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In over 1400 schools nationwide children can receive primary care and behavioral health services from school-based health centers. School health centers support schools by providing prompt attention to health concerns, thereby keeping students in the classroom. The school-based health center is based upon collaboration between the school and the health provider to promote the health and educational success of school-aged children. School-based health centers develop programs based on the needs of the communities they serve. School-based health centers focus on the student as an integral part of the health care process. Students are encouraged to be active in health care decisions and prevention activities. Services provided are respectful of family values and diversities within the community. Care provided is comprehensive and can include a large scope of services. This can include: age-appropriate well-child exams, immunizations, diagnosis and treatment of acute illness and injury, management and monitoring of chronic conditions, basic laboratory services, prescription medications, health education and guidance, basic mental health services, substance abuse services, violence prevention education & intervention counseling and primary dental care. Parents value the centers because their children can receive services at school while they remain at work.

"Healthy Students Make Better Learners" is the theme for the 2004 awareness campaign. A major focus of School-Based Health Centers is to advance effective health promotion activities to students and the community. They are a good resource for classroom-based and school-wide health promotion targeting risk factors prevalent among the students served. The SOBO Health Center located in the South Beloit High School, Illinois is a good example of this concept. Seeing a trend in obesity, poor nutritional habits and lack of exercise among students, they decided to develop a program to address these health issues.

The SOBO (South Beloit) Health Center was started from a joint effort of the school nurse, Lynn Grover, RN and superintendent, Michael Duffy. They saw a need to address a student population underserved medically because of the rural location of the town. With the help of the other school nurse, Jackie May and the support of the South Beloit School Board, monies were requested through many grants and local organizations. SOBO was established. Several years ago a separate expansion grant from tobacco monies was received and this has been the catalyst for a fitness program sponsored by SOBO.

Sue Shutt, RN is a registered nurse for the health center and is the Program Director for the "FUN FITNESS"-Fitness & Weight Management Program. Sue developed programs to address the 3 issues facing the students: obesity, poor nutritional habits and lack of exercise.

JoAn Todd, a registered dietitian and nutrition & wellness educator with the University of Illinois-Rockford Extension does "Healthy Eating" programs for the students. She stresses the value of breakfast, helps students make smart choices at restaurants, promotes healthy snacks, and discusses sports nutrition and addresses "portion distortion". She also helps the school nurses with health fairs, so that parents can come to the school and also learn how they can help their child make better educated food choices. She also writes health education articles for the SOBO Health newsletter, which parents receive. A favorite topic was "Portion Distortion". She advises the students regarding portion control and "super-sized" marketing.

Jennifer Jeske-Sabuda, a medical student from the University of Illinois College of medicine is doing a study on the relationship between social skills and obesity. She will work with the health center, staff, and the faculty and students. Students will receive education on the risk of developing health problems related to overweight and obesity. She will target all children in grade K-8; overweight children will not be singled out.

The SOBO Health center has 2 equipped fitness facilities with traditional fitness equipment: stationary bikes, ellipticals, rowing machines, free weights and strength training equipment. The goal of the fitness and nutrition activities provided by the health center is to stress the need for students to develop fitness activities. Sue and staff do not want students to rely exclusively on physical education classes for their source of exercise activity but to supplement these activities with the use of the fitness rooms as well as other fitness activities. Sue felt it necessary for the children to be exposed to a variety of "cross-over" activities. Activities that they could learn to do for a lifetime. By exposing the students to some of these sports in the school, Sue felt that they could realize the enjoyment of a variety of exercise outlets. The students were also able to learn many of the skills required for these activities and would not be apprehensive in the future.

Some of the Cross-Over Sports she introduced to the students were:

Other activities introduced to the students using an outside instructor have been aerobic classes that introduce the students to a variety of activities that can increase their aerobic capacity. Classes that the students have been offered are: step aerobics, slides, circuit training, floor aerobics, aerobic kick box and Hip Hop Dance.

The fitness center is equipped with a climbing wall that the 5th-8th grade classes use during physical educations classes. This year families were invited to come and join their students on this climbing wall. This became a fun event for all to enjoy.

Sue's next goal is to get BMI's on all of the students and track their progress. She would like to get BMI's at the beginning and end of each year, on all grades so as to check any progress by the time they reach Junior and Senior High School. She is also in the process of obtaining pedometers and initiating a walking program.

Further Information

National Assembly on School-Based Health Care website:
http://www.nasbhc.org/

2004 Postcard Campaign:
http://www.nasbhc.org/APP/Advocacy_Communications.htm

The School Nurse/School Based Health Center Partnership
http://nasbhc.org/app/school_nurse_policy.htm

School-Based Health Centers and Childhood Obesity: An Ideal Location to Address a Complex Issue:
http://www.nasbhc.org/APP/obesity_and_SBHCs.pdf

The National School Board Association has published an article on the obesity epidemic in the January 2004 issue of American School Board Journal. This article discusses school food service policies, highlighting the recent decision by Los Angeles public schools to ban junk food and carbonated drink sales. Internet resources on school health and nutrition are also included.

You can read the article by visiting: http://www.nsba.org/site/docs/32700/32675.pdf

National Poison Prevention Week
National Poison Prevention Week is March 17 to 23. Learn more about how you can help reduce deaths and injuries due to poisonings.

The goal of National Poison Prevention Week, this year held March 17 to 23, is to help reduce the annual toll of about 30 deaths to children under 5 years old. The theme of National Poison Prevention week is "Children Act Fast… So Do Poisons!" The nation's poison control centers receive more than one million calls each year about unintentional poisonings of children under the age of 5 from medicines and household chemicals.

Experts emphasize three ways to reduce deaths and injuries from poisonings:

	1.	Keep medicine and household chemicals locked up and out of reach, and out of sight of young children at all times.
	2.	Use child-resistant packaging because it saves lives.
	3.	Call (800)222-1222 to get immediate treatment advice for poison emergencies.

		Learn CPR
		Support AED programs in your community
		Learn more about American Heart Month. Call 877-AHA-4CPR or visit http://www.americanheart.org/love

	1.	Go to "CPR & ECC" information http://www.americanheart.org
	2.	Enter in your zip code in the "Find a class near you" box in the upper right corner of the screen.
	3.	This will give you a list of Community Training Centers. Look for centers that indicate "Yes" in the CPR/BLS/AED column. This indicates that they offer cardiopulmonary resuscitation (CPR), basic life support (BLS) and automated external defibrillator (AED) training.
	4.	Call the trainer center nearest you that offers CPR/BLS/AED training.

Bio-Terrorism

A few years ago, School Health’s catalog cover series, A Day in the Life of a School Nurse, depicted a mock disaster exercise that took place in a high school. The scene attempted to demonstrate the key role a school nurse plays in responding to emergencies. That same year, our nation was shocked by several incomprehensible school shootings. School nurses were on the scene to help manage disaster plans and counsel students and families in the difficult days and months that followed.

Last year, school nurses responded to the September 11th tragedy with bravery and leadership. Only weeks later, the anthrax scare began. Recently, our president has warned the nation that terrorists could use chemical and biological weapons against us. Today, the need for school nurses to have a plan for sudden emergencies has never been more critical. Disaster preparedness has now reached a new level.

Here are links to information on how you can prepare for Bio-Terrorism threats. If you know of other good information that we are missing, please notify us at info@schoolhealth.com.


 

	Anthrax Department of Defense Anthrax Site Anthrax - History, Photos, and Other Information
	Biological and Chemical Terrorism http://www.cdc.gov/mmwr/PDF/RR/RR4904.pdf A strategic plan for preparedness and response by the CDC. The plan contains recommendations to reduce U.S. vulnerability to biological and chemical terrorism --- preparedness planning, detection and surveillance, laboratory analysis, emergency response, and communication systems. http://www.cidrap.umn.edu Center for Infectious Disease Research And Policy (CIDRAP) at the University of Minnesota, provides a wealth of bioterrorism information and is updated daily. http://www.cdc.gov/ Centers for Disease Control main page: latest press releases, state of nation, information on Anthrax and other biological agents http://www.cdc.gov/ http://www.bt.cdc.gov/ CDC page specific to bio-terrorism. Regularly updated. http://www.hopkins-biodefense.org/ Johns Hopkins University schools of medicine and public health Information for Clinicians on Anthrax, Botulinum Toxin • Plague • Smallpox • Tularemia Concise Diagnostic Criteria and Treatment Guidelines for Anthrax, Botulism, Smallpox and Plague: How to Handle Anthrax Threat Letters. BT Preparedness and Response Post-Sept. 11. FAQ: Information for the General Public. http://www.fda.gov/ Government information on approved drugs for various bioagents http://www.who.int/emc/deliberate_epi.html World Health Organization Health Aspects of Biological & Chemical Weapons http://www.ama-assn.org/special/infohome.htm Journal of the American Medical Association search excellent site for research on bio-terrorism, history, vaccines. This site maintains an archive of easy-to-use, peer-reviewed collections of resources on specific conditions. You can browse abstracts but may be required to pay a fee to view full text. http://www.aap.org/terrorism/index.html American Academy of Pediatrics - resources on disaster preparedness to meet children's needs.
	Smallpox http://www.bt.cdc.gov/agent/smallpox/vaccination/pdf/smallpox-vax-clinic-guide.pdf Find out how the virus works, what is being done to protect us from this potential threat and the plan to vaccinate everyone during a smallpox attack. CDC Issues Smallpox Vaccination Clinics Guide: The Smallpox Vaccination Clinic Guide is available in PDF format at

Taking Care of the School Nurse
We realize school nurses play a very important role in the life of a student. The demands of your job seem to increase daily. We developed this section just for you. You will find helpful links regarding your profession, helpful tools and resources, chat rooms for school nurses, inspirational messages, advice on how to balance work and personal life, and much more.

	School Nurse Perspectives Thoughts, tools, resources and inspirational information for school nurses.
	SchoolNurseChat.Com School Nurses get together from across the country and share vital information. Discussions may include health questions, salaries, employment issues, and any other general information under the field of school nursing.
	Taking time for yourself and for your work Learn tips on how to take better care of your health, making time for you, your finances, as well as caring for yourself as a nurse professional.
	National Association of School Nursing Find resources, tools regarding school nursing. Learn more about National School Nurse Day. Learn all the important topics in school nursing today.
	Federal Language to Support School Nurses Learn more about what's happening in Washington D.C. regarding school nursing. Congresswomen Carolyn McCarthy fights to have a nurse in every school.

	Medical Emergency I: Emergencies dealing with respiratory, circulatory and neurological
	Medical Emergency II: Emergencies dealing with facial, musculoskeletal and mental health.
	Medical Emergency III: Multiple trauma Emergencies. The triage and the care of mass casualties.

	MSE (Managing School Emergencies) Health emergencies and managing school emergencies III. Multi trauma emergencies.
	Bookstore Day courses managing school emergencies.
	EMSC - National Resource Center Emergency medical services for children.
	SNIP - Past Events School Nurse Institute Partnership - Second in Managing School Emergencies Series.

	Asthma in Children Asthma is the leading cause of school absenteeism. It is also the leading cause of hospitalization among children.
	SchoolAsthmaAllergy.com Asthma and allergies in school - tools to help the school nurse manage asthma in schools.
	Asthma and Upper Respiratory Illnesses Asthma is the leading chronic illness in children of the U.S. and leading cause of school absenteeism due to this chronic illness.
	How Asthma Friendly is your School Parents and school staff will find the following resources useful for determining how well their school setting accommodates children with asthma.
	Library Helpful resources such as Asthma Care and Minorities, Asthma Inhalers at School, Asthma Meds Risk Tooth Enamel and Asthma signs for Parent Education.
	Back to School - Health Tips for Children with Asthma What makes a child's asthma worse, helpful to have a school nurse, health aide and teacher involved in asthma management.
	Asthma Site for Parents, Teachers and School Administrators A place where parents, teachers, and school administrators can find information on keeping kids with asthma and allergies safe at school.
	IAQ Tools for Schools - Managing Asthma in Schools The most common cause of children being hospitalized. Find out what triggers asthma, take an asthma quiz to test your knowledge and learn important asthma facts.
	American Lung Association Asthma can be a life-threatening disease if not properly managed. In this section, you will find in-depth information including asthma and older people, teens and asthma, asthma medicines and attacks, peak flow meters, and home control of allergies and asthma.

Currently, a person who suffers a sudden cardiac arrest outside of a hospital has only a 5% chance of surviving. Scientific research has confirmed that the single most important determinant of survival from SCA is rapid defibrillation. An Automated External Defibrillator (AED) is the only way to save their life, but most victims do not have timely access to defibrillation.

Ninety percent of sudden cardiac arrest victims who are treated with a defibrillator within one minute of arrest can be saved, but every minute that a person goes without treatment decreases a person's chance of survival by 10 percent. While a defibrillator has a 97 percent success rate in terminating ventricular fibrillation, fewer than half of the nation's ambulance services, less than 15 percent of emergency service fire units, and less than 2 percent of police vehicles are currently equipped with an AED.

Sudden Cardiac Arrest in Schools
Many communities are actively looking into ways to improve access to defibrillation. In addition to equipping firefighters and police, many are now equipping schools with automated external defibrillators, due to the fact that Sudden Cardiac Arrest has been increasing significantly over the past several years among students. It is important to realize that sudden cardiac arrest does happen to children as well as adults, sometimes due to a blow to the chest during a sporting event or a genetic defect.

Many school districts and community members are initiating programs to equip their schools with AEDs and to provide training to staff. Here are just a few of them:

	News Release from Medtronic - Tenet HealthSystem Donates LifePak 500 AEDs to 14 Philadelphia-Area Schools
	Wisconsin has initiated PROJECT ADAM which is a new program geared toward saving the lives of Wisconsin high school students.
	The Loius J. Acompora Memorial Foundation is a group of volunteers with a special focus on the placement of AED’s in schools. They have developed the “AEDs in the School” kit which detailed the steps necessary to implement a public defibrillation program.
	Indian River School District has a goal of placing AEDs in each of its 15 schools.
	Reno Gazette Journal reports “Ten Schools to get Heart Attack Devices."

Resources

	Product Information: Information on the Lifepak 500 Automated External Defibrillator
	Articles: Portable Defibrillators Protect Fans, Players at High School Athletic Events - will setup links per product information page Why do Athletes Experience Sudden Deaths? will setup links per product information page Planning for Scholastic Cardiac Emergencies - “The Ripley Project” will setup links per product information page
	Books: Automated Defibrillation for Professional and Lay Rescuers Automated External Defibrillation Challenging Sudden Death: A Community Guide to Help Save Lives Heartsaver FACTS First Aid AED CPR Training System RapidZap: Automated Defibrillation
	Legislation Documents: Chart on state AED laws Summary of AED Related Legislation in 107th Congress Cardiac Arrest Survival Act of 2000 Airport Medical Assistance of 2000 FAA Final Rule Rural AED Act Rural AED Act Summary Public Health Improvement Act Adobe Acrobat is required to view or print the above documents. Click the icon below to download a free copy.

Frequently Asked Questions
Q:	What is sudden cardiac arrest?
A:	Sudden cardiac arrest (SCA) can be thought of as an "electrical storm" in the heart that does not allow it to beat properly. This abnormal rhythm causes the heart to "quiver" rather than pump blood properly. Without shocking the heart back to a normal rhythm, the victim will most likely die within minutes.
Q:	Who is most likely to suffer sudden cardiac arrest?
A:	Sudden cardiac arrest (SCA) is unpredictable and can happen to anyone at anytime. The risk of SCA increases with age and previous heart disease, but even a child can become a victim of SCA. In fact, many school systems are implementing AEDs in their districts because of recent sudden cardiac deaths in schools.
Q:	How common is sudden cardiac death?
A:	Sudden cardiac death kills approximately 450,000 Americans each year. That means about 1,250 people a day die from sudden cardiac arrest.
Q:	Is sudden cardiac arrest the same as a heart attack?
A:	No, a heart attack (a myocardial infarction) is very different from a sudden cardiac arrest. Sudden cardiac arrest is often mistakenly referred to as a "heart attack" by the public. SCA is caused by an abnormal heart rhythm (arrhythmia) that does not allow the heart to pump blood to the body. The only way to return the heart to a normal rhythm is by shocking the heart with an AED. In comparison, a heart attack is caused by a blockage of blood to the heart muscle which causes the muscle to die.
Q:	How much time do I have to respond to a sudden cardiac arrest victim?
A:	For every minute that the heart is not beating normally, the chance of survival decreases by 10 percent. After 10 minutes, the chance of survival is minimal.
Q:	I know CPR, why do I need an AED?
A:	While CPR is very important, an AED is the only thing that can save a SCA victim. Because SCA is caused by an abnormal heart rhythm, you need to deliver a shock to the heart to reverse the abnormal rhythm and return it to normal. This can only be done through the use of an automated external defibrillator (AED).
Q:	Is an AED hard to use?
A:	An AED is very easy to use thanks to advanced technology. There are only 2 buttons on the LIFEPAK 500 - the power button and a shock button. A voice and LCD display will prompt you through the necessary steps and tell you whether or not a shock is advised. The AED will only allow a shock to be delivered if the heart rhythm is shockable. The AED will NOT allow a shock to be delivered if the victim does not need it.
Q:	Do I need to be trained to use an AED?
A:	Yes, you need to be trained to use an AED. The training course is generally given along with a CPR course and is available through American Heart Association, American Red Cross, American Safety & Health Institute, Save-A-Life and other local providers.
Q:	Do I need a prescription in order to buy an AED?
A:	Yes, AEDs are class III medical devices which require a prescription for sale and use.
Q:	Do I need a medical director for my AED?
A:	Every state has different legislation specific to AEDs. We invite you to review state AED legislation information provided on the Medtronic Physio-Control web-site. In the majority of states, medical director oversight is required for the Good Samaritan laws to provide protection.

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