cereal in your pantry.
· If you are in a rush, grab a banana and some nuts for the road.
· Breakfast does not necessarily have to include "breakfast food"; leftovers of self-prepared meals are better than any convenience store's offerings.
For more information on healthy breakfast suggestions see the following article; Boost Your Metabolism: Quick & Easy Breakfasts to Jump Start Your Day.

Better Performance
Children who eat breakfast regularly perform better in school. Just ask any teacher. When you are not hungry, you can focus on other tasks. Children who eat breakfast also perform better on tests. You can extrapolate this to your life: Adults who eat breakfast perform better in the workplace and home environment. Breakfast helps reduce distraction and can actually help you feel more alert.
For more information on the performance benefits of kids eating breakfast see the following article: Brain Food for Kids: Feed Your Children So They Excel at School.

Pleasantly full feeling
People who eat breakfast eat less throughout the day. You may be saying to yourself, "But breakfast actually makes me hungrier!" This is true, if it is unbalanced. Try combining a bit of protein, carbohydrate, fiber, and fat at every breakfast. This combination makes you feel full for longer than a straight carbohydrate breakfast will. A whole-wheat bagel with low-fat peanut butter is a better option than a white bagel with jelly. The protein, fat, and fiber in the first breakfast slows digestion and stomach emptying. In this way, it outlasts the carbohydrate load of the latter breakfast, even if the calories are similar.
It is okay to feel hungry between breakfast and lunch. Prepare yourself for this situation by packing a snack with less than 250 calories. If you feel guilty about eating so often, keep this in mind: A healthy small breakfast and a healthy small snack in order to get you to a healthy small lunch is a much better option than a gigantic fattening early lunch you attacked because of morning food depravation.

Looking out for number one
Starting your day with breakfast sets you on the path to success that day. Breakfast helps avoid distraction, helps you avoid overeating, and enhances your attentiveness and performance. Breakfast should be high in fiber and protein, moderate in fat, and adequate in carbohydrate. Most people can sustain themselves for a few hours on a breakfast of 250-350 calories. But skipping that small amount entirely could be the biggest mistake of your day!
For further information on the why you should eat breakfast see the following article; Why It's Important to Make Breakfast a Priority.

Nurse Donna

4 Ways to Stay Healthy at Work

noreply@blogger.com (Donna) — Fri, 03 Oct 2008 11:47:00 +0000

Viruses that infect the nose, throat, and lungs cause the flu and the common cold. These germs usually spread from one person to another when an infected person coughs or sneezes. Here are four ways to stop this cycle:

Cover your mouth and nose when you sneeze or cough. Use a tissue or cover your mouth with your hands. Then clean your hands, and do so every time you cough or sneeze.
Clean your hands often. For 15 to 20 seconds, rub your hands vigorously together and scrub all surfaces with soap and warm water. It is the soap, combined with the scrubbing action, that helps dislodge and remove germs. When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers may be used. If using a gel, rub it on your hands until they are dry.

Avoid touching your eyes, nose, and mouth. Germs are often spread when a person touches a contaminated surface and then touches his or her eyes, nose, or mouth. Germs can live for up to two hours or more on surfaces such as doorknobs, desks, and tables.
Stay home when you are sick. Also, see a health care provider if necessary. Your employer may need a doctor's note for an excused absence.

Nurse Donna

Head lice facts

noreply@blogger.com (Donna) — Thu, 02 Oct 2008 17:53:00 +0000

What are head lice?
The head louse, or Pediculus humanus capitis (peh-DICK-you-lus HUE-man-us CAP-ih-TUS), is a parasitic insect that can be found on the head, eyebrows, and eyelashes of people. Head lice feed on human blood several time a day and live close to the human scalp. Head lice are not known to spread disease.

Who is at risk for getting head lice?
Head lice are found worldwide. In the United States, infestation with head lice is most common among preschool children attending child care, elementary school children, and the household members of infested children. Although reliable data on how many people in the United States get head lice each year are not available, an estimated 6 million to 12 million infestations occur each year in the United States among children 3 to 11 years of age. In the United States, infestation with head lice is much less common among African-Americans than among persons of other races, possibly because the claws of the of the head louse found most frequently in the United States are better adapted for grasping the shape and width of the hair shaft of other races.

Head lice move by crawling; they cannot hop or fly. Head lice are spread by direct contact with the hair of an infested person. Anyone who comes in head-to-head contact with someone who already has head lice is at greatest risk. Spread by contact with clothing (such as hats, scarves, coats) or other personal items (such as combs, brushes, or towels) used by an infested person is uncommon. Personal hygiene or cleanliness in the home or school has nothing to do with getting head lice.

What do head lice look like?
Head lice have three forms: the egg (also called a nit), the nymph, and the adult.

Egg/Nit: Nits are lice eggs laid by the adult female head louse at the base of the hair shaft nearest the scalp. Nits are firmly attached to the hair shaft and are oval-shaped and very small (about the size of a knot in thread) and hard to see. Nits often appear yellow or white although live nits sometimes appear to be the same color as the hair of the infested person. Nits are often confused with dandruff, scabs, or hair spray droplets. Head lice nits usually take about 8-9 days to hatch. Eggs that are likely to hatch are usually located no more than ¼ inch (or 1 centimeter) from the base of the hair shaft.

Nymph: A nymph is an immature louse that hatches from the nit. A nymph looks like an adult head louse, but is smaller. To live, a nymph must feed on blood. Nymphs mature into adults about 9-12 days after hatching from the nit.

Adult: The fully grown and developed adult louse is about the size of a sesame seed, has six legs, and is tan to grayish-white in color. Adult head lice may look darker in persons with dark hair than in persons with light hair. To survive, adult head lice must feed on blood. An adult head louse can live about 30 days on a person’s head but will die within one or two days if it falls off a person. Adult female head lice are usually larger than males and can lay about six eggs each day.

Where are head lice most commonly found?

Adult louse claws. Head lice and head lice nits are found almost exclusively on the scalp, particularly around and behind the ears and near the neckline at the back of the head. Head lice or head lice nits sometimes are found on the eyelashes or eyebrows but this is uncommon. Head lice hold tightly to hair with hook-like claws at the end of each of their six legs; head lice nits are cemented firmly to the hair shaft and can be difficult to remove.

What are the signs and symptoms of head lice infestation?
Tickling feeling of something moving in the hair.
Itching, caused by an allergic reaction to the bites of the head louse.
Irritability and difficulty sleeping; head lice are most active in the dark..
Sores on the head caused by scratching. These sores can sometimes become infected with bacteria found on the person's skin.

How did my child get head lice?
Head-to-head contact with an already infested person is the most common way to get head lice. Head-to-head contact is common during play at school, at home, and elsewhere (sports activities, playground, slumber parties, camp).

Uncommonly, head lice may be spread by sharing clothing or belongings onto which lice or nits may have crawled or fallen. Examples include: sharing clothing (hats, scarves, coats, sports uniforms) or articles (hair ribbons, barrettes, combs, brushes, towels, stuffed animals) recently worn or used by an infested person; or lying on a bed, couch, pillow, or carpet that has recently been in contact with an infested person. The risk of getting an infestation by a louse or nit that has fallen onto a carpet or furniture is very small.
Dogs, cats, and other pets do not play a role in the spread of human lice.

How is head lice infestation diagnosed?
The diagnosis of a head lice infestation is best made by finding a live nymph or adult louse on the scalp or hair of a person. Because nymphs and adult lice are very small, move quickly, and avoid light, they can be difficult to find. Use of a magnifying lens and a fine-toothed comb may be helpful to find live lice. If crawling lice are not seen, finding nits firmly attached within a 1/4 inch of base of the hair shafts strongly suggests, but does not confirm, that a person is infested and should be treated. Nits that are attached more than 1/4 inch from the base of the hair shaft are almost always dead or already hatched. Nits are often confused with other things found in the hair such as dandruff, hair spray droplets, and dirt particles. If no live nymphs or adult lice are seen, and the only nits found are more than ¼-inch from the scalp, the infestation is probably old and no longer active and does not need to be treated.

If you are not sure if a person has head lice, the diagnosis should be made by their health care provider, local health department, or other person trained to identify live head lice.

How is head lice infestation treated?

This fact sheet is for information only and is not meant to be used for self-diagnosis or as a substitute for consultation with a health care provider. If you have any questions about the disease described above or think that you may have a parasitic infection, consult a health care provider.

Treatment:

General Guidelines
Treatment for head lice is recommended for persons diagnosed with an active infestation. All household members and other close contacts should be checked; those persons with evidence of an active infestation should be treated. Some experts believe prophylactic treatment is prudent for persons who share the same bed with actively-infested individuals. All infested persons (household members and close contacts) and their bedmates should be treated at the same time.
Retreatment of head lice usually is recommended because no approved pediculicide (peh-DICK-you-luh-side) is completely ovicidal.

To be most effective, retreatment should occur after all eggs have hatched but before before new eggs are produced. The retreatment schedule can vary depending on the pediculicide used.
When treating head lice, supplemental measures can be combined with recommended medicine (pharmacologic treatment); however, such additional (non-pharmacologic) measures generally are not required to eliminate a head lice infestation. For example, hats, scarves, pillow cases, bedding, clothing, and towels worn or used by the infested person in the 2-day period just before treatment is started can be machine washed and dried using the hot water and hot air cycles because lice and eggs are killed by exposure for 5 minutes to temperatures greater than 53.5°C (128.3°F). Items that cannot be laundered may be dry-cleaned or sealed in a plastic bag for two weeks. Items such as hats, grooming aids, and towels that come in contact with the hair of an infested person should not be shared. Vacuuming furniture and floors can remove an infested person’s hairs that might have viable nits attached.
Treat the infested person(s): Requires using an over-the-counter (OTC) or prescription medication. Follow these treatment steps:
Before applying treatment, it may be helpful to remove clothing that can become wet or stained during treatment.
Apply lice medicine, also called pediculicide, according to the instructions contained in the box or printed on the label. If the infested person has very long hair (longer than shoulder length), it may be necessary to use a second bottle. Pay special attention to instructions on the label or in the box regarding how long the medication should be left on the hair and how it should be washed off.
WARNING: Do not use a creme rinse, combination shampoo/conditioner, or condition before using lice medicine. Do not re-wash the hair for 1-2 days after the lice medicine is removed.
Have the infested person put on clean clothing after treatment.
If a few live lice are still found 8-12 hours after treatment, but are moving more slowly than before, do not retreat. The medicine may take longer to kill all the lice. Comb dead and any remaining live lice out of the hair using a fine-toothed nit comb.
If, after 8-12 hours of treatment, no dead lice are found and lice seem as active as before, the medicine may not be working. Do not retreat until speaking with your health care provider; a different lice medicine (pediculicide) may be necessary. If your health care provider recommends a different pediculicide, carefully follow the treatment instructions contained in the box or printed on the label.
Nit (head lice egg) combs, often found in lice medicine packages, should be used to comb nits and lice from the hair shaft. Many flea combs made for cats and dogs are also effective.
After each treatment, checking the hair and combing with a nit comb to remove nits and lice every 2-3 days may decrease the chance of self-reinfestation. Continue to check for 2-3 weeks to be sure all lice and nits are gone.
Retreatment generally is recommended for most prescription and non-prescription (over-the-counter) drugs after 9-10 days in order to kill any surviving hatched lice before they produce new eggs. However, if using the prescription drug malathion, retreatment is recommended after 7-9 days ONLY if crawling bugs are found. Click here for instructions on how to use malathion to treat head lice.
Supplemental Measures : Head lice do not survive long if they fall off a person and cannot feed. You don't need to spend a lot of time or money on housecleaning activities. Follow these steps to help avoid re-infestation by lice that have recently fallen off the hair or crawled onto clothing or furniture.
Machine wash and dry clothing, bed linens, and other items that the infested person wore or used during the 2 days before treatment using the hot water (130°F) laundry cycle and the high heat drying cycle. Clothing and items that are not washable can be dry-cleaned
ORsealed in a plastic bag and stored for 2 weeks.
Soak combs and brushes in hot water (at least 130°F) for 5-10 minutes.
Vacuum the floor and furniture, particularly where the infested person sat or lay. However, the risk of getting infested by a louse that has fallen onto a rug or carpet carpet or furniture is very small. Head lice survive less than 1-2 days if they fall off a person and cannot feed; nits cannot hatch and usually die within a week if they are not kept at the same temperature as that found close to the human scalp. Spending much time and money on housecleaning activities is not necessary to avoid reinfestation by lice or nits that may have fallen off the head or crawled onto furniture or clothing.
Do not use fumigant sprays; they can be toxic if inhaled or absorbed through the skin.

Prevent Reinfestation:
Avoid head-to-head (hair-to-hair) contact during play and other activities at home, school, and elsewhere (sports activities, playground, slumber parties, camp). Lice are spread most commonly by direct head-to-head (hair-to-hair) contact and much less frequently by sharing clothing or belongings onto which lice or nits may have crawled or fallen.
Do not share clothing such as hats, scarves, coats, sports uniforms, hair ribbons, or barrettes.
Do not share infested combs, brushes, or towels.
Do not lie on beds, couches, pillows, rugs, carpets, or stuffed animals that have recently been in contact with an infested person.
To help control a head lice outbreak in a community, school, or camp, children can be taught to avoid activities that may spread head lice.

Over-the-counter Medications
Many head lice medications are available over-the-counter without a prescription at a local drug store or pharmacy. Each over-the-counter product approved for the treatment of head lice contains one of the following active ingredients.
Pyrethrins (pie-WREATH-rins) combined with piperonyl butoxide (pie-PER-a-nil beu-TOX-side);Brand name products: A-200*, Pronto*, R&C*, Rid*, Triple X*.
Pyrethrins are naturally occurring pyrethroid extracts from the chrysanthemum flower. Pyrethrins are safe and effective when used as directed. Pyrethrins can only kill live lice, not unhatched eggs (nits). A second treatment is recommended in 9-10 days to kill any newly hatched lice before they can produce new eggs. Treatment failures can be common depending on whether lice are resistant to pyrethrins in the patient’s geographic location. Pyrethrins generally should not be used by persons who are allergic to chrysanthemums or ragweed.
Permethrin (per-meth-rin):Brand name product: Nix*.
Permethrin is a synthetic pyrethroid similar to naturally occurring pyrethrins. Permethrin is safe and effective when used as directed. Permethrin kills live lice but not unhatched eggs. Permethrin may continue to kill newly hatched lice for several days after treatment. A second treatment often is necessary in 9-10 days to kill any newly hatched lice before they can produce new eggs. Treatment failures can be common depending whether lice are resistant to permethrin in the patients geographic location. Permethrin is not approved for use in children less than 2 years old.

Prescription Medications
The following medications approved by the U.S. Food and Drug Administration (FDA) for the treatment of head lice are available only by prescription.
Malathion (Ovide*); Brand name product: Ovide*
Malathion is an organophosphate. The formulation of malathion approved in the United States for the treatment of head lice is a lotion that is safe and effective when used as directed. Malathion is pediculicidal (kills live lice) and partially ovicidal (kills some lice eggs). A second treatment is recommended if live lice still are present 7-9 days after treatment. Malathion is intended for use on persons 6 years of age and older. Malathion can be irritating to the skin and scalp; contact with the eyes should be avoided. Malathion lotion is flammable; do not smoke or use electrical heat sources, including hair dryers, curlers, and curling or flat irons, when applying malathion lotion and while the hair is wet. See our information on treating with Malathion for more details.
Lindane; Brand name products: None available
Lindane is an organochloride. Lindane is not recommended as a first-line therapy. Overuse, misuse, or accidentally swallowing lindane can be toxic to the brain and other parts of the nervous system; its use should be restricted to patients who have failed treatment with or cannot tolerate other medications that pose less risk. Lindane should not be used to treat premature infants, persons with a seizure disorder, women who are pregnant or breast-feeding, persons who have very irritated skin or sores where the lindane will be applied, infants, children, the elderly, and persons who weigh less than 110 pounds.
Which medicine is best?
If you arent sure which medicine to use or how to use a particular medicine, always ask your physician, pharmacist, or other health care provider. CDC does not make recommendations about specific products. When using a medicine, always carefully follow the instructions contained in the package or written on the label, unless the physician and pharmacist direct otherwise.
When treating head lice
Do not use extra amounts of any lice medication unless instructed to do so by your physician and pharmacist. The drugs used to treat lice are insecticides and can be dangerous if they are misused or overused.
Do not treat an infested person more than 2-3 times with the same medication if it does not seem to be working. This may be caused by using the medicine incorrectly or by resistance to the medicine. Always seek the advice of your health care provider if this should happen. He/she may recommend an alternative medication.
Do not use different head lice drugs at the same time unless instructed to do so by your physician and pharmacist.

Page last modified: May 16, 2008
Page last reviewed: May 16, 2008
Content Source: Division of Parasitic Diseases (DPD)
National Center for Zoonotic, Vector-Borne, and Enteric Diseases (ZVED)
Page Located on the Web at http://www.cdc.gov/lice/head/factsheet.html

Nurse Donna

Back to school means "backpack safety."

noreply@blogger.com (Donna) — Thu, 02 Oct 2008 15:56:00 +0000

Backpacks help kids carry schoolbooks and supplies, but they can also be harmful when overloaded and/or improperly fitted, warns the American Physical Therapy Association.

"Wearing backpacks improperly or ones that are too heavy put children at increased frisk for musculoskeletal injuries," Mary Ann Wilmarth, assistant dean and director of the transitional doctors of physical therapy degree at Northeastern University in Boston, said in a prepared statement. She's conducted a number of studies on school backpacks.

Injuries occur when children use faulty postures -- such as arching the back, bending forward, twisting, or leaning to one side -- when they're trying to manage a heavily loaded backpack. These faulty postures can cause improper spinal alignment, which hampers the functioning of spinal discs that provide shock absorption, Wilmarth explained.

Overloaded backpacks also place an extra burden on muscles and soft tissues, causing fatigue and strain that increases the risk of neck, shoulder and back injuries.

Wilmarth offered some backpack safety tips:

1. Use both straps in order to better distribute the weight of the backpack and to promote a well-aligned, symmetrical posture. Using one strap means that one side of the body has to bear most of the weight of the backpack.
2. Be careful when putting on and removing backpacks. Keep the trunk of the body stable and avoid excessive twisting.
3. The backpack should be positioned evenly in the middle of the back, near the wearer's center of gravity. The backpack should not extend below the lower back. Adjust the shoulder straps so that the child is able to put on and remove the backpack without difficulty. While the straps should not be too loose, they should be adjusted to permit free movement of the arms.
4. Keep the load at 10 percent to 15 percent or less of the child's bodyweight. Children should carry only items they require for the day. The heaviest items in the backpack should be positioned closest to the back.
5. Encourage children to be active, in order to promote better muscle strength and flexibility, which makes it easier to carry a backpack.

For additional information go to; The American Academy of Orthopaedic Surgeons has more about backpack safety.

Nurse Donna

Information from SNAP (School Network for Absenteeism Prevention)

noreply@blogger.com (Donna) — Wed, 01 Oct 2008 13:46:00 +0000

The single most important thing we can do to keep from getting sick and spreading illness to others is to clean our hands!

Here are the reasons why . . .

One of the most common ways people catch colds is by rubbing their noses or eyes after touching someone or something that's contaminated with the cold virus (rhinovirus).

Nearly 22 million school days are lost annually due to the common cold.

52.2 million cases of the common cold affect Americans under age 17 each year.

Than some food borne illnesses are spread through lack of hand cleaning. In fact, certain strains of E. coli, salmonella, and other bacteria can live on surfaces like cafeteria tables and doorknobs for up to two hours.

Rotavirus - a germ that causes gastrointestinal illness - can be transferred from a dry, smooth surface to a clean hand for as long as 20 minutes after the surface has been contaminated.

Infectious disease accounts for millions of lost school days each year.

Diarrhea is second only to the common cold as a cause of lost working time, with about 25 days lost from work or school each year for every 100 Americans.

Teacher illness costs time and money - not to mention the negative effects that teacher absences may have on student learning. In fact, teachers can be absent from school more days a year than students. One study found that teacher illness-related absences averaged 5.3 days a year, in contrast to an average of 4.5 days a year for students.

Students don't clean their hands often or well enough. In one study, only 58% of female and 48% of male middle and high school students washed their hands after using the bathroom. Of these, only 33% of the females and 8% of the males used soap.

Adult hand cleaning behaviors also need improvement. In one study, about 33% of adults using public restrooms didn't wash their hands after using the bathroom.

Hand cleaning and basic hygiene habits are generally learned during early childhood. But people need to be reminded periodically about the importance of clean hands to wash them as often and thoroughly as they should.12,13 Research suggests that it is important for hygiene lessons to be repeated during the K-12 school curricula.

One study involving Detroit school children showed that scheduled hand washing, at least four times a day, can reduce gastrointestinal illness and related absences by more than 50%.

A case-control study of 6,080 school children showed that those who used classroom-dispensed, instant hand sanitizers at specific times during the day, in addition to normal hand cleaning habits, experienced 20% fewer absences due to illness.

A four-week hand washing program for a class of first grade students was associated with fewer absences and prescribed antibiotics than were reported the previous school year.

So there you have it . . . clean hands are key to good health for the whole school community!

Compliments of:

School Network for Absenteeism Prevention. Established 2003. The information contained in this Web site was compiled by the Centers for Disease Control and Prevention, U.S. Department of Health and Human Services and The Soap and Detergent Association. This information is not copyrighted. It is for educational purposes only.

USEFUL LINKS

Clean Hands Coalition-http://www.cleanhandscoalition.org/

American Society for Microbiology Clean Hands Campaign-http://www.washup.org/

An Ounce of Prevention Keeps the Germs Away-http://www.cdc.gov/ounceofprevention/

BAM!-http://www.bam.gov/

CDC Clean Hands Save Lives-http://www.cdc.gov/cleanhands/

CDC Germ Stopper-http://www.cdc.gov/germstopper/

Fight BAC!®-http://www.fightbac.org/

National Coalition for Food Safe Schools-http://www.foodsafeschools.org/

Scrub Club-http://www.scrubclub.org/home.aspx

Think healthy...

Nurse Donna

Straight from the CDC website to you...Handwashing

noreply@blogger.com (Donna) — Wed, 01 Oct 2008 13:24:00 +0000

Keeping hands clean is one of the most important steps we can take to avoid getting sick and spreading germs to others. It is best to wash your hands with soap and clean running water for 20 seconds. However, if soap and clean water are not available, use an alcohol-based product to clean your hands. Alcohol-based hand rubs significantly reduce the number of germs on skin and are fast acting.

When washing hands with soap and water:

Wet your hands with clean running water and apply soap. Use warm water if it is available.
Rub hands together to make a lather and scrub all surfaces.
Continue rubbing hands for 20 seconds. Need a timer? Imagine singing "Happy Birthday" twice through to a friend!
Rinse hands well under running water
Dry your hands using a paper towel or air dryer. If possible, use your paper towel to turn off the faucet
Remember: If soap and water are not available, use alcohol-based gel to clean hands.

When using an alcohol-based hand sanitizer:

Apply product to the palm of one hand
Rub hands together
Rub the product over all surfaces of hands and fingers until hands are dry.

When should you wash your hands?

Before preparing or eating food
After going to the bathroom
After changing diapers or cleaning up a child who has gone to the bathroom
Before and after tending to someone who is sick
After blowing your nose, coughing, or sneezing
After handling an animal or animal waste
After handling garbage
Before and after treating a cut or wound
Featured Items

Remember, Clean Hands Save Lives!

* Links to non-Federal organizations found at this site are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred. CDC is not responsible for the content of the individual organization Web pages found at these links.

Page last modified: February 18, 2008
Page last reviewed: November 22, 2006
Content Source: National Center for Zoonotic, Vector-Borne, and Enteric Diseases (ZVED)
Page Located on the Web at http://www.cdc.gov/cleanhands/

The above material is compliments of the Center for Disease (CDC).
Nurse Donna