Overview

In accordance with Texas Education Code §38.208 and §38.221, GISD has adopted a policy that allows trained and authorized school personnel to administer unassigned epinephrine (in the form of auto injector and nasal spray) to someone who is reasonably believed to be experiencing an anaphylactic reaction and to administer unassigned naloxone nasal spray to someone who is reasonably believed to be experiencing an opioid overdose.

Unassigned Epinephrine Protocol

This protocol is to be used in the care of children and / or adults who present with signs and symptoms of a severe allergic reaction while on an GISD campus. Anaphylaxis is a life-threatening allergic reaction that may involve multiple body systems. This is a medical emergency that requires immediate intervention and treatment.

Causes:

• Food allergies (examples may include milk, eggs, peanuts, tree nuts, shellfish, wheat, soy)
• Insect stings (examples may include bees, hornets, yellow jackets, wasps, fire ants)
• Latex allergies
• Medication
• Exercise

Food allergies are the leading cause of anaphylaxis in children. Children who have asthma and food allergies are at greater risk for anaphylaxis and may often react more quickly, requiring aggressive and prompt treatment.
Symptoms of anaphylaxis may include any or several of the following:

• Skin: hives; rash; flushing; itching/tingling/swelling of lips, mouth, tongue, throat; nasal congestion or itchiness, runny nose, sneezing; itchy, teary, puffy eyes; sweating
• Respiratory: chest tightness; shortness of breath; wheezing; shallow respirations; difficulty swallowing; hoarseness; coughing; choking
• Gastrointestinal: nausea, vomiting, abdominal cramps, diarrhea
• Cardiovascular: dizziness; fainting; loss of consciousness; flushed or pale skin; cyanosis; low blood pressure; weak, thready pulse; shock
• Mental: change in level of consciousness; sense of impending doom; crying; anxiety

Treatment:

Epinephrine is the emergency drug of choice for an anaphylactic reaction and must be given immediately. There should be no delay in the administration of epinephrine.

• Administer epinephrine based on individual's weight:

• ·       Epinephrine auto injector (0.15mg IM dose of epinephrine) for children weighing < 66 pounds OR

  ·       Epinephrine auto injector (0.3mg IM dose of epinephrine) for children and adults weighing > 66 pounds OR

  ·       Epinephrine nasal spray (1mg dose of epinephrine) for children 4+years old weighing < 66 pounds OR

  ·       Epinephrine nasal spray (2mg dose of epinephrine) for children and adults weighting > 66 pounds 

• Call EMS (911) and report anaphylactic episode. EMS transport is required after administration of an epinephrine injection.
• Place individual on back with legs elevated. If individual begins to vomit, turn to their side.
• Notify parents / guardians / alternate adults.
• Place AED close to the individual.
• Monitor pulse, breathing, level of consciousness, and progression of symptoms while waiting for EMS arrival. Prepare individual for EMS transport.

Unassigned Opioid Antagonist (Narcan)

Purpose:

The purpose of this policy is to establish guidelines and procedures governing the utilizations of the opioid antagonist Narcan administered by trained staff of Gatesville ISD.

Policy:

All  ISD campuses will stock opioid antagonists (naloxone), for emergency use to assist a student, staff member, or visitor suspected of experiencing an opioid overdose. 

A person or organization acting under a standing order issued by a prescriber may store an opioid antagonist and may distribute an opioid antagonist, provided the person or organization does not request or receive compensation for storage or distribution. Health and Safety Code 483.104

A prescriber may, directly or by standing order, prescribe an opioid antagonist to a person in a position to assist a person experiencing an opioid-related drug overdose. Health and Safety Code 483.102; 22 TAC 170.6

Immunity- A person who, acting in good faith and with reasonable care, administers or does not administer an opioid antagonist to another person whom the person believes is suffering an opioid-related drug overdose is not subject to criminal prosecution, sanction under any professional licensing statute, or civil liability, for an act or omission resulting from the administration of or failure to administer the opioid antagonist. Health and Safety Code 483.106

The District shall purchase and store opioid antagonist medication, such as Naloxone, to assist a person who may be experiencing an opioid-related drug overdose. Designated and trained District employees (may include nurses, school resource officers, school administrators, athletic trainer, and Friends on Duty (FODs)) shall be authorized to administer this medication and may do so only in accordance with a standing order or procedures approved by a physician licensed to practice medicine in the state of Texas.

The Superintendent shall develop administrative procedures addressing acquisition, maintenance, expiration, disposal, and availability of opioid antagonist medication in the District, as well as employee training and emergency notification requirements.

Administration of Narcan:

In case of a suspected opioid overdose, the school nurse or other trained staff should follow the protocols outlined in the Narcan training:

• Call for medical help immediately (dial 911).
• Assess breathing and perform rescue breathing if needed.
• Prepare and administer the Narcan as instructed in training.
• Continue rescue breathing (or CPR if needed) as instructed in training.
• Administer a second dose of Narcan in 3 minutes if there is no response or minimal breathing or responsiveness.
• Place in the recovery position as instructed in training.
• Stay with the individual until emergency medical help arrives.
• Cooperate with EMS personnel responding to the incident.
• Notify the building administrator or designee of the incident.

Follow-up:

The school nurse or trained employee will:

• Ensure that the overdose victim is transported to the emergency department, even if symptoms are better.
• Contact parent / guardian.
• Complete a Report of Narcan Administration and submit to the Texas Department of State Health Services within 10 days of the use of stock Narcan.
• Provide substance abuse prevention resources for the overdose victim and family, as appropriate.

Health Screenings

The state of Texas requires schools to administer basic health screenings to ensure that any students experiencing problems can be identified early and linked to appropriate resources. The school nurse will be conducting the required screenings throughout the school year. In the event that a screening indicates the need for medical evaluation, the parent/guardian will be notified.

If the student has received a hearing, vision, or spinal examination by a medical practitioner within the last year, the results may be submitted to the school nurse in lieu of having the school based screening. If these screenings conflict with the tenets and practices of a recognized church or religious denomination of which the pupil is a member, please submit an affidavit to the school nurse.

Gatesville ISD is pleased to provide these important health screenings for our students. If you have any questions please contact the school nurse on your child's campus.

Additional Information

Vision and Hearing Screening - on the Texas Department of State Health Services website

Spinal Screening Program - on the Texas Department of State Health Services website

Medication Authorization Form

Asthma Medication Form

Food Allergy Action Plan (English)

Food Allergy Action Plan (Spanish)TEA Seizure Management Plan (English)

TEA Seizure Management Plan (Spanish)Medication Policy

Fentanyl Education Resources - Song for Charlie

First Aid for Choking

Medication Safety Video

DHSH Vaping Resources

CDC Vaping Resources

Based on recommendations from the American Academy of Pediatrics (AAP), the Texas Department of State Health Services (DSHS), the Centers for Disease Control (CDC) and the 2013 update to the Texas Administrative Code, Gatesville ISD has updated its Lice Policy to reflect the most current guidelines in the control of lice.

The most important finding from the agencies listed above is that students should NOT be routinely excluded from school due to head lice. The CDC, AAP, and Texas DSHS support that there is little evidence that exclusion from school reduces the transmission of head lice (Texas DSHS, 2007, 2014). Head lice are common for children ages 3-12. Head lice are not a health hazard and are not responsible for the spread of any disease. They are the cause of much embarrassment, misunderstanding, and many unnecessary days lost from work and school. “No-nit” policies which keep students with lice at home do not benefit these students or their classmates and “should be abandoned” (AAP, 2015). The goal of lice prevention and control in schools is to limit the spread of lice from one student to another through accurate diagnosis and meaningful and consistent communication and education (AAP, 2015).

What will the school do if a case of lice is reported or found?

• The nurse’s office will check any student reported to possibly have lice. If active lice or nits (eggs) are found, the parent will be notified. The nurse’s office will provide information to the parents about proper treatment.
• A lice check will be conducted by looking closely through the hair and scalp for viable nits or live lice. Lice and nits (gray colored eggs attached to the hair shaft) are visible to the naked eye. Nits which are further than ¼ inch from the scalp are not considered viable because eggs are laid at the scalp and the lifecycle is short (Nits take 6-9 days to hatch, CDC 2015).
• If no lice or nits are found but the parent or the student reports he or she has recently been treated for lice, the student may be checked again in one week.
• Household members of the student with lice may also be checked at the request of the parent (though parents are encouraged to routinely check their student at home).
• Parents of students in the classroom in which a student was found to have lice will receive written or electronic notice according to Texas Education Code Section 38.031 (updated by 2017 Texas Senate Bill 1566).
• If a student is heavily infested or proper treatment of live lice infestation has not been completed at home, the student may be excluded from school until proper treatment has been completed, at the discretion of the campus nurse.

Tips for Staying Ahead of Head Lice:

• Watch for signs/symptoms of head lice: excessive itching or scratching of the head especially behind the ears and nape of the neck.
• Check family members for lice and nits/eggs at least once a week. It helps to use natural light and a magnifying glass.
• Treat ONLY family members who have lice. Over the counter medications (pediculocides) that kill lice and nits are recommended. Most of these chemicals require 2 treatments 7 -10 days apart.
• Use these specialized shampoos exactly as instructed to be most effective. Use the product over a sink and use a washcloth to protect your eyes.
• Removing all nits (eggs) with a special fine-toothed comb is the most effective way to get rid of all of them. This may be a tedious job.
• Wash infested articles that can be laundered at 130F and dried on the hot setting. This includes hats, bedding, pillows, and clothing.
• Toys, personal articles, bedding, other fabrics, and upholstered furniture that cannot be laundered with hot water and a dryer or dry-cleaned should be kept away from people (in a plastic bag) for more than 2 days if there is a concern of infestation.
• Head lice can live for 1 – 2 days away from the scalp but chemical treatment of the environment is not necessary. Instead vacuum floors, carpets, mattresses, and furniture.
• Continue to check the head daily for 2-3 weeks after discovery. Removing nits EVERY day for 3 weeks is the MOST effective treatment.
• Help prevent lice infestation by encouraging your child not to engage in activity that causes head-to-head contact (ex- sharing hats, hoodies, brushes, etc).

References:
American Academy of Pediatrics

Head Lice PEDIATRICS 2015; Vol. 135 published online April 27, 2015, 31355-1365; DOI: 10.152/peds.2015-0746

Center for Disease Center for Disease Control

Parasites-Lice-Head Lice – updated 6/4/2024

National Association of School Nurses Head Lice Management in the School Setting (Position Statement). Adopted: 1999; Revised: 2004, January 2011, January 2016

Texas Administrative Code, Title 25, Part 1, Chapter 97, Subchapter A, Rule 97.7, Update 2013

Texas Department of State Health Services

• Recommendations on “No-Nit” Policies in Schools, September 2007
• Managing Head Lice in the School Setting and at Home, November 2014

Gatesville ISD Head Lice Policy, Facts & Treatment

Head Lice Facts & Treatment

Headlice Classroom Letter