Health Services Protocols

An AED will be maintained on the premises of each Calhoun County School campus. The AED shall be used in emergency situations warranting its use by individuals specifically trained in the use of the device. The Health Services Director will be responsible for coordinating the AED program, communicating with appropriate local physicians and/or emergency medical service providers, and for advising the Superintendent in developing, implementing, and publishing procedures and guidelines for AED use in school system facilities. 

Authorized personnel who have successfully completed appropriate training and/or any volunteer responder who has successfully completed an approved CPR/AED training program and has a current course completion card are authorized AED users. Signage and/or publications in school buildings shall identify the location of AEDs.  School system office personnel are responsible for receiving emergency medical calls from internal locations, contacting the EMS (911) if required, and deploying the school nurse and/or AED/CPR-trained staff members to the location of the emergency. 

Initial training in first aid/CPR/AED use will be conducted through the American Red Cross or American Heart Association. Designated staff members will renew CPR/AED training annually. The Health Services Director will keep training records. 

Reference(s): Code of Alabama 16-11-12, Alabama Legislative Act 2009-754

View the Calhoun County Schools AED Guidelines/Protocol here.
 

Anaphylaxis is a severe allergic reaction that is rapid in onset and may cause death. Allergic reactions to foods have become the most common cause of anaphylaxis in community health settings. Studies indicate that anaphylactic events related to the accidental consumption of food allergens in school settings are not rare. In addition, severe and potentially life-threatening reactions (anaphylaxis) can occur in schools when children with no previous diagnosis of food allergies are exposed to allergens at school and have an initial anaphylactic event. 

It is the protocol of the Calhoun County School System that an Anaphylaxis Preparedness Program be implemented as part of the school health services. The program shall incorporate three levels of preparedness: 

•  Level I Primary Prevention: Education programs that address food allergies and anaphylaxis through both classroom and individual instruction for staff and students. 
•  Level II Secondary Prevention: Identification and management of chronic illness which could lead to anaphylaxis. 
•  Level III Tertiary Prevention: The development of a planned response to anaphylaxis-related emergency in the school setting.

Calhoun County Schools, in collaboration with a supervising physician, shall develop and maintain a protocol for emergency response that shall include a supply of premeasured auto-injectable epinephrine on each school campus, to treat potentially life threatening allergic reactions. 

References:    Code of Alabama 16-1-48(D)
Alabama Legislative Act 2014-405
Alabama Act No. 2019-456 (Kyle Grady Act)
 

Carrying too heavy of a backpack may affect children’s health and have long term effects.  Research shows that children carrying more than 10% of their body weight is damaging to their spinal and postural health.

What are the possible problems related to carrying heavy backpacks?

• Strain to the shoulders and back affecting overall ease of movement and causing pain/discomfort
• Affects balance and posture
• Spinal problems such as:  scoliosis (crooked spine) and disc degeneration
• May alter nerve communication
• Pull bones out of alignment by stretching ligaments/muscles

What should I do?

• Your backpack should weigh no more than 10% of your body weight
• Make sure you wear your backpack with both straps over your shoulders.  Wearing your backpack over just one shoulder puts your spine out of balance and stresses that side
• See your physician or chiropractor for an exam for early detection or if you are symptomatic
• For more information view applicable law documents at ALSDE Health Laws & Policies.

Choking is the fourth leading cause of accidental deaths in the US and is considered a common and life-threatening form of an emergency.  The Calhoun County Board of Education has chosen to have anti-choking devices (LifeVac) available at each of our school campuses. 

A LifeVac is a non-invasive, non-powered, portable Airway Clearance Device (ACD) that removes objects like food or toys from a victim with airway obstruction.  This device does NOT replace the traditional Heimlich Maneuver as the first line of defense but is an alternative in the event that the Heimlich Maneuver fails to expel the object and EMS is not on site.

Authorized personnel who have successfully completed appropriate training are authorized users.  This training (along with the Heimlich Maneuver) will be conducted by the Health Services Department and/or licensed school nurse.  

Choking Protocol

CHOKING Responsive Child or Adult Speaking, Breathing and/or Coughing
Child (ages 1-8) and Adult (age 8 and older)
1.       If individual can breathe, cough, or speak, do not interfere.
2.       Stay with the individual. Encourage them to cough out the obstruction.
3.       If individual cannot clear airway by coughing, is unable to speak, breathe, or cough, or if breathing and coughing become weaker and more difficult, call 911 and see Responsive Child or Adult Unable to Dislodge Object.
 
Responsive Child or Adult Unable to Dislodge Object Difficulty Breathing, Weak/Faint Cough, Difficulty Speaking
Child (ages 1-8) and Adult (age 8 and older)
1.       Universal sign of choking: individual clutching neck
2.       Ask individual, “Are you choking?”
3.       Perform Heimlich Maneuver/abdominal thrusts if any of the following are present:

• Unable to speak;
• Weak, ineffective cough;
• High-pitched sound or no sound while inhaling;
•  Increasing difficulty breathing; or
• Blue lips or skin.

4.       If someone is with you, have them call 911.
5.       Heimlich Maneuver or Abdominal Thrusts (see diagram)

• Stand behind individual.
• Wrap arms around waist.
• Make a fist with one hand.
• Place thumb side of fist against middle of the abdomen, just above navel and well below lower tip of breastbone.
• If individual is pregnant or obese, use chest thrusts instead of abdominal thrusts. Stand behind individual, wrap arms around chest, position hands (one in fist, the other grasping it) on center of breastbone, between nipples. Deliver set of 5 chest thrusts until object is expelled or victim becomes unresponsive.
• Grasp your fist with your other hand.
• Provide quick upward thrusts into individual’s abdomen.
• Repeat thrusts until the individual coughs up the object or becomes unresponsive.

6.       If individual coughs up object and is coughing, breathing, and speaking normally, watch the individual to make sure he or she continues to breathe easily.
7.       If victim becomes unresponsive, place appropriately sized LifeVac mask on victim’s face with a C-clasp to create a seal and press down and rapidly pull back plunger. 
8.      If a call has not been made, call 911 now. 
9.      If individual becomes unconscious, see Choking Unresponsive Child or Adult
 
Choking: Unresponsive Child or Adult Unable to Dislodge Object
Child (ages 1-8) and Adult (age 8 and older)
1.       If you are alone, call 911. If someone is with you, have them call 911.
2.       Begin CPR (see CPR) starting with chest compressions and activate the emergency response system.
3.       Every time you open airway to provide rescue breaths, open the mouth widely. Quickly look for a foreign body. If you see an object in the throat, remove it. Do not perform a blind finger sweep.
4.       If you do not see an object, try 3 plunges with LifeVac, if object not dislodged, resume CPR for 2 minutes, then try LifeVac again. 
 
NOTE: You can tell you have successfully removed an airway obstruction in an unresponsive victim if you:

• Feel air movement and see the chest rise when you give breaths.
• See and remove a foreign body from the victim’s mouth.
• Continue to provide CPR or rescue breathing as needed if victim remains unresponsive.
• If victim responds, they must seek medical attention immediately.

View the Calhoun County Schools Choking/Lifevac Protocol here.

Policy 6.04
Original Adopted Date: 06/06/2023 | Last Reviewed Date: 06/06/2023

Drawing on such medical and other authoritative publications and resources as may be available, the Board will:
a. Develop materials and information that are designed to educate students and their parents or guardians about the nature of concussion and brain injury and the risks of continuing to participate in athletics after receiving a concussion or brain injury;
 
b. Suitably summarize such materials on a concussion and head injury information sheet which is to be provided annually to current and prospective student athletes and their parents or guardians.  Prior to the student’s participation in practice or competition, the head coach of the team must obtain and keep on file a copy of the information worksheet signed by the team member and his or her parent or guardian.
 
c. Develop a program designed to educate coaches on how to learn to recognize the symptoms of a concussion and how to seek proper medical treatment for a person suspected of having a concussion.  The training shall be provided by qualified medical personnel or persons with special expertise in recognizing and responding to concussions and brain injuries, and shall be offered to every coach prior to the beginning of practice for the athletic team that he or she coaches.
 
d. Promulgate or otherwise inform coaches of the statutory requirement that a youth athlete must be removed “from participation and may not return to play the day of the injury and until the athlete is evaluated by a licensed physician and receives written clearance to return to play from a licensed physician.”
The Board may use information and forms prepared by the Alabama High School Athletic Association as they may be revised from time to time, but nothing in any such materials should be interpreted or otherwise understood to create a duty or standard of care on the part of any person charged with its implementation.

[Reference:  Ala. Code §22-11E-2 as amended by Act of Alabama 2012-314]

Concussion Law - ALSDE
 

The Calhoun County School System has implemented the Alabama Safe at School Act for Diabetes Education, awareness, and levels of training. All standards of practice and guidelines set forth by the Alabama State Department of Education are followed within Calhoun County Schools. Appropriate documentation and training of the program are kept with the Health Services Director.

Reference(s): Alabama Legislative Act 2014-437

ALSDE and Alabama Health Services Diabetic Curriculum

Alabama Delegation Chapter
 

It is Alabama Law that every student prior to entering kindergarten or first grade or prior to re-entering the higher grades of school,  shall provide/have an up-to-date Certificate of Immunization (“Blue Card”) detailing proof of immunization, or a Certificate of Exemption (Religious or Medical) issued by the Alabama Department of Public Health. 

A written objection from the parent or guardian based on religious tenets and practices shall be submitted in person by the parent or guardian to the Calhoun County Health Department for issuance of a Certificate of Religious Exemption.  The Certificate of Religious or Medical Exemption must be on forms issued/approved by the Alabama Department of Public Health in order to be in compliance/accepted in lieu of Certificate of Immunization. 

Immunization certificates are available from the Calhoun County Health Department located at 3400 McClellan Blvd, Anniston (256-237-7523) and from local physicians or military clinics.
 

Immunization Law - ALSDE

What is influenza disease?

• Influenza (flu) is a contagious respiratory illness caused by a virus.
• The virus infects the nose, throat, and lungs.
• It can cause mild to severe illness, hospitalization, and even death.

What are the symptoms?

• Anyone can get flu and it strikes suddenly and can last several days.
• Symptoms of flu disease may include:
  • Fever or feeling feverish/chills
  • Cough
  • Sore throat
  • Runny or stuffy nose o Muscle or body aches
  • Headaches o Fatigue (very tired)
  • Vomiting and diarrhea

How does influenza disease spread?

• Flu is spread by:
  • An infected person’s droplets from cough, sneeze or talk enter the mouth, eye or nose.
  • Touching a surface or object with flu virus on it and then touching mouth, eyes or nose.
• An infected person can infect others 1 day before symptoms start and up to 5 to 7 days after symptoms start.
• Some people, especially young children and people with weakened immune systems, might be able to infect others for an even longer time.

How do I prevent the flu?

• Get a yearly flu vaccine.
• Wash your hands properly and often.
• Cover your cough and sneeze with arm.
• Clean and sterilize surfaces.
• Stay home if you are sick.

Where can I find more information?

• Ask your doctor.
• Call the Alabama Department of Public Health, Immunization Division, at 1-800-469-4599.
• Go to cdc.gov and type influenza in the SEARCH box.

Who should get the influenza (flu) vaccine?

• The flu vaccine is recommended every year for everyone age 6 months or older.

Who should be vaccinated against influenza because they are at increased risk?

• Children 6 months of age through 5 years Adults 65 years of age or older
• Pregnant women
• Residents of nursing homes and other long-term care facilities
• People who have medical conditions including the following:
  • Asthma
  • Chronic lung disease
  • Heart disease
  • Blood disorders (such as sickle cell disease)
  • Kidney disorders
  • Liver disorders
  • Weakened immune systems due to disease or medication (such as HIV/AIDS or cancer)
  • People younger than 19 years of age who are receiving long-term aspirin therapy
  • People with extreme obesity

What are the common vaccine side effects and risks?

• Flu vaccines are safe, but some side effects can occur.
• Minor problems following the flu vaccine include soreness, redness, and/or swelling from the shot, hoarseness, sore, red or itchy eyes, cough, fever, aches, headache, itching, and fatigue.
• More serious problems may include Guillain-Barré syndrome (GBS) in fewer than 1 or 2 cases per one million people vaccinated, children receiving multiple vaccines slightly increase in fever with seizure.
• People who should not get the flu vaccine include anyone with severe, life threatening allergies, had GBS before, or not feeling well the day of vaccination.

Where can I find more information?

• Ask your doctor.
• Ask you school nurse.
• Call the Alabama Department of Public Health, Immunization Division, at 1-800-469-4599.
• Go to cdc.gov and type influenza in the SEARCH box.

Alabama Department of Public Health
Immunization Division, 201 Monroe St, Montgomery, AL 36104
1-800-469-4599 www.adph.org/imm 2/29/16

The Alabama Board of Nursing, Alabama State Department of Education, and Calhoun County Board of Education have strict guidelines regarding medications in the school setting.  Administration (including self-administration) of medication is allowed in accord with state law and as outlined in the Medication Procedure located in the Student Handbook and Code of Conduct. 

Reference:  

Code of Alabama  16-1-39
Code of Alabama 16-11-9
Alabama Act No. 2019-456

Medication Delegation Act

Self Administration Act
 

The Jessica Elkins Act (2014-274) provides awareness and vaccine information regarding meningococcal meningitis disease and its vaccine to parents and guardians of students.

For information regarding immunizations, meningitis, and flu, please visit the ALSDE Immunizations Page, and click on the appropriate tab.

Meningococcal Disease information

 

Calhoun County Schools will stock Naloxone for Opioid overdose in accordance with the Alabama Department of Public Health and Alabama State Department of Education. Appropriate documentation and training of the program are kept with the Health Services Director.

References(s): Code of Alabama 16-11-9 Alabama Legislative Act 2016-307
 

ALSDE and Alabama Health Services Training
 

Student participation in and travel to off-campus events, concerts, functions, and activities, and the use of school buses or other Board provided transportation for such purposes may be authorized under and subject to the following terms and conditions:

a. The destination is an activity, event, or function that services a bona fide educational or related extracurricular purpose, or is an athletic event or function sponsored or sanctioned by the school or the school system and the state athletic association;
 
b. Adequate information regarding the trip (e.g., destination, duration, purpose, educational purpose, mode of transportation, nature and extent of student participation) has been provided and field trip/bus request form completed with minimum of two weeks prior to off campus event.
 
c. Adequate arrangements are made for supervision and other risk management considerations (e.g., parental permission, special insurance requirements, medical treatment authorization and any health requirements as deemed necessary by the school nurse and Health Services Director).
 
d. Properly certified and qualified drivers have been selected and arrangements for the costs of the trip (e.g., salary, fuels, maintenance, lodging) have been made to include potential health related coverage.
 
e. Approval of the trip is obtained from the Board or authorized Board personnel.
The Board does not assume responsibility for ensuring the safe operation of vehicles that are not owned or operated by the Board.

The Superintendent is authorized to develop additional specific requirements for participation in and travel to and from official events and activities that are consistent with the terms of this policy.

Field Trip Procedures

Extended Hours/Non-School Day Procedures
 

The Health Services Department Of Calhoun County Schools has completed a review of scientific research related to head lice.  This information was developed based on current research and knowledge obtained from guidelines set forth by the American Academy of Pediatrics, the Centers for Disease Control, the National Institutes of Health, the National Association of School Nurses and the Alabama Department of Public Health.  

These efforts have culminated in the creation of procedures related to the management of head lice in school.  The current recommendations using evidence-based practice states that students with eggs (nits) and/or head lice should remain in school and not be immediately excluded. 

View the Calhoun County Schools Head Lice Guidelines/Protocol here.

Calhoun County Schools follows the most current CDC's respiratory virus isolation guidance for illnesses such as COVID-19, Influenza (Flu), and Respiratory Syncytial Virus (RSV).

For respiratory illnesses such as COVID-19, Flu, or RSV, individuals may return to school and normal activities if the following is true for at least 24 hours: symptoms have mostly resolved with overall improvement and if a fever was present, the fever has been gone without use of fever-reducing medication.

Please reach out to your school nurse with any questions as to when your child can return to school and other school sponsored activities.

For more information, please see the CDC website pages regarding COVID-19, Influenza (Flu), and Respiratory Syncytial Virus (RSV).
 

The Alabama State Department of Education and Alabama Department of Public Health require that school districts in Alabama offer and provide scoliosis screening for male and female students in grades 5 through 9. Screening is performed by observing the spine, viewing the student from the back, side, and front, and also from all sides with the student bending forward. A device known as a scoliometer (a type of level for the spine) may be used to determine any abnormal degree of curvature. Parents/Guardians of students found to have signs of a possible spinal abnormality will be asked to see their own physicians for further evaluation. Girls and boys will be screened separately to ensure privacy.  It is recommended that your student wear a snug-fitting undergarment, such as a tank top or fitted t-shirt, under their clothing the day of the screening.  
If your child is currently under treatment for a spinal deformity, please let us know and your child will be exempt from the screening process. 

Please be advised that this is an opt-in only. You will be notified by letter and/or the school notification platform when the screening will take place.  A permission form “opting in” must be completed and turned in prior to your child being screened.  (Copy of the Authorization form is located on the Health Services web page under “Parent Information”. )

ALSDE and ADPH Scoliosis Guidelines

 

The Alabama Health Services Seizure Safe Schools Curriculum is the school nurses' training program that provides a framework for local school districts to implement the Alabama Seizure Safe Schools Act (Alabama Act No. 2021-76). This act allows registered nurses to delegate to unlicensed school personnel in the school setting the nursing act of administering pre-measured medication for the treatment of a seizure to students. This curriculum was developed to ensure that local school districts are adequately prepared to delegate the administration of seizure medication to school-age children with epilepsy and to provide continuity in training school personnel. The Alabama State Department of Education (ALSDE), in collaboration with the Alabama Board of Nursing (ABN), developed a standardized training program for registered nurses to educate and validate the competency of those unlicensed school personnel to whom administration of medication may be delegated. The purpose of this curriculum is to provide a standardized, evidence-based training program for the school registered nurse to utilize in training seizure management and medication administration to unlicensed personnel in schools. According to the Alabama Board of Nursing (ABN) Administrative Code § 610-X-7.-10(5)(c), rectal medications are not delegated in the school setting.

Seizure House Bill

ALSDE Safe School Seizure Curriculum

Current USMA's:

Danielle Brady
Lena Calloway
Tessa Chambless
Theresa Cunningham
Paula Dickeson
Jennifer Faulkner
Brad Hood
Tonia Lipham
Tony McCarley
Cam McCombs
Robert Parnell
Kama Underwood
Jonathon Williams

The teacher, principal or nurse shall isolate a student who becomes ill while at a school until the student can be removed. (See “How Sick is too Sick” located on the Health Services tab of the CCBOE website as well as at each local school) 

No internal medicine of any kind may be given to a student without the state required authorization forms as outlined in Medication Policy and Procedures. 

The following procedures shall be followed when a student is injured on any Calhoun County School Campus: 

• First aid shall be administered by the nearest person with first aid training and 911   Emergency will be called if the situation is threatening. 
• The school shall attempt to notify the student’s parent(s)/legal guardian immediately. 
•  A student shall be taken to the emergency room of a hospital when a threatening situation occurs. Discretion shall be used in moving a critically injured student without medical advice. 
•  A serious injury to a student shall be reported immediately to the principal who shall make a prompt report by telephone to the Superintendent or designee. 
•  An accident report shall be filed when an injury occurs, including a detailed description of the accident and a list of witnesses.

References: Code of Alabama 16-11-9
 

Requirements
Permitted Products: Students may possess and use FDA-regulated over-the-counter sunscreen at school and school events.

Authorization:

• A Parent Prescriber Authorization Form must be submitted to the school nurse if a school employee is requested to apply sunscreen.
• Parents/guardians are responsible for providing sunscreen.
• Sunscreen Criteria:
• Must be safe for the child’s age.
• Must be in the original container and labeled with the child’s full name.
• Must be within the expiration date.
• Aerosols and combined sunscreen/insect repellent products are prohibited.
• Chemical agents containing Oxybenzone are not recommended; Zinc Oxide or Titanium Dioxide are preferred.
• Must provide broad-spectrum coverage (UVB and UVA protection) with an SPF of 15 or greater.

Allergy Testing: Sunscreen should be applied at home at least once prior to school use to test for allergic reactions.

Annual Update: The Prescriber/Parent Authorization Form must be updated annually.

Sun Protection Recommendations

• Shade: Avoid sun exposure during peak hours (10 AM - 4 PM) and seek shaded areas.
• Clothing: Wear protective clothing (long-sleeved shirts, tightly woven fabric, UV-protective clothing).
• Hats: Use a wide-brimmed hat to shade the face, ears, and neck. For baseball caps, protect the ears and neck.
• Sunscreen Provision: Parents/guardians must provide labeled sunscreen. The school will not stock or share sunscreen.

Application Guidelines

• Timing: Apply sunscreen 20-30 minutes before going outdoors for effective absorption. Reapply every two hours, or more frequently if swimming or sweating.
• Coverage: Apply to all exposed skin areas. School-age children may apply sunscreen to themselves with adult supervision.
• Amount: Use 1-2 ounces for adequate coverage.
• Avoid Reflective Areas: Limit time in reflective areas (e.g., water, sand) to prevent sunburn.

For more information, view applicable law documents at ALSDE Health Laws & Policies.

Sunscreen Act