POTS/Dysautonomia

[CanIcallmymom, BSN, RN]

Tell me your experience with POTS and/or Dysautonomia in the school setting.

[OldDude]

Involve all staff with care plan, identify what predisposes an episode, implement preventive precautions, prepare for interventions according to severity of episodes, identify when to call 911.

[CanIcallmymom, BSN, RN]

1 minute ago, OldDude said:

Involve all staff with care plan, identify what predisposes an episode, implement preventive precautions, prepare for interventions according to severity of episodes, identify when to call 911.

Thanks. This student just started yesterday, so I called parents as I saw it listed on his registration paperwork, but I have no other documentation/notification. Parents didn't answer, so I'm hoping for a call back to get some clarification on the details.

[OldDude]

I've had a few over the years and it always seems there's an element of student anxiety...my most recent was a kid who had been in public school in KG/1st grade, somewhere along the way he was pulled out and home schooled until 3rd grade. He was very anxious, and had several episodes of varying degrees. It took most of the school year for him to emotionally adjust and become a "happy go lucky" kid along with the rest of the kids but afterwards he was symptom free...no episodes at all in 4th or 5th grade.

[CanIcallmymom, BSN, RN]

1 minute ago, OldDude said:

I've had a few over the years and it always seems there's an element of student anxiety...my most recent was a kid who had been in public school in KG/1st grade, somewhere along the way he was pulled out and home schooled until 3rd grade. He was very anxious, and had several episodes of varying degrees. It took most of the school year for him to emotionally adjust and become a "happy go lucky" kid along with the rest of the kids but afterwards he was symptom free...no episodes at all in 4th or 5th grade.

That's great! Hoping mine doesn't have severe symptoms at school any longer.

[GdBSN, RN]

I have a few students at my school now with POTS. I encourage students to carry salty snacks, and I keep back-up in the clinic. I list in their accommodations: allow to snack and drink in the classroom, allow them to sit with their legs elevated if needed, move around in the classroom to encourage circulation, and to come to the clinic when requested. If they come to the clinic, I take a full set of VS, and allow them to rest with their legs elevated until they feel better. I'm in HS, so these students are able to describe their symptoms and degree of severity. Also encourage compression stockings to improve circulation. I also see an element of anxiety and exhaustion from school work and activities.

[ruby_jane, BSN, RN]

It's real...but like any disorder, the degree of disorder vs. avoidance of work may be magnified per each child. And by that I mean: do your full vitals assessment but don't be surprised if everything's WNL.

GdBSN gave excellent practical suggestions. Much like my sickle cell kiddos, the POTS kids are worse when they're deyhdrated. Good luck.

[CanIcallmymom, BSN, RN]

Thanks for the great suggestions! I don't think I will see this kiddo unless he actually needs me, after talking to him. I am concerned he may avoid the clinic even when he needs the rest/eval.

[Amethya]

I hate to sound ignorant, but what is POTS- Dysautonomia?

[NutmeggeRN, BSN]

48 minutes ago, Amethya said:

I hate to sound ignorant, but what is POTS- Dysautonomia?

You are not ignorant,. Here are a couple of links for you.

Postural Orthostatic Tachycardia Syndrome

https://www.webmd.com/heart-disease/atrial-fibrillation/postural-orthostatic-tachycardia#1

Dysautonomia

https://my.clevelandclinic.org/health/articles/6004-dysautonomia

[Amethya]

3 hours ago, NutmeggeRN said:

You are not ignorant,. Here are a couple of links for you.

Postural Orthostatic Tachycardia Syndrome

https://www.webmd.com/heart-disease/atrial-fibrillation/postural-orthostatic-tachycardia#1

Dysautonomia

https://my.clevelandclinic.org/health/articles/6004-dysautonomia

Thank you!

[beachynurse, ASN, BSN]

I have seen a significant number of students with this disorder, and the number seems to be growing. I agree that there seems to be elements of anxiety, and or avoidance related to the diagnosis depending on the student. I have also seen it used as attention seeking in some instances. I also have the parents provide salty snacks and have detailed emergency care plans that I provide for the teachers with instructions based on the symptoms that each student presents with.