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

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....

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

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.

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

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?

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

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

Nurse Donna

What is pertussis?

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