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Working Together
Health Services and Health Education
2008 ArkAHPERD Conference, Hot Springs, AR
Paula Smith, RNP, MNSc.
State School Nurse Consultant
Arkansas Department of Education
Why are we here?

Share information about select health
topics:
MRSA
 HIPAA/FERPA
 Respiratory emergencies
 Hypoglycemia
 Seizures
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What is Staphylococcus aureus?
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A type of bacteria.
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Known as “staph”
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Very common cause of skin
infections.
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Found on the skin and in the
noses of healthy people.
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MRSA: “staph” resistant to
commonly used antibiotics.
What are the differences…
Hospital Acquired -vs- Community Acquired?
•
Sick
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Health People
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Elderly
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Young
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Recent hospital stay
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Athletes
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Surgery
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Children attending
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Dialysis
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Patients undergoing an
invasive medical procedure.
daycare/school
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Intravenous drug
users
Potential Sites or Sources of Staph
infections
Characteristics of CA-MRSA
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Spreads quickly
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Often looks like a “spider bite”
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Can release very strong toxins that destroy
tissue
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Bacteria is mutating and becoming a more
prominent infection worldwide
CA-MRSA Misdiagnosed
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Commonly misdiagnosed as:
 Simple staph infection
 Spider bite
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Delayed proper treatment leads to:
 Increased chance of spreading infection
to others
 Increased severity of infection
 Increased risk of fatality
How Is MRSA Spread?
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Direct physical contact with someone who has an
open, infected sore
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Direct physical contact with a contaminated
personal item or a contaminated surface
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Sharing needles, drug “works” or tattoo
equipment are particularly high-risk activities
Signs and Symptoms of a Staph Infection
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Small red bumps resembling pimples, boils or
spider bites.
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The site may be warm, red and painful to touch.
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Can turn into deep, painful abscesses.
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Can cause potentially life-threatening infections in
bones, joints, surgical wounds, the bloodstream,
heart valves and lungs.
Minor “Staph” Infection
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Typical infection is in
the form of a boil or
folliculitis.
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Ulcerated wound

Arms and legs are
common sites of
infection.
Staphylococcus aureus
Skin and Soft Tissue Infections
Stop the Spread of MRSA
…
Wash your hands! Wash often
with soap and warm water for
20 sec!
Wash your hands!
Wash your hands!
Keep cuts and abrasions
covered
DO NOT share towels,
personal items, clothing or
equipment.
Stop the Spread of MRSA …
Shower with hot water 
and wash with soap.
Use pump soap, not bar
soap.
Clean and disinfect items
such as gym and
sports equipment.
X
Avoiding Resistance to Antibiotic
Therapy

Do not overuse antibiotics!
 Antibiotics will not help a virus

Take ALL of your antibiotics when on
Antibiotics Therapy!
 Don’t save them for a later date or for
someone else!
HIPAA/FERPA
What is Personal Health Information
(PHI)?
 Who has a “legitimate educational
interest”?
 Who needs to know what?

All personally identifiable
health information is
considered personal and
private and is protected by the
U.S. Constitution, state
constitutions and federal and
state laws.
Confidential vs. Highly Sensitive
School officials MUST treat all personally
identifiable student health information as
confidential and sensitive and protect it
accordingly.
 All personally identifiable records are
confidential, certain records must be
considered “highly sensitive” and less
easily accessed by school officials.

Highly Sensitive Records
Special Education
 Student health
 Third-party medical and mental health
records released to the school for
planning
 Family information provided in
counseling and social work settings.

What can I do?
Treat all students the same
 DO NOT discuss any student with
anyone who does not have a “legitimate
need to know”
 Be careful where conversations about
students occur. Maintain privacy!
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Respiratory Symptoms
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Wheezing (high pitched sound)
Coughing
Can’t speak/can’t cough
Flaring nostrils
Clutching throat/wild gestures
Blueness around lips (late sign)
Excessive drooling
Agitation
Loss of consciousness (late sign)
Sitting up, leaning forward
Head bobbing with each breath
Respiratory First Aid
Maintain CALM
 Ask if the student uses a rescue inhaler
 Call the school nurse
 Maintain ABCs

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Airway, Breathing, Circulation
If experiencing late signs of respiratory
distress, call 911
Hypoglycemia
 Causes:
 too
much insulin,
 not enough food,
 unusual amount of exercise,
 delayed meal.
Hypoglycemia Symptoms
nervousness, headache,
 sweating, intense hunger,
 personality change,
 trembling, weakness,
 dizziness, difficult to awaken
 palpatations, blurred vision, and
 often have trouble speaking.
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Hypoglycemia treatment
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1/2 to 3/4 cup of orange or grape juice (a juice
box is good when you're away from home)
2 glucose tablets or 2 doses of glucose gel
2–4 pieces hard candy
5 gumdrops
1–2 tablespoons of honey
6 oz. regular (not diet) soda (about half a can)
2 tablespoons of cake icing
All of these are 10-15 grams Carbohydrates
Seizures
Treatment:
 Position patient on side
 Do not insert anything in patient’s mouth
 Prevent self-injury to patient, move furniture
 Allow rest period after seizure subsides
 Notify parent & refer for medical care when
indicated
 Call 911 if seizure activity is continuous or nonsubsiding
Resources
Your School Nurse(s)
 Child Abuse Hotline
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Poison Control
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800-482-5964
800-3POISON (376-4766)
American Red Cross
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501-748-1022
Coordinated School Health
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Laura McDowell, Coordinator
Debby Woods, PANT Coordinator
Kathleen Courtney, HIV/AIDS
Joy Rockenbach, Act 1220 Coordinator
Paula Smith, State School Nurse
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2020 W. 3rd St., Suite 320
Little Rock, AR 72205
501-683-3600
www.arkansascsh.org