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Clinic Manual

(subject to revision as needed, at nurse/administration discretion)

Screenings 

**all screenings and immunizations are mandated per Texas law**

Vision and Hearing Screening

Vision and hearing screenings will be conducted in the Fall of each school year for all children 4 years and older before September 1st, Pre-K, Kindergarten, 1st, 3rd, 5th and 7 graders. 

These screenings will also be conducted on all new incoming students without prior record of such screenings having been done at the legally defined intervals in the state of Texas.

Acanthosis (Diabetes) Screening

Screening for diabetes will be done on children in 1st, 3rd, 5th and 7th grade. This is a visual exam typically done with vision or hearing screens. 

Scoliosis Screening

Males aged 13-14 years, or in the fall semester of 8th grade, will be screened one time for scoliosis.

Females will be screened twice. Once at age 10 (or fall semester of 5th grade), and once at age 12 (or fall semester of 8th grade). 

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First Aid

Scratches and Scrapes

On a visit to the clinic all cuts and scrapes will be evaluated. On a case by case basis, basic first aid will be administered. This may include, but is not limited to:

-cleansing with soap and water

-use of hydrogen peroxide, as an antiseptic cleanser

-use of triple antibiotic ointment

-possible application of various types of bandages

Bumps and Bruises

All injuries will be assessed with special attention to the bodily location of injury. Most bumps will not be serious, but in the unlikely event there is a serious injury, a child’s parents will be notified. Head injuries will always need evaluation in the nurse’s office, and parents will be notified every time a child has any type of bump or injury to the head. 

Other parts of the body will be evaluated and possibly reported to parents at the discretion of the nurse or administrator evaluating the child. 

Upon assessment, treatments may include:

-rest

-elevation of an extremity

-ice pack application

-medication for pain (only with parental consent)

Any injury with abnormal neurological assessment, especially to the head, will always warrant a call to emergency services. 

Sprains and Breaks

With any suspected sprain or break, parents will be notified immediately. Emergency services may be called, depending on the extent of the injury. 

In the clinic, the student will be assessed for:

-range of motion

-pain scale

-any evidence of fracture or compound fracture(when bone has gone through skin)

-any excessive bleeding from a compound injury

-any neurological abnormalities

Emergency services will always be involved if a compound fracture occurs. These types of fractures need immediate medical attention. 

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Illness

Fever

Any student presenting to the clinic with a fever greater than 100*F will be sent home with instructions not to return until they have been fever free for 24 hours, without the use of fever reducing medications.

Elevated temperatures, above 98.6*F, will be evaluated on a case by case basis. Elevated temperatures with other symptoms of sickness may also be sent home at nurse’s discretion.

Vomiting

Smaller children sometimes regurgitate. This usually happens after eating, playing or laughing, and is not actual vomiting, but due to the valve between the stomach and esophagus not being fully formed. This is not a reason for exclusion from class. Water will be given with a 15 minute rest break.

Actual vomiting involves other symptoms, and is likely not related to recent eating. A vomiting child looks unwell, and has symptoms such as:

-headache

-fever

-diarrhea

Any child presenting to the clinic with vomiting will be sent home with instruction to exclude themselves from school until symptom free for 24 hours without the use of medication.

Stomach Ache

Any child presenting with a stomach ache will be assessed for fever and other symptoms. If no symptoms or fever exist, water will be given and the child will be sent back to class. 

If other symptoms exist, the child will likely be sent home. 

There is not anything in the clinic that can be given for a stomach ache.

Diarrhea

A child with 2 or more loose stools will be sent home. Diarrhea is a symptom of illness, and children with diarrhea should remain at home until no longer affected, without the use of antidiarrheal medication. Nothing can be given in the clinic for diarrhea.

Sore Throat

Throats get sore for many reasons. A visit to the clinic with a sore throat will warrant an assessment of the following:

-if cough, fever or other symptoms present

-if there is redness or pustules in the throat

-has the student been outside in the cold weather

If there are at least 2 other symptoms present, or just a fever present, the student will be sent home. 

Earache

Any earache will be assessed for signs of infections with an otoscope. If any signs of infection are present, the parent will be notified, and a decision will be made if the student may remain at school. If fever accompanies the earache, the student will be sent home. 

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Pain

Headache

Water will always be given to the student in the event of a headache. Most of the time, dehydration is the cause of the headache. If the headache persists, a parent or guardian may give permission to BVISD staff to administer acetaminophen or ibuprofen according to the label for appropriate age. 

Body pains and aches will be treated in the same manner.

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This and That

Skin Conditions

Many skin conditions are contagious, and can be passed easily between students. Most conditions only require 24 hours of antibiotics or medications before returning to school. Other conditions require lesions to be crusted over or be covered before returning to school. Examples of conditions are as follows:

-Coxsakie (Hand Foot and Mouth)

-Herpes Simplex

-Varicella (Chicken Pox)

-Impetigo

-Scabies

-Staph infections

-Scabies

-Tinea (Ringworm)

If a child is diagnosed with any of these conditions, the school must be notified immediately. A recommendation will be made about returning to school, based on the condition.

Lice

Students who are discovered to have lice at school will not be excluded from class that day. 

They will be required to receive treatment before returning to class the next day. An FDA approved treatment should be used according to the instructions it comes with, or instructions from a licensed provider. Students do not have to be nit-free to resume classes. Treatment should continue if any new live bugs are seen. 

Eye Discharge/Infection

Any child with purulent drainage from eyes will be required to be seen by a provider before returning to school. Children diagnosed with any eye infection will need to remain home until seen by a provider, and released by that provider to return to school. 

Cardiac Events

Any type of cardiac event will immediately require involvement of emergency personnel. Four defibrillation devices are located on campus, and will be used if such an event occurs.

For more information on this, please defer to the nurse’s office or administration offices. 

Over the counter medications that may be administered are as follows:

Alcohol/Alcohol Prep Pads —-----------  Cleansing/ antiseptic

Aloe Gel—--------------------------  Sunburns

Anti-fungal Cream—------------------   *Fungus/ringworm

Benadryl Cream/Spray—--------------- Topical reactions( mosquito bites, ETC)

Calamine lotion—--------------------  Skin irritation

Cough Drops—-----------------------Cough

Eye wash solution—-------------------Eye irritation

First Aid Cream—---------------------Cuts and Scrapes

Hydrocortisone Cream—--------------- Skin Rashes

Hydrogen peroxide—------------------ Antiseptic Cleansing for skin abrasions

Lice Spray/shampoo—----------------- Lice control

Lip Balm—-------------------------- Dry Lips

Peppermints—----------------------- Nausea/upset stomach

Petroleum Jelly—--------------------- Chapped skin/lips

Saline Solution—--------------------- Contact lens care

Sting Kill—--------------------------Insect bites

Triple Antibiotic Ointment—------------*Impetigo/skin abrasions

Acetaminophen(Tylenol)--------------- **Head/body aches, cramps

Ibuprofen (Advil)--------------------- **Head/body aches, cramps

**Acetaminophen and Ibuprofen will NOT be given for temperature. Any other reason will be at the discretion and judgment of the nurse. WILL ONLY BE GIVEN WITH PARENT’S PERMISSION

Emergent Medications

In addition to the medications listed above, Narcan spray, epinephrine pens and albuterol inhalers will be kept in the school clinic for strict emergency use only. 

Narcan is used for suspected drug overdoses, and is administered nasally as a spray. 

Epinephrine is used for severe allergic reactions, and is administered as an injection. 

Albuterol is used for severe asthma attacks, and is administered orally as an inhalation spray.

These medications are kept on campus as a resource in the event of an emergency. Any questions may be directed to the nurse or administration. 

Any type of ingested medication, or topical medication outside of basic first aid will ALWAYS warrant a call to a parent before administering, except for certain life saving situations.

These medications are approved and validated by the standing medical orders from Cactus Health Services.

Any type of ingested medication, or topical medication outside of basic first aid will ALWAYS warrant a call to a parent before administering.

Cactus Health Services in Fort Stockton, TX is the medical director for BVISD. Standing orders are obtained from them yearly, and posted in the school clinic. 

Their information is as follows:

Cactus Health Clinic

700 North Main

Fort Stockton, TX 79735

432-336-8110

As always, health and safety is a priority at BVISD!