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Marla K. Brown, RN
A.A.S., Nursing, Angelo State University
District Health Services
Office: 325.655.2851 (x-111)
Fax: 325.655.3355
marla.brown@veribestisd.net






DISTRICT HEALTH SERVICES


Veribest ISD Health Services Vision

The Veribest Independent School District (ISD) Health Services Department envisions a nurturing confidential environment that allows students, staff and families to move forward to achieve the ability to lead healthy lives and to become life-long learners.

Veribest ISD Health Services Mission Statement

The mission of the Veribest Independent School District Health Services is to provide compassionate care in a nurturing, confidential and safe environment, and to advocate for those in our care by promoting healthier lives through training and early detection.

Services Provided

  • Assesments and interventions of illness, injury and student health concerns
  • Specialized nursing procedures per medical physician and parent/guardian requests
  • Health Screenings
  • Education to promote health and healthy lifestyles
  • Chronic disease management and education
  • Individualized Nursing Care Plans and services for students with disabilities and/or health condition that interfere with learning
  • Medication administration
  • School/community/health care provider liaison


The Flu: What Parents Need To Know To Keep Kids Healthy

With flu season upon us, it is important that we work together to keep our children and school healthy. By keeping our children flu-free, we benefit the community as a whole. Additionally, healthy students miss fewer days of school, which results in less stress on the family. Following are answers to frequently asked questions about the flu and how to help protect your child.

What is the flu?
  • The flu is caused by the influenza virus, which infects the lungs, nose and throat
  • Flu can cause mild to severe illness, and sometimes, can lead to death
  • Each year in the United States:
    • 5-20 percent of Americans fall ill to the flu
    • Children are two to three times more likely than adults to get sick with the flu, and they frequently spread the virus to others
  • Young children are at the greatest risk for developing serious flu complications, as well as the elderly and those with certain health conditions
How does the flu spread?
  • There are two ways to get the flu. Usually flu is spread from person to person through coughing and sneezing. Occasionally, people can get the flu from touching a germ-infested surface
What are the common symptoms of flu?

Often we get confused about the symptoms of the flu and how they are different from a common cold. Knowing the symptoms of the flu is important and will help you act quickly to get your child feeling better faster.
  • Common symptoms of flu include: high fever, severe headache, muscle and body aches, exhaustion and dry cough
  • Children often have additional flu symptoms that are rare in adults, such as nausea, vomiting and diarrhea
  • Symptoms of a common cold include: stuffy nose, sneezing, sore throat and hacking cough
Simple steps for keeping your child healthy:
  • According to the Centers for Disease Control and Prevention (CDC), the best way to prevent your child from getting the flu is to take him/her to get a flu vaccine
  • You should talk to your child about practicing good health habits, such as:
    • Washing hands frequently with soap and warm water for at least 20 seconds
    • Covering mouth and nose with a tissue when sneezing or coughing, and disposing of the tissue in a proper trash receptacle
    • Avoiding sharing drinks, water bottles or silverware with others
  • You can help prevent the flu from spreading at home by disinfecting frequently touched surfaces, toys and other commonly shared items
  • Also, if someone in your household gets the flu, a doctor can prescribe a medication – called an antiviral – that can actually prevent other members of the household from catching the flu. Studies show that some antiviral medications are up to 92 percent effective in preventing the flu when taken once daily for seven days
Don’t take the flu lying down:
  • If you are concerned about your child’s flu symptoms, call your doctor early. Call your doctor immediately if your child has a chronic disease. Some children may benefit from an antiviral medication, which can be prescribed by a physician and can help lessen the symptoms and reduce the risk of complications. To be effective, antiviral medication must be taken within 48 hours after flu symptoms begin
  • If your child has the flu, it is important for them to stay home from school, rest, and drink plenty of fluids
  • Additionally, notify your child’s school if he/she has the flu. Monitoring flu incidence will help keep students, faculty and our community healthy
* Note: For additional information on the influenza virus, visit www.cdc.gov/flu .

Student Illness or Injury at School

We will promptly attempt to notify you or a person you have authorized us to notify if we have knowledge that your child has been injured or becomes ill at school. One of the forms we ask you to complete at the beginning of each school year is a form authorizing designated school employees to consent to medical treatment in case your child is injured or becomes ill at school or school –related activity and requires emergency treatment. We, of course, will call you in such a situation and will also call for emergency assistance. It is important, however, that you understand that the school district is not responsible for any cost of medical treatment or services provided after an injury at school or a school related activity. We cannot and will not use public funds to pay individual student medical expenses.

Chronic Illness/Health Conditions:
Because your child may have a medical condition that requires extra attention/care from the school personnel, it is important the parent/guardian visit with school nurse on the student’s campus. The school nurse will then inform others of care as needed. Up-to-date addresses and telephone numbers are imperative to the school as emergency care can arise at any time during school hours.

Communicable Disease:
Children should only be in school when they can fully participate in their educational program. Therefore, children with the following should stay at home and or will be referred home by the nurse or other school personnel:
  1. If a child has a fever over 100 degrees, parents must keep the child home until he/she is fever free for 24 hours without the aid of medication.
  2. If a child vomits or has diarrhea, parents must keep the child home for 24 hours after the condition ends.
  3. A child with a persistent cough and/or excessive (discolored: green, yellow) discharge from the nose or eyes should stay home until the condition subsides.
  4. Under state and local Health Department regulations, if your child has certain medial conditions, he/she must be excluded from school for a period of time. The school nurse or principal can provide parents with a complete list of conditions and periods of exclusion. All communicable diseases must be reported to the school office, who will, if the disease is reportable, report it to the Health Department. Some of these diseases include:

    Amebiasis, Campylobacteriosis, Chicken pox, Common cold w/fever, Gastoenteritis (viral), Hepatitis A, Impetigo, Infectious Mononucleosis, Influenza, Measles (Rubeola), Meningitis, Bacterial, Mumps, Rubella/German Measles, Salmonellosis, Scabies, Tuberculosis, Shigellosis, Streptoccocal disease
By following the above guidelines, we hope to provide a healthy environment for everyone in the school community.

Bacterial Meningitis Information:
English (Ingles) Version or Espanol (Spanish) Version

Immunizations

In accordance with the Texas Department of Health immunization schedule, recommendations and adopted by the Texas Board of Health and published in the Texas Register annually, a child or student shall show acceptable evidence of vaccination prior to entry, attendance, or transfer to a child care facility or public or private elementary or secondary school, or institution of higher education. Children enrolled in child care facilities, pre-kindergarten, or early childhood programs shall have the following; diphtheria, pertussis, rubeola (measles), rubella, mumps, tetanus, Heaemophilus influenza type B, poliomyelitis, hepatitis B, and varicella (chicken pox), Hepatitis A, and invasive pneumococcal .

Exclusions from compliance are allowable on an individual basis for medical contraindications, reasons of conscience, including a religious belief, and active duty with the armed forces of the United States. Children and students in these categories must submit evidence for exclusion from compliance as specified in the Health and Safety Code, 161.004(d), Health and Safety Code 161.0041, Education code, Chapter 38, Education code, Chapter 51, and the Human Resources code, Chapter 42.
  1. To claim an exclusion for medical reasons, the child or student must present a statement signed by the child’s physician, duly registered and licensed to practice medicine in the United States who has examined the child, in which it is stated that, in the physician’s opinion, the vaccine required is medically contraindicated or poses a significant risk to the health and well being of the child or any member of the child’s household. Unless it is written in the statement that a lifelong condition exists, the exemption statement is valid for only one year from the date signed by the physician.
  2. To claim an exclusion for reasons of conscience, including a religious belief, a signed affidavit must be presents by the child’s parent or guardian, stating that the child’s parent or guardian declines vaccinations for the reasons of conscience, including a person’s religious beliefs. The affidavit will be valid for two years. Affidavit MUST BE obtained by submitting a written request to the Texas Department of State Health Services, 1100 West 49th Street Austin, Texas 78756 (Rule 97.62 Title 25 of the Texas Administrative Code).

A student may be provisionally enrolled for 30 days, if the student has an immunization record that indicates the student has received at least one dose of each specified age-appropriate vaccine. If at the end of the 30 day period, a student has not received a subsequent dose of vaccine, the student is not in compliance and the school shall exclude the student from school attendance until the required dose is administered (Rule 97.66, Title 25 of the Texas Administrative Code).

In the event that office personnel or the school nurse finds a student is lacking an immunization, they will contact the parent who then has ten (10) school days to immunize their child. After that, the student will not be allowed to return to school until proof of immunization is given to the school. Proof of immunization may be in the form personal records from a licensed physician or public health clinic with a signature or rubber stamp validation.

Changes in Texas Immunization Requirements

Last school year the state of Texas added several required vaccines for all students entering 7th grade. Two (2) doses of Varicella vaccine are required---a written statement from a parent (legal guardian or managing conservator), school nurse, or a physician attesting to the child’s positive history of varicella disease (chicken pox), or of varicella immunity, is acceptable instead of either dose of varicella vaccine. Additional requirements include one (1) dose of meningococcal vaccine, and one (1) dose of Tdap. Students entering 7th grade are required to have a booster of Tdap only if it has been five (5) years since their last dose of tetanus-containing vaccine. Td is acceptable in lieu of Tdap if a contraindication to pertussis exists.

It is a Texas state law that immunizations must be up to date in order for a student to attend school. Your child will not be allowed to attend 7th grade without these immunizations. It is the responsibility of the parent/guardian to provide the updated records to your child’s campus. Please consider getting these immunizations early and providing the record to your child’s campus in order for them to be input into our computer system.

Download 7th Grade Immunization Letter

Protect Your Entire Family Against Pertussis

New Vaccine Now Available for Children 10 to 18 and Adults

School is back in session and your kids could be bringing home more than just homework. Pertussis, also known as whooping cough, is a highly contagious disease spread through coughing. In 2005 there were more than 2,000 pertussis cases in Texas, and eight babies died from the disease. The good news is pertussis can be prevented by a vaccine. And there is a new vaccine available for older children, teens, and adults.

Symptoms of Pertussis:
  • Runny nose, sneezing & cough (similar to a cold)
  • Severe coughing fits
  • Coughing spells lasting for more than six weeks
Make sure children, teens, and adults receive the complete series of vaccines at the recommended ages. Ask your doctor or health care provider if your child is up to date with his/her vaccinations. It can help keep your kids in school – and out of the doctor’s office.

Download Pertussis vaccination information in printable format:
English (Ingles) Version or Espanol (Spanish) Version

HB 1316 - New Vaccine Requirements for Child Care Attendance

Effective September 1, 2005, House Bill 1316 became law. This law requires that children attending child care facilities be vaccinated against invasive pneumococcal and hepatitis A disease. This change will affect children attending pre-kindergarten, Head start, or other early childhood programs.

Immunization Schedules

2009-2010 Texas Minimum State Vaccine Requirements for Students Grades K-12

The following document summarizes the vaccine requirements incorporated in Title 25 Health Services, §§97.61-97.72 of the Texas Administrative Code (TAC).
English (Ingles) Version or Espanol (Spanish) Version

Recommended Immunization Schedule for Persons Aged 0–18 Years

This schedule indicates the recommended ages for routine administration of currently licensed childhood vaccines, as of December 1, 2008, for children aged 0–18 years. Additional information is available at:
www.cdc.gov/vaccines/recs/schedules/child-schedule.htm .
English (Ingles) Version or Espanol (Spanish) Version

To view the most up-to-date immunization recommendations and requirements for school attendance, please visit the Department of State Health Services website.

Immunizations Locations

  1. Your child's Primary Care Physician
  2. San Jacinto School Based Clinic
    800 Spaulding
    San Angelo, TX 76903


    Phone: (325)942-2178
    Fax: (325)942-2179

    Hours of operation:
    M-F, 7:30 am-12:00 Noon and 1:15 pm - 4:30 pm
    Closed for lunch from 12:00-1:15pm

    Please bring a copy of your current shot record. Fee is $15.00.
  3. Tom Green County Health Department
    2 City Hall Plaza
    San Angelo, TX 76903


    Phone: (325)657-4214
    Fax: (325)481-2634

    Hours of operation:
    M-F, 8 a.m.-11:00 a.m. and 1:00 p.m.-4:30 p.m.

    Please bring a copy of your current shot record and social security number. Fee is $15.00
* Note: the flu vaccine is also available at the above locations.

Medications at School

Often, students have to take prescription medications and/or over the counter medications for a certain period of time as treatment for a medical condition.
  1. Prescribed medication must come to school in the original pharmacy bottle with the label on it. This includes inhalers.
  2. If medication is only given 1-3 times per day or time released, it can usually be given at home unless specific times are ordered by the doctor.
  3. Parents must sign a medication consent form before medication can be given at school. The parent’s written request must not conflict with the label instructions.
  4. Any increase or decrease in dosage must be stated in writing by a physician until a new prescription bottle is provided. Otherwise, school personnel must administer medication as it is stated on the container label, or parents may choose to come to the school and dispense the medication to their student.
  5. No medication is supplied by the school
  6. Medication purchased in a foreign country will not be given
  7. Over the counter medication must be in its original container stating directions and dosage. If school personnel reading the label directions find that the medicine is contraindicated for that student, a parent must come to school and administer the medication (ex: if a student is younger than the recommended age on the label directions, school personnel cannot administer the medicine without a physician’s order).
  8. If over the counter medication is given for three (3) consecutive days, a physician’s order is required.
  9. Herbal or dietary supplements will not be administered unless the medication will benefit the student’s educational achievement as stated in the student’s individualized education program (IEP) or Section 504 Plan and is prescribed by a physician.
  10. All medication must be turned in to the office upon arrival on the campus. We do not permit students to carry their own medications and self-administer without prior approval from the physician and the school nurse.
Guidelines for Self-Administration of Asthma Medicine

A student with asthma is entitled, according to House Bill 1688, to possess and self administer prescription asthma medicine while on school property or at a school related event or activity if:
  1. the prescription asthma medicine has been prescribed for the student as indicated by the prescription label on the medicine;
  2. the self administration is done in compliance with the prescription or written instructions from the student’s physician or other licensed health care provider;
  3. a parent of the student provides the school written authorization, signed by the parent, for the student to self administer prescription asthma medicine; and
  4. a parent of the student provides the school a written statement from the student’s physician, signed by the physician that states:
    1. the student has asthma and is capable of self administering the prescription asthma medication;
    2. the name and purpose of the medicine;
    3. the prescribed dosage for the medicine;
    4. the time at which or circumstances under which the medicine may be administered; and
    5. the period for which the medicine is prescribed.
The physician’s statement must be kept on file in the office of the campus the student attends. A person standing in parental relation to a student or the student himself, if over the age of 18, may give permission to use an asthma inhaler under these guidelines.

Sports Eye Safety

More than 40,000 people a year suffer eye injuries while playing sports.  For all age groups, sports-related eye injuries occur most frequently in baseball, basketball, and racquet sports.  Almost 90% of all sports-related eye injuries can be prevented.  Whatever your game, whatever your age, you need to protect your eyes!

The risk of eye injuries can be ranked at three levels, depending on the sport and equipment used:
  1. Low-risk sports do not use a ball, stick, bat, puck, or racquet and do not have bodily contact.  They include swimming, cycling, gymnastics, and running.
  2. High-risk sports use a ball, stick, bat, puck, or racquet and involve bodily contact.  Hi-risk sports include baseball, basketball, football, hockey, tennis, racquetball, golf, fencing, water polo, and more.
  3. Very high-risk sports include bodily contact and feature little or no eye protection.  They include boxing, wrestling, and contact martial arts.
Here is a list of some common sports eye injuries:
  • Blunt trauma injuries (orbital blowout fracture, ruptured globe, detached retina, etc.)
  • Broken blood vessels in the eye
  • Bruising of the eyelids
  • Corneal abrasions
  • Eye swelling
  • Internal bleeding
  • Radiation injuries from exposure to ultraviolet sunlight
Take the following steps to avoid sports eye injuries:
  • Wear proper goggles (lensed polycarbonate protectors) for racquet sports or basketball
  • Use batting helmets with polycarbonate face shields for youth baseball
  • Use helmets and face shields approved by the U.S. Amateur Hockey Association when playing hockey
  • Regular eyeglasses, sunglasses, contact lenses, and industrial or occupational safety glasses are not considered sufficient to protect the eyes during sports
If an eye injury occurs, see an ophthalmologist or go the emergency room immediately, even if the eye injury appears minor.  Delaying medical attention can result in permanent vision loss or blindness.
For more information on eye safety, go to www.aao.org/eyesmart/injuries/sports.cfm .

Screening

Children shall be screened by the school nurse or other school official with consideration for privacy and confidentiality. Screenings may be scheduled or conducted at random throughout the year. When a student is suspected of having head lice, the school nurse or other school official shall inspect the child. When live lice are found, the school nurse or other school official shall check the student's siblings and all known household contacts on campus. Letters shall be sent to the parents of students with active infestations.

Children identified with live lice shall be sent home immediately or excluded from the classroom until treatment is completed by the parents or guardians. The school nurse or other school official shall provide instruction to the parent and/or guardian regarding identification of active infestation, treatment procedures, and readmission guidelines.

Re-Admission

Children who are sent home for head lice infestation must be free of live lice and virtually all nits must be removed from the hair before the student may return to school. When a student has missed five consecutive days of school related to lice infestation, a warning letter shall be sent to the parent to notify them that the student is immediately required to be at school. With excessive absences, both the student and parent can be subject to truancy laws. Procedures are as follows:
  1. When a student is examined by the school nurse or other school official and found to have head lice, the teacher or other office personnel shall be notified. The parent shall be notified, and the student shall be sent home with head lice treatment information.
  2. When the student returns to school (presumably on the next day), the student shall be re-examined. If the student is free of lice and virtually nit-free, the student may return to class. If lice and nits are found, the office and teacher shall be notified. The parent shall be notified and the student shall be sent home again for treatment, if it cannot be determined that treatment was done or with instructions for alternate treatments.
  3. When the student returns to school for the second time, the student shall be re-examined. If the student is free of lice and virtually nit-free, the student may return to class. If lice and nits are found, the office and teacher shall be notified and a referral shall be made to the nurse. The parent shall be notified, and the student shall be sent home with instructions from the nurse.
State Mandated Screenings

Veribest ISD addresses state mandated screening procedures by conducting screens for vision, hearing, spinal (scoliosis and kyphosis) and Acanthosis Nigricans (AN).

Vision and Hearing Screening

  • Any student referred by a teacher, principal, parent and physician.
  • Students referred by Special Education.
  • All students in Pre-K, Kindergarten, 1st, 3rd, 5th, and 7th grades.
  • All students new to the state of Texas.
If a child requires prescription eyewear or hearing aids, please be sure they have these prior to screening dates.

Spinal Screening

Spinal screening was mandated by HB 832. Students must be screened at least twice during the growth years-ages 10-14. Veribest ISD provides spinal screening to all students in the 5th and 8th grades.

Acanthosis Nigricans Screening

Acanthosis Nigricans (AN) serves as an indicator of risk for Type 2 diabetes and other chronic health problems. All students in the 1st, 3rd, 5th, and 7th grades are screened for acanthosis nigricans.

Parents may exclude their child from the screening by providing the school in advance with the results of the screening done by a medical doctor. Parents may also exclude their child out for religious reasons. The religious affiliation of which the student attends is required to submit a notarized letter stating this screening is against their belief.

What You Need to Know About Staph/MRSA Skin Infections
English (Ingles) Version or Espanol (Spanish) Version

MRSA in Schools

Answers to commonly asked questions about MRSA skin infections in schools (from the U.S. Department of Education). MRSA in Schools - Most people have heard of terms like “staph infection,” “antibiotic resistant bacteria,” and “MRSA” (pronounced mersa).  Staphylococcal bacteria often referred to as “staph” are commonly occurring bacteria found on the skin and in the noses of all people.  Most staphylococcal species never cause infection.  However, when infection does occur due to staph, Staphylococcus aureus—one of these species of staph—is usually the cause.  While all people have some staphylococcus species on their skin and in their noses, only one in every three or four people have S. aureus.  Even if they have S. aureus on their skin or in their noses, most people are not ill.  These people who have bacteria but are not ill are called “carriers”.  S. aureus carriers do not have staph infections. When staph does cause infections, it may cause minor skin or soft tissue infections, such as boils or impetigo, which occur spontaneously without an obvious source of infection.  Persons with staph skin infections may complain of an “infected pimple,” “an insect bite,” “spiders bite,” or “a sore.”  Many staph infections cause minor redness and swelling without pain, and infected persons may not seek medical attention.  However, staph infections can cause more serious, sometimes deadly, infections such as abscesses, pneumonia, and soft tissue (wound) and bloodstream infections.  Staph can also cause food borne illness in persons who eat food contaminated with the bacteria. “MRSA” stands for methicillin resistant S. aureus.  Initially, MRSA strains were resistant to the antibiotic methicillin, a form of penicillin.  Now they are resistant to many antibiotics and are sometimes called “multi-resistant” S. aureus.  MRSA is not the only antibiotic resistant bacteria.  Initially, infection with MRSA was associated with exposure to health care environments, such as hospitals.  However, other MRSA strains have evolved that affect previously healthy persons who have not had contact with health care facilities.  MRSA causes the same types of infections as S. aureus that is not resistant to methicillin; however, MRSA may be more difficult to treat and can be rapidly fatal. We cannot eliminate staph because it is everywhere. However, because staph is everywhere and has the potential to cause infection, everyone—not just health care workers—must be involved in prevention. Staph can be transmitted by infected persons and by carriers.  Factors that appear to be related to transmitting staph from one person to another or making a person more susceptible to infection include:
  1. Poor hygiene, especially lack of hand washing
  2. Close physical contact or crowded conditions
  3. Sharing personal products
  4. Contaminated laundry items
  5. Shaving
  6. Lancing (puncturing, picking, piercing) boils with fingernails or tweezers
  7. Activities that result in burns, cuts, or abrasions or require sharing equipment
  8. Intravenous drug use, unsanitary tattoos, and body piercing
  9. Inadequate access to proper medical care
All information contained in this article as well as more detailed information is available at the Texas Department of State Health Services website at www.mrsaTexas.org .

Health Services Forms

                 
                 

Veribest ISD
P.O. Box 490,
10062 F.M. Hwy.
Veribest, TX. 76886
Phone: 325.655.2851
   Fax: 325.653.0551

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