Health Services

The Fox Chapel Area School District Health Services Handbook was prepared to help parents/guardians understand state-mandated health policies, school district policies related to the health and growth of its students, and to introduce the role of the Certified School Nurse (CSN).

The CSN is an integral part of the educational team, providing guidance to school personnel to ensure that students' specific health needs are met.

• The CSN is dedicated to the emotional and physical well-being of students.
• The CSN must provide, perform, administer, and/or supervise all necessary treatment procedures required by the student population.
• The CSN attends workshops and seminars to keep abreast of current information regarding health problems among student populations.
• The CSN helps provide students with the opportunity to develop sensible self-care skills for responsible lifelong choices.

For special, large, or even small medical problems, you are always encouraged to contact your school's CSN.

The learning environment is best maintained by working with our schools to give children the best chance of success. This includes their best health. Learning is enhanced by wellness.

Help us keep our children well!

Immunization against certain communicable diseases is necessary for a healthier school life.

Under the regulations of the Pennsylvania Department of Health and the Allegheny County Health Department, students entering Kindergarten, seventh grade, 12th grade, and all new students are required to have certain immunizations prior to attending school.

A student must have the required doses complete, or medically appropriate doses up to date, and a plan in place for remaining doses by the fifth day of school, or they are at risk of exclusion. For a single-dose vaccine, the child must receive it before the first day of school, or the child may be excluded from attending. 

Students will only be admitted to school with the required immunizations.

Kindergarten

• Four doses of tetanus, diphtheria and acellular pertussis (one dose on or after the fourth birthday) *
• Four doses of polio (fourth dose on or after fourth birthday and at least six months after previous dose given) **
• Two doses of measles, mumps, rubella (MMR)
• Three doses of hepatitis B
• Two doses of varicella (chickenpox) or evidence of immunity
  *Usually given as DTP or DTaP or DT or Td
  **A fourth dose not necessary if the third dose was administered at age 4 years or older and at least six months after the previous dose.

Seventh Grade

In addition to all other required grade school immunizations:

• One dose of tetanus, diphtheria, acellular pertussis (Tdap) on the first day of seventh grade
• One dose of meningococcal conjugate vaccine (MCV) on the first day of seventh grade
  Note: If a child gains entrance to school in any succeeding year, the same immunizations are required on the first day.

12th Grade

In addition to all other required grade school immunizations:

• One dose of meningococcal conjugate vaccine (MCV) on the first day of 12th grade. If one dose was given at 16 years of age or older, that shall count as the 12th grade dose.

These requirements allow for the following exemptions: medical reason, religious belief, or philosophical/strong moral or ethical conviction. Even if your child is exempt from immunizations, he or she may be excluded from school during an outbreak of vaccine preventable disease.

Proof of immunization must be presented when enrolling in school. Immunization information can be obtained from your family doctor or former school district.

Immunizations that are required for school are available from the Allegheny County Health Department to children that are uninsured, have Medicaid or are an American Indian or an Alaskan native. Call 412-578-8060 for time and location. Any further questions may be addressed to the Certified School Nurse in the building to which your child is assigned.

Parents should notify the school nurse of any immunizations (booster shots) given to the student during the school year. Updated tetanus information is extremely important if your child becomes injured.

Testing Schedules

Pennsylvania school health laws requires physical examinations for students entering kindergarten and first grade, and again in sixth and eleventh grades.

Dental examinations are required upon entering school (kindergarten or first grade) and in third and seventh grades.

Height, weight, and vision screenings are given annually by the school nurse.

Audio screening tests are given in kindergarten and first, second, third, seventh, and eleventh grades.

Body Mass Index (BMI)

Height and weight are measured and recorded annually from kindergarten through twelfth grade. This assists in the evaluation of each child’s growth.

The Body Mass Index (BMI) for age percentile is also calculated and used as a guideline to help assess whether a person may be overweight or underweight.

• BMI less than 5th percentile - at risk for underweight
• BMI between 85th and 95th percentiles - at risk for overweight
• BMI equal to or greater than 95th percentile - overweight

Parents/guardian notification of height, weight and BMI is done yearly.

Scoliosis Screening

Scoliosis screening is mandated in sixth and seventh grades. Scoliosis is a lateral and rotary curvature of the spine, most commonly found during the adolescent growth period. This curve can exist in varying degrees, from very subtle to quite severe.

More Information

Although it is recommended that these state-mandated examinations be conducted by the student’s family physician or pediatrician, they are also provided by the school district with parental written permission and given by an approved physician and dentist.

Those wishing to have the state-mandated examinations performed by their family physician or pediatrician must obtain the required forms from the school nurse. These forms must then be returned to the school nurse upon completion.

Occasionally, parents must make a difficult decision regarding their child’s health and ability to attend school.

When should you keep your child home from school? Following are a few suggestions:

• A fever of 100 degrees or more;
• Vomiting or diarrhea within the last 24 hours;
• A suspicious rash;
• Stomachache or fatigue, accompanied by a fever and/or vomiting;
• A headache lasting 1-2 days, or recurring;
• Red, irritated eyes with pus-like or excessive water drainage; and/or
• Persistent, uncontrollable coughing and sneezing.

Exclusion From School

Students who exhibit signs and symptoms of communicable illnesses will be immediately excluded from school. This includes any student with a temperature of 100 degrees or more. Students will be readmitted only when:

• Free of fever for 24 hours;
• A non-communicable illness has been diagnosed and certified in writing by a physician; and/or
• The child has recovered or received appropriate treatment and is no longer infectious.

The Pennsylvania Department of Health and the Allegheny County Health Department demand exclusion of all students who are suspected of or have been diagnosed as having the communicable diseases listed below.

The Emergency Care Card is extremely important. It is your child’s lifeline from school to you in the event of an emergency situation. A new card having current information is requested each year. Please take the time to complete the front and the back of it. If a parent cannot be contacted during the school day, another local responsible adult (relative or friend) should be designated as an emergency contact. This person must be willing to make decisions regarding your child and should be able to provide the necessary transportation. Please provide us with these individuals’ phone numbers. If at any time during the school year this information should change, please notify the school nurse immediately.

Parents/guardians are responsible for transporting an ill or injured student from the school. If a parent or guardian is not available to transport the student, arrangements for a relative, friend, neighbor, or public transportation must be made by the parent or guardian. The parent is responsible for the cost of transportation arranged through a public carrier or an ambulance in the event of an emergency and transportation to a hospital is required.

It is extremely important that parents notify the school nurse of all changes in their child’s medical status.

The school needs current health information to provide proper care in the event of an emergency.

Please inform the school nurse of:

1. Any chronic medical conditions, such as heart disease, asthma, seizure disorders, bone or joint disorders, etc.
2. Any acute situations (physical, emotional, or personal) which may affect the student’s performance in school
3. All allergies, including bee stings, medications, and food
4. Routine prescribed medications, even those not taken during school hours
5. Any additional vaccinations

All information will be included in the comprehensive and confidential school health record.

Teachers will be notified of special health issues on a need-to-know basis, that is, only when such knowledge may be necessary to ensure the child’s well-being. Seizure disorders, diabetes, asthma, bee sting allergy, and significant food allergies are examples of such health issues.

Medication should be given at home. Should the need arise for a student to be given medication during school hours, these procedures must be followed or medication will not be administered.

1. Written instructions signed by a physician with the diagnosis, medication, dosage, length of time to be given, possible side effects, and parent signature is required for all types of medication. Forms are available from the Certified School Nurse. A medication order and parent permission is required at the start of each school year.
2. It is the parent’s responsibility to maintain an adequate supply of medication throughout the school year.
3. Medications must be brought to the school nurse by the parent/guardian in the prescription-labeled container, or original over the counter container that must remain at school.
4. If the school nurse is not available, the building principal or acting principal will accept and sign for medication.
5. Over-the-counter medication, such as Advil, Tylenol, and cough drops, will not be administered to kindergarten-5th-grade students unless prescribed by a physician. Over the counter and holistic medications not listed on the high school and middle school emergency care card will require a doctor’s order to be administered.
6. The Certified School Nurse will review all new medication requests.
7. The first dose of a new medication: It is the parent’s responsibility to give the first dose when the child is able to stay at home to ascertain the child’s reaction to the medication.
8. Medications will be discarded one week following termination date or conclusion of the school year, unless return is requested by the parent. Medication will be returned to the parent or an adult designee only.

No medication will be administered at school unless all requirements of the medication policy are met.

Children with serious, life-threatening, or potentially life-threatening medical conditions may request that medication be given on a field trip. No other medication will be permitted.

Note: According to the American Academy of Pediatrics, life-threatening conditions may include, but are not limited to, conditions such as: asthma, diabetes, seizure disorders, hormonal disorders, or severe allergy.

Students who do not already have emergency medication on their person, but may require administration of emergency medication on a field trip, will be allowed to carry and selfadminister the medication if the following criteria have been met:

1. The parent/guardian has completed the section of the Field Trip Form Permission Slip that addresses the administration of emergency medication.
2. The student has on file in the nurse’s office authorization for self-administration of emergency medication that meets all the criteria previously addressed in the medication policy. If the school nurse deems the student competent to self-administer his or her medication, he or she will be allowed to take it on the field trip.
3. The medication is currently located in the nurse’s office for use by the student.
4. The student will be responsible for obtaining his or her medication from the nurse on the day of the field trip. The nurse will notify the teacher that the student is carrying the medication.
5. The student is responsible for returning the medication to the nurse upon returning to school.
6. Students who are able to self-medicate may do so with signed parental consent.

Any parent who has a child needing medication in such a situation should contact the Certified School Nurse.

• Parents of students who receive routine medication during school hours may choose to have the child not receive his or her medication on the day of the field trip, or
• The parent may accompany the child on the field trip or may make other arrangements with the principal.

No medication will be administered unless all requirements of the medication policy are met.

First aid and emergency care is help given until further or more advanced treatment is available. Every effort will be made to notify parents or guardians about emergencies. Minor first aid treatment will be administered to all students with injuries or illnesses that occur at school. This may include:

1. Assessment of the illness/injury
2. First aid procedures (wound cleansing and dressing, ice packs, etc.) established by school physician
3. Rest and re-evaluation
4.  Verbal or written notification to parents, when necessary
5. Early dismissal from school due to injury or illness.
6. Emergency medical services will be called when necessary.

Serious illness or injury necessitates parent notification and possible further medical attention. These decisions are at the nurse's discretion, with consideration for the student's needs.

Purpose

The Fox Chapel Area School District is committed to maintaining a healthy environment for students and staff. To fulfill that commitment, the district has established these guidelines for the prevention and control of head lice.

Guidelines

1. If a student is suspected of having pediculosis (head lice), the certified school nurse or designee shall examine the suspected student and the student’s siblings.
2. When pediculosis (head lice) is found, the school nurse shall contact the parent of the student and provide educational materials concerning treatment and environmental control.
3. Following treatment, the school nurse will examine the student’s head prior to readmission to school.
4. If the treatment has been ineffective, the certified school nurse or designee will contact the parent to review procedures.
5. Students who have been identified with pediculosis and have been readmitted after treatment may be checked for re-infestation or at the discretion of the certified school nurse or designee.
6. Students diagnosed with live head lice do not need to be sent home early from school; they can go home at the end of the day, be treated, and return to class after appropriate treatment has begun. Nits may persist after treatment, but successful treatment should kill crawling lice.

When a child is found to have head lice at school, the school nurse will contact the parent or guardian to discuss treating the child at the conclusion of the school day.

If head lice are discovered by you, the parent, please notify either the building principal or school nurse where your child attends. Examine other family members and apply treatment procedures to each infested person. (For children younger than 5, contact your physician for specific instructions.)

Treatment can begin in one of two ways:

1. Contact your family physician for diagnosis and further instructions, or
2. Visit your local pharmacy to obtain an over the counter pediculicide and follow the directions contained within.

There are also commercial companies that can help you eliminate head lice. Two local companies that you can contact are LiceDoctors and Center for Lice Removal.

The control of head lice in home and school or other institutions is similar. Early treatment of infested individuals coupled with a few environmental precautions is the key to interrupting transmission. The infested individual should be treated and personal articles (e.g., caps, combs, brushes, towels, clothing, and bedding) should be disinfected by appropriate laundering, vacuuming, dry cleaning, etc.

The drugs most commonly available for the treatment of pediculosis are shampoos A-200 Pyrinate, Nix, R&C, RID, and Kwell. A-200 Pyrinate, Nix, R&C, and RID can be bought over the counter. Kwell requires a prescription. While these pediculicides rapidly kill immature lice and adult lice, they are not left on the hair long enough to kill eggs. Therefore, the treatment should be repeated in seven to ten days to kill newly hatched lice. (The incubation period for louse eggs is six to ten days.)

Treating the Individual

To treat an infested individual, parents/guardians should:

1. Remove or protect the student’s clothing.
2. Apply an approved pediculicide according to label directions.
3. Have student put on clean clothing after treatment. Removal of nits (with a fine-tooth comb) after shampooing is essential. Nit removal by hand may be required.

Treating the Home Environment

Adult head lice can survive away from a human host for two to three days. Their eggs may lie dormant in the environment for up to 14 days. To reduce the chances of re-infestation from an environmental source, it is important to follow this treatment:

• Clean clothing, fresh bedding, towels, and linens: The person puts on clean clothing and uses fresh bedding, towels, and linens. All clothing (especially coats and sweaters), bedding and other linen which the person used before treatment should be laundered or dry cleaned. One of the following methods should be used:
  • Machine wash on hot cycle: Since heat is lethal to lice and their eggs, many personal articles can be disinfected by machine washing in hot water and/or drying using the hot cycle of the dryer.
  • Dry Clean: Personal articles of clothing or bedding that cannot be washed may be dry cleaned or placed in a plastic bag and sealed for a period of ten days.
• Disinfect combs and brushes by soaking them for one hour in a 2% Lysol solution or heating them in a pan of hot water for 10 to 20 minutes, provided they will not be damaged by heat.

Note: Because pediculosis (head lice) is not transmitted from animals to humans, domestic pets should not be treated.