- Management of Communicable Disease Plan
- Immunization Information from the Colorado Department of Public Health & Environment
- Nurses & Health Clerks
- Student Health Concern Information & Forms
- Health-Related Services
- Health and Wellness Information & Resources
- Medicaid, CHP+, and Private Insurance Resources
Students with Health Concerns
Many students have health concerns which may need to be addressed or cared for at school. School Registered Nurse Consultants work with Health Care Providers and School Health Clerks to administer medications, treatments and care.
Health care plans (HCPs) are written by the School Registered Nurse Consultant for students who have health conditions for which the health office has specific procedures to follow such as medications, treatments, special directions for emergency care or special precautions.
All students who have diabetes, seizures, severe allergies or medications in school should have a HCP. Other disorders may also have specific precautions which would require a HCP. PLEASE contact the School Registered Nurse Consultant or School Health Clerk if you have concerns about your child.
Not all students with health concerns require a specific HCP unless we have specific medications, treatments, or care that should be given at school.
Additional Information & Forms
Exclusion from School
When should I keep my child at home instead of sending them to school?District 6 - Health Exclusion Guidelines (07/17/2012)
Recommended for students experiencing severe, uncontrolled coughing or wheezing, or difficulty breathing.
Recommended for students with other symptoms in addition to diarrhea such as: vomiting, abdominal pain, fever, the diarrhea cannot be contained in a toilet, there is blood or mucus in the stool. Student should be diarrhea free for 24 hours without medication before returning to school.
Fever (defined as a temperature >100.5 F orally)
Recommended if the student has symptoms in addition to the fever such as a rash, sore throat, vomiting, diarrhea, etc. Student should be fever free for 24 hours without medication before returning to school.
Recommended if student is drooling uncontrollably.
Recommended if student has symptoms in addition to the rash such as behavioral change, fever, joint pain, bruising not associated with injury, or if the rash is open and oozing.
Recommended if the pain is severe, if the pain appears after an injury, or if the student had symptoms in addition to the stomach ache such as vomiting, fever, diarrhea, etc.
Recommended if the student has symptoms in addition to the swollen glands such as difficulty breathing or swallowing, fever, etc.
Generally recommended if the student has vomited more than 2 times in 24 hours, if the vomit is green or bloody, if the student had a recent head injury, or if the student has symptoms in addition to the vomiting such as fever, diarrhea, stomach ache, etc. Student should be vomit free for 24 hours without medication before returning to school.
No exclusion necessary
No exclusion necessary. Contact nurse if headache is persistent, severe, is accompanied by other symptoms or if the student has a health care plan.
Exclusion is for children found with live head lice only. Data does not support school exclusion for nits (lice eggs).
Students on antibiotics for contagious illnesses, such as strep throat, tonsillitis, bronchitis, pinkeye or pneumonia, must stay home until antibiotic has been taken for 24 hours.
All skin lesions must be covered by a bandage or clothing during the school day. This may include impetigo, ring worm, scabies, and other fungal, bacterial or viral skin infections.
Consider exclusion if:
- The student is unable to participate comfortably in usual activities
- The student requires more medical care than the school personnel are able to provide
- The student has a high fever, behavioral changes, persistent crying, difficulty breathing, uncontrolled coughing, or other signs suggesting a severe illness.
- The student is ill with a potentially contagious disease and exclusion is recommended by a health care provider, the state or local public health agency.
*Adapted from CDPHE - Infectious Disease Guidelines in Public Schools, Revised Dec. 2004.
Colorado Department of Public Health and Environment.
Release of Confidential Information
Releases of information allow appropriate school staff (typically school nurse, psychologist or administrators) to obtain mental and physical health related records as well as discuss health concerns, treatments and care while at school with student’s health care provider. Parent must sign and date any release of information and may revoke the release at any time.
Release of Information (Typically works for most providers, except The Children's Hospital and North Range Behavioral Health)
The Children's Hospital
North Range Behavioral Health
Medication at School
Medication administration at school require authorization from a licensed health care provider (MD, DO, PA or advanced practice RN) and signed parent permission. Medication must be provided by the parent/guardian in an individual pharmacy labeled bottle for the student who is to receive it. Medication will be given as directed on the pharmacy label and according to health care provides' specific orders.Medications include all prescription or over the counter medication (all pills, syrups, injections, inhalers, epipens, creams, sprays, eye drops, cough drops, vitamins, herbal remedies, etc.). Medications may not be expired.Medications will be given following state laws only. It is required that all medication (except for those approved for self-carry by the school nurse) be kept in the Health Office for the safety of all students.
Forms (Physician completes and signs)Self-carry contracts can be found in the links specific to the condition or disorder (asthma, diabetes, allergies).
For the safety of all students with asthma, the health office requests a signed health care plan from your health care provider along with an inhaler for school use. Typically, middle and high school students who are proficient users of inhalers may “self-carry” their inhaler with signed health care plan from physician, parent and approval of school nurse. However, a second inhaler is requested to be stored in the health office.
Asthma Action Plan
Asthma Parent Information
Asthma Self-Carry Contract
Asthma is a chronic disease involving the airways in the lungs. These airways, or bronchial tubes, allow air to come in and out of the lungs. If you have asthma your airways are always inflamed. They become even more swollen and the muscles around the airways can tighten when something triggers your symptoms. This makes it difficult for air to move in and out of the lungs,causing symptoms such as coughing, wheezing, shortness of breath and/or chest tightness.
Childhood asthma impacts millions of children and their families. In fact, the majority of children who develop asthma do so before the age of five. There is no cure for asthma, but once it is properly diagnosed and a treatment plan is in place you will be able to manage your condition, and your quality of life will improve.
For many asthma sufferers, timing of these symptoms is closely related to physical activity. Staying active is an important way to stay healthy, so asthma shouldn't keep you on the sidelines. Your physician can develop a management plan to keep your symptoms under control before, during and after physical activity.
Source: American Academy of Allergy, Asthma and Immunology. http://www.aaaai.org/conditions-and-treatments/asthma.aspx
For the safety of all students with diabetes, we require a health care plan with instructions about how to care for the student.
Diabetic Orders - Injections (NO PUMP)
Diabetic Orders - PumpFor more information please visit Colorado Kids with Diabetes.For special dietary needs information (including carb counts) and forms, please visit the District 6 Nutrition Services webpage (click here). These forms must be returned to the school health office as soon as possible to ensure your child's health and safety needs.
In type 1 diabetes, the body does not produce insulin because the cells that make insulin in the pancreas have been destroyed. A person with type1 diabetes needs insulin shots to use the glucose from their food. Type I diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes. Only 5% of people with diabetes have this form of the disease. With the help of insulin therapy and other treatments, even young children with type 1 diabetes can learn to manage their condition and live long, healthy, happy lives.
- In type 2 diabetes, either the body does not produce enough insulin or the body’s cells ignore the insulin. Some people with type 2 diabetes need diabetes pills or insulin shots to help their bodies use glucose for energy. Insulin cannot be taken as a pill because it would be broken down during digestion just like the protein in food. It must be injected into the fat under your skin for it to get into your blood.
When glucose builds up in the blood instead of going into cells, it can lead to diabetes complications including serious long term problems with eyes (glaucoma, cataracts), feet (neuropathy, numbness), skin (infections),increased risk for heart disease, high blood pressure (heart attack, stroke, kidney disease), mental health disorder.
Emergent and potentially life threatening conditions include hyperglycemia and hypoglycemia. Hyperglycemia occurs when blood glucose levels get too high, however glucose cannot get into cells to be used for energy so stores of fat are converted for energy, causing ketones to build up quickly in the blood, potentially causing ketoacidosis (DKA). Hypoglycemia occurs when the blood glucose gets too low(typically because of too much insulin injected, or not enough food eaten). The brain can only function on glucose and if there is no glucose in the blood, you could pass out. If a diabetic passes out, they will need immediate treatment, such as an injection of glucagon or emergency treatment in a hospital.
Source: American Diabetes Association http://www.diabetes.org/
For the safety of all students with severe allergies, the health office requests a signed health care plan from your health care provider along with an antihistamine and/or epipen for school use. In extreme cases, middle and high school students who have proficient knowledge of anaphylaxis may “self-carry” an epipen with signed health care plan from the health care provider, parent, and approval of school nurse. However, a second epipen and antihistamine is requested to be stored in the health office.
Allergy and Anaphylaxis Action Plan and Medication Orders
Self Carry Contract
Special Dietary NeedsAllergies are among the most common chronic conditions worldwide. Symptoms of allergies range from a runny nose and itchy eyes to life-threatening reactions. An allergic reaction begins in the immune system. Our immune system protects us from invading organisms that can cause illness. If you have an allergy, your immune system mistakes an otherwise harmless substance as an invader. This substance is called an allergen. The immune system overreacts to the allergen by producing Immunoglobulin E (IgE) antibodies. These antibodies travel to cells that release histamine and other chemicals, causing an allergic reaction.An allergic reaction typically triggers symptoms in the nose, lungs, throat, sinuses, ears, lining of the stomach or on the skin. For some people, allergies can also trigger symptoms of asthma. In the most serious cases, a life-threatening reaction called anaphylaxis (an-a-fi-LAK-sis) can occur.
A number of different allergens are responsible for allergic reactions. The most common include:Pollen, Dust, Food, Insect stings, Animal dander, Mold, Medications, Latex.
Food Allergies - your immune system overreacts to a particular protein found in that food. Many food allergies are diagnosed in young children, though allergies may also appear in older children and adults. There’s no cure for food allergies; however, many children outgrow food allergies. Allergic reactions usually occur within a few minutes of eating the trigger food, though reactions can sometimes appear a few hours later. If you believe you or your child may have a food allergy, consult an allergist or immunologist who can order tests to determine whether it’s a food allergy, food intolerance, or something else. Some symptoms of intolerance and allergies are similar, but the differences between the two conditions are important. If you have a food intolerance, eating the food can leave you feeling miserable. With a true food allergy, your body’s reaction to the food could be life-threatening. The main symptoms include hives, “throat closing, ”and difficulty breathing.
Eight foods responsible for most allergic reactions:
• Cow’s milk • Eggs • Fish • Peanuts • Shellfish • Soy • Tree nuts• Wheat
Symptoms: • Stuffy or itchy nose, sneezing, or itchy, teary eyes •Vomiting, stomach cramps, or diarrhea • Hives or red, itchy skin • Swelling.
Source: American Academy of Allergy, Asthma and Immunology.
REAP Manual:REAP The Benefits of Good Concussion Management Manual (Click Here)
Informational Video with Illustrations:
An Acquired Brain Injury (ABI) is any type of damage to the brain acquired after birth. ABIs are classified as either:· Non-traumatic – caused by either an internal or external source, such as stroke, brain tumors, infection, poisoning, hypoxia, ischemia, encephalopathy or substance abuse.
· Traumatic Brain Injury (TBI) - a blow or jolt to the head or a penetrating head injury that disrupts the function of the brain. Not all blows or jolts to the head result in a TBI. The severity of such an injury may range from “mild,” i.e., a brief change in mental status or consciousness to “severe,” i.e., an extended period of unconsciousness or amnesia after the injury. A TBI can result in short or long-term problems with independent function.Concussion is a traumatic brain injury that alters the way your brain functions. Effects are usually temporary, but can include problems with headache, concentration, memory, judgment, balance and coordination. In the Fall of 2004,Jake Snakenberg was a freshman football player at Grandview High School. He likely sustained a concussion in a game the week prior, however, he did not fully understand that he had experienced a concussion and he did not report his symptoms to anyone. One week later, Jake took a typical hit in a game, collapsed on the field and never regained consciousness. Jake passed away from “Second Impact Syndrome” on September 19, 2004.On January 1, 2012, the ‘Jake Snakenberg Youth Sports Concussion Act’ became law making Colorado one of the dozen or so states to enact legislation. The bill requires that coaches receive education about concussion, that a student athlete is removed from the field of play if a concussion is suspected and that the student be signed off by a healthcare professional before returning to play.
The REAP Project is a TBI Trust Fund Education grant between Rocky Mountain Hospital for Children/Health One Emergency Departments and four school districts. The REAP Project is the culmination of a study funded by the Center for Disease Control (CDC) from 2004 to 2007. The results of the study were enlightening… the researchers found that the two most essential factors to good concussion management are: Education and Collaboration – essentially, good communication between a School Team, a Family Team and a Medical Team. As a result, the REAP Project has compiled all of the lessons learned into a manual to promote a Community-Based Approach to Concussion Management.Source: Colorado Brain Injury Alliance
Seizure Action Plan (to be completed by physician)Epilepsy (also called a seizure disorder) is a medical condition that produces seizures affecting a variety of mental and physical functions. Seizures happen when clusters of nerve cells in the brain signal abnormally, which may briefly alter a person's consciousness, movements or actions. Instead of discharging electrical energy in a controlled manner, the brain cells keep firing. The result may be a surge of energy through the brain, causing unconsciousness and contractions of the muscles. If only part of the brain is affected, it may cloud awareness, block normal communication, and/or produce a variety of undirected, uncontrolled, unorganized movements.
There are many different types of seizures. People may experience just one type or more than one. The kind of seizure a person has depends on which part and how much of the brain is affected by the electrical disturbance that produces seizures. The symptoms of a seizure may affect any part of the body. Most seizures last only a minute or two, although confusion afterwards may last longer. Experts divide seizures into generalized seizures (absence, atonic, tonic-clonic, myoclonic), partial (simple and complex) seizures, gelastic seizures, dacrystic seizures, non-epileptic seizures and statusepilepticus. Generally, the most frequent cause of an unexpected seizure is failure to take the medication as prescribed. Other factors include ingesting substances, hormone fluctuations, stress, sleep patterns and photosensitivity.
While medications and other treatments help many people of all ages who live with epilepsy, more than a million people continue to have seizures that can severely limit their school achievements, employment prospects and participation in all of life's experiences. It strikes most often among the very young and the very old, although anyone can develop epilepsy at any age. In the U.S., it affects more than 300,000 children under the age of15--more than 90,000 of whom have seizures that cannot be adequately treated.
Source: Epilepsy Foundation http://www.epilepsyfoundation.org/index.cfm
Lice and Bed Bugs Information
District Lice Policy
Lice InformationCDC Information (Click Here)NPIC Information (Click Here)
Bed BugsBed Bug InformationInformation on Classrooms (Click Here)EPA Information (Click Here)CDC Information (Click Here)