Jr high emergencies

[luvmysoldier]

What type of emergencies do school nurses(lvn) get at the jr high level and how do you handle it? How do you determine whether or not a child should be sent home?(besides the obvious signs fever,diarrhea)

[NutmeggeRN, BSN]

Off the top of my head

Fractures (especially open), severe concussions, uncontrolled asthma episode, epi pen administration, seizure (no known hx), glucagon administration, diastat or midazolam for seizures- all definite EMS calls

When they cannot control a cough, they are disruptive to the classroom and are clearly not geting anything out of being there, vomiting, uncontrolled blood sugars-when they need intense management by a parent.

[mycsm]

concussions...sprains, fractures, asthmatic attacks...

not an emergency but to a teenage girl...menses leaking through her pants= MAJOR EMERGENCY!

[JenTheSchoolRN, BSN, RN]

Yes, I agree that period leakage is a MAJOR EMERGENCY to every middle school girl, lol!

I'd add acute abdominal pain to the list for EMS - I mean severe pain, can't get up. Happened to a student for me this year, couldn't reach parents, kid down on the floor. EMS call. (Kid had hx of severe constipation; I thought the student might have an impaction - student did.)

As for home calls, beside the obvious (fever, severe diarrhea, witnessed vomiting, injury that needs x-ray), you get a feel for what else warrants dismissal. NutmeggeRN mentioned a few above, but I also take a closer look at a student that come to my office in April and has never been there before. May not be running a temp, states they are nauseous, and they just look "off." Those are case-by-case, and I usually end up calling home to check in with parent/guardian and usually the student is dismissed.