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Welcome to the District Nurse Site. Here you will find a number of resources, required forms, and the latest health information pertinent to the school-aged child. Thank you for your efforts helping us ensure a safe and healthy year for the students in our district.
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Please reach out to the Health Office at your school(s) to make arrangements.
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The Centers for Disease Control (CDC) is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus that was first detected in China, which has now been detected in over 100 locations worldwide, including in the United States. The virus has been named “SARS-CoV-2” and the disease it causes has been named “coronavirus disease 2019” (abbreviated “COVID-19”). This is an emerging, rapidly evolving situation. Please visit the CDC Coronavirus Disease 2019 website for more information.
The Muskego-Norway School District (MNSD) values the health and well-being of our students, staff, and families. We work throughout the year to promote healthy schools. The CDC encourages schools and communities to begin planning in the event that COVID-19 spreads locally.
On Wednesday, February 26, 2020, the Wisconsin Department of Public Instruction (DPI) shared a recommended pandemic plan template with school districts. MNSD and districts across the state are in the process of customizing their plans to meet the specific needs of their district and communities. MNSD leadership is meeting regularly to customize the Plan to meet our district and community needs. We are at the point of activating portions of the Plan, specifically classroom interventions related to the prevention of transmission of COVID-19.
An initial letter was sent to families and shared with staff between March 4-6. Updates will be sent regularly and as needed. These communications are uploaded on the right of this page.
You may find the following website valuable for real-time, up to date tracking of COVID-19 worldwide: Coronavirus COVID-19 Global Cases by Johns Hopkins CSSE.
PREVENTIVE MEASURES THAT YOU CAN TAKE INCLUDE:
- Wash your hands regularly and frequently with soap and water
- Help your students to wash their hands well (minimum of 20 seconds)
- Cover your nose and mouth when coughing and sneezing (cough or sneeze into your elbow)
- Avoid touching your face
- Keep your students home when they are sick
- Stay home when you are sick
- Call your doctor and let them know your symptoms and travel history
- Avoid close contact with people who are sick
- Get your flu vaccine – it’s never too late
Influenza and other respiratory viruses are common in Wisconsin at this time of year. To stay healthy, wash your hands often, cover coughs and sneezes, and stay home when you are sick.
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MNS requests that staff and parents/guardians provide MNS advance notice of travel out of the country, on cruises or to any areas currently identified or that become identified as a Level 2 or Level 3 risk areas.
Current Level 2 and Level 3 Travel alerts:
- GLOBAL Level 2 alert which states that older adults or those who have chronic medical conditions consider postponing travel.
- Level 3 alerts to China, Iran, South Korea, and select European areas which state that travelers avoid all non-essential travel to those areas.
PLEASE SUBMIT YOUR NOTIFICATION USING THIS LINK
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MNS requests notice as soon as possible of potential exposure to COVID-19 or the presentation of symptoms of the virus which include fever, cough, shortness of breath.
Any official communication regarding confirmed COVID-19 cases within our community or district will be directed by the Wisconsin Department of Health Services and the Waukesha or Racine County Public Health Departments. Please see COVID-19 Update - (3/17/2020)
If you or your student does come in contact with someone with COVID-19 or presents with shortness of breath, fever, and cough, contact your primary physician or the Waukesha County Health Department at 262-896-8430 or Racine County Health Department 262-898-4480 for next steps.
COVID-19 is a Category I disease that must be reported immediately to the local health officer, or their designee upon identification of a case or suspected case. Wisconsin Statute Section 252.2
PLEASE SUBMIT YOUR NOTIFICATION USING THIS LINK
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When you report your child as absent please provide as much information as possible. This allows MNSD to monitor specific conditions more accurately and provide a healthy learning environment for your child. In addition, we have some students throughout MNSD that have health conditions requiring close surveillance of potential illness exposure.
Absence information related to illness is optimal if it includes the following:
- Symptoms such as
- Fever
- Flu-like (see above)
- Sore Throat
- Respiratory - nasal or sinus congestion / drainage, cough (productive or non-productive)
- Gastro-intestinal - diarrhea or vomiting including frequency and last episode
- Skin - rash
- Onset - Date and/or time of onset
- Diagnosis - Healthcare provider diagnosis including lab test confirmation (ex. flu, strep)
- Treatment - Prescribed by healthcare provider (ex. antibiotics) or parent-initiated
- Others - If other family members are also ill
The Wisconsin Childhood Communicable Disease Chart is a handy reference.
PLEASE CLICK ON THE CHART FOR CURRENT CONDITIONS REPORTED TO MNSD |
If the number of students absent due to illness is greater than 10% of the student population the Waukesha County Public Health department is notified. Absentee Form
If student has a reportable condition as defined under DHS 145 Appendix A the Waukesha County Public Health department is notified.
This also includes " Any illness caused by an agent that is foreign, exotic or unusual to Wisconsin and that has public health implications."
All reporting first goes to the Waukesha Department of Public Health (WDPH) as we are a "Home Rule" State" *
WI STAT 252.21 Communicable diseases; schools; duties of teachers, parents, officers.
(1) If a teacher, school nurse, or principal of any school or child care center knows or suspects that a communicable disease is present in the school or center, he or she shall at once notify the local health officer.
(6) Any teacher, school nurse or principal may send home pupils who are suspected of having a communicable disease or any other disease the department specifies by rule. Any teacher, school nurse or principal who sends a pupil home shall immediately notify the parents of the pupil of the action and the reasons for the action. A teacher who sends a pupil home shall also notify the principal of the action and the reasons for the action.
DHS 145.04(d) Reports of communicable diseases.
Any teacher, principal or nurse serving a school or day care center knowing of a case or suspected case in the school or center shall notify the local health officer or, if required under Appendix A of this chapter, the state epidemiologist, in the manner prescribed in this section.
* While reportable conditions are clear within state law ...state law is silent as to a specific numerical requirement, but we at MNSD are obliged to follow our "Home Rule" guidance by Waukesha County - the 10% rule.
Further, "Any person licensed, permitted, registered or certified under Chs. 441 or 448 shall use ordinary skill in determining the presence of communicable diseases." - this means that 20 cases of strep in the district is not cause for alarm but one case of meningococcal meningitis is significant. Nurses and doctors must know this.
- 441 - Regulation of Nursing Practice
- 448 - Regulation of Medical Practice
Condition Reporting
MNSD staff report conditions via the online reporting tool located on the District Nurse website: MNSD Staff: Report a Health Condition or Concern
Numerical Monitoring
- Each school has a designated thresholds that alerts the District Nurse.
- Thresholds are set at 7% - this allows the District Nurse to begin more intensive monitoring prior to reaching the reportable 10% threshold. Intensive monitoring includes but is not limited to:
- Identification of a particular sub-group that has many absences - such as a classrom or grade level..
- Identification of condition clusters - such as strep throat or influenza
- Data is obtained via various reporting tools in Infinite Campus
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Week ending February 29, 2020
Wisconsin:
United States
Recommendations:
- It’s not too late to get vaccinated. Flu vaccination is always the best way to prevent flu and its potentially serious complications.
- Antiviral medications are an important adjunct to flu vaccine in the control of influenza. Almost all (>99%) of the influenza viruses tested this season are susceptible to the four FDA-approved influenza antiviral medications recommended for use in the U.S. this season.
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A total of 15,319 laboratory-confirmed influenza-associated hospitalizations were reported by FluSurv-NET sites between October 1, 2019 and February 22, 2020.
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10,439 (68.1%) were associated with influenza A virus
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4,797 (31.3%) with influenza B virus
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47 (0.3%) with influenza A virus and influenza B virus co-infection
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36 (0.2%) with influenza virus for which the type was not determined
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Among those with influenza A subtype information, 2,834 (94.1%) were A(H1N1)pdm09 virus and 179 (5.9%) were A(H3N2)
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While influenza B/Victoria viruses predominated earlier in the season, during recent weeks, influenza A(H1N1)pdm09 viruses have been reported more frequently than B/Victoria viruses. For the season, the number of B/Victoria and A(H1N1)pdm09 viruses are approximately equal. The predominant virus varies by region.
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The predominant virus also varies by age group:
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Influenza B viruses are the most commonly reported influenza viruses among children and young adults less than 25 years.
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Influenza A(H1N1)pdm09 viruses are the most commonly reported influenza viruses among persons 25 and older.
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Based on National Center for Health Statistics (NCHS) mortality surveillance data available on February 27, 2020, 6.9% of the deaths occurring during the week ending February 15, 2020 (week 7) were due to P&I. This percentage is below the epidemic threshold of 7.3% for week 7.
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You may not realize that you need vaccines throughout your life. Adults need to keep their vaccinations up to date because immunity from childhood vaccines can wear off over time. You are also at risk for different diseases as an adult. Vaccination is one of the most convenient and safest preventive care measures available. |
A recent CDC letterclarifying Measles immunizations for adults recomends the following:
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Most adults in the U.S. are at low risk for measles. In general, providers do not need to actively screen low-risk adult patients for measles in non-outbreak areas in the U.S.
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Certain adults are considered to be at high risk for either acquiring measles and/or transmitting disease to vulnerable persons. High risk adults include:
- students at post-high school educational institutions
- healthcare personnel
- international travelers to any country outside the United States
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High-risk adults need written documentation of two doses of MMR vaccine (each dose separated by at least 28 days), or other presumptive evidence of immunity. Other presumptive evidence of measles immunity includes:
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Laboratory confirmation of disease
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Laboratory evidence of immunity
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Birth before 1957
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During outbreaks, health departments may provide additional recommendations to protect their communities.
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One dose of MMR vaccine, or other presumptive evidence of immunity (listed above), is sufficient for other U.S. adults.
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If a patient’s measles immunity is unknown, providers should vaccinate with MMR, unless there are contraindications.
- Providers do not need to actively screen adult patients for measles immunity. This is because of high population immunity and low risk of disease among adults in non-outbreak areas in the U.S
- Providers should make sure patients have measles protection before international travel. U.S. residents traveling internationally are at high risk for acquiring measles abroad. They can also transmit measles to susceptible persons, such as infants, when they return home.
- If a patient is traveling internationally and measles immunity is unknown, providers should vaccinate, unless there are contraindications. Serologic testing for measles immunity is not recommended.
- During outbreaks, providers should consult with local health departments for the most up-to-date recommendations for their community. This may include additional doses of MMR for your patients.
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| Tracy Staudacher |
| District Nurse |
| Email |
| Office: 262-971-1790 Ext. 4535
Fax: 262-679-5222
Text: 262-710-0515
My office is located at MHS in Student Services:
Muskego High School
W183 S8750 Racine Avenue
Muskego WI 53150
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Ms. Amy Wieting and Ms. Jeanne Steiner
EMAIL: mhshealthoffice@muskegonorway.org
Office: 262-971-1790 Ext. 4516
Fax: 262-679-5222
Text Message: 262-682-3165
Ms. Diane Domurat and Ms. Anna Ozolins
EMAIL: ld-health-office@muskegonorway.org
Office: 262-971-1820 Ext.7436
Fax: 262-662-1588
Text Message: 262-477-9360
Ms. Heather Niemiec and Ms. Carolyn Unger
EMAIL: ml-health-office@muskegonorway.org
Office: 262-971-1860 Ext.5003
Fax: 414-427-1945
Text Message: 262-477-5776
Ms. Karen Maher and Ms. Angela Ewald
EMAIL: bl-health-office@muskegonorway.org
Office: 262-971-1810 Ext. 6225
Fax: 414-422-2204
Text Message: 262-682-0394
Ms. Andrea Liberski
EMAIL: lv-health-office@muskegonorway.org
Office: 262-971-1850 Ext. 3228
Fax: 262-895-7631
Text Message: 262-477-5710
Ms. Danielle Bykowski and Ms. Erica Bryce
EMAIL: mv-health-office@muskegonorway.org
Office: 262-971-1830 Ext. 8223
Fax: 262-679-4087
Text Message: 262-477-9187
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Autonomic disorders are often considered functional conditions, which means that there is not a clear cause for the patient’s symptoms. Endoscopy, X-rays, or blood tests may come back normal. Often, these disorders affect the part of the nervous system that controls our “automatic” body functions, such as our blood pressure, heart rate, sweating, temperature, bowel and bladder. We treat children with autonomic disorders who are experiencing gastrointestinal complaints such as nausea and abdominal pain, along with other symptoms such as dizziness, fatigue, headaches and joint hypermobility.
Autonomic disorders are often under-recognized. Sometimes people might assume that the pain is in a child’s head or that he or she is simply trying to avoid school, and a child’s complaints might be dismissed for some time before the correct diagnosis is made.
Causes of autonomic disorders
Doctors don’t yet know what causes problems in the autonomic nervous system, but symptoms often start after an acute illness. Researchers continue to study the potential causes of functional and autonomic disorders.
Autonomic disorders occurrence
These disorders are relatively common. For example, about 10 to 15 percent of children who report abdominal pain have pain that cannot be easily explained by the routine tests or studies that doctors perform.
Autonomic disorders development
Although doctors don’t know for sure, they suspect that patients with autonomic and functional disorders are predisposed in some way. It could be related to genetics, stress at an early age or changes in gut bacteria. Children with these disorders often develop chronic abdominal pain after a significant stressful event, such as an acute illness or a psychological stressor like a parent’s divorce. Chronic pain could start after something as simple as the common flu.
Symptoms of autonomic disorders
Children with autonomic disorders may have one or more of these symptoms:
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Dizziness
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Lack of energy
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Fainting
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Nausea
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Abdominal pain
Postural Orthostatic Tachycardia Syndrome, also known as POTS, is an autonomic disorder that most often affects teenagers. The main symptom of POTS is orthostatic intolerance due to a significantly reduced volume of blood returning to the heart after a patient stands up from a lying position. Symptoms may include:
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Lightheadedness
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Dizziness
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Extreme lack of energy
Often these children will also have migraines, gastrointestinal problems (such as nausea, vomiting and abdominal pain), aches and pains all over the body that strike after an acute illness, and near fainting or fainting.
Risk of developing this condition
We do not know how many children or teens suffer from these disorders, but we do know that they affect mainly teen girls. We have noticed that these conditions may run in families, but we still don’t understand the factors that may predispose children to these disorders.
Concerns of autonomic disorders
Although these disorders are not life threatening, they are extremely disabling. Many affected children drop out of school and extracurricular activities as the symptoms force them to become homebound. A high-achieving child who is a gifted athlete might suddenly find him or herself unable to complete even 10 minutes of aerobic exercise. An autonomic disorder can have a dramatic and detrimental effect on a child’s life.
Diagnosis and evaluation of autonomic disorders
It’s important for primary care physicians to believe a child’s symptoms even if the child appears healthy. After conducting a physical exam and obtaining a detailed medical history, your physician may refer you to the autonomic lab for autonomic testing.
Treatment for functional autonomic disorders
Treatment depends on the severity of the patient’s problem. Increased physical activity, increasing the amount of water and salt in the diet, and cognitive behavior therapy might be all that’s needed to treat some very mild disorders of the autonomic nervous system. It is important to recognize that besides these functional autonomic disorders, there are other disorders of the autonomic nervous system that can be much more severe, though they are very rare in children. These include congenital central hypoventilation syndrome and familial dysautonomia, also known as Riley-Day syndrome.
Researchers think that functional disorders, including functional autonomic disorders, could be caused by the brain responding to a stimulus in the wrong way. For example, the brain could perceive every movement of the intestine as painful, even though most people don’t realize those movements are happening. Cognitive Behavioral Therapy, led by a psychologist who has special training in CBT, can help “rewire” a patient’s brain to improve his or her pain response.
With patients who have POTS, the first step may be to increase salt and fluid consumption, which expands the volume in your child’s blood vessels so he or she will be less likely to feel dizzy and faint. Exercise can also be incredibly effective because it improves the efficiency of blood pumping, among other positive benefits.
In some cases, doctors may also prescribe medications to help alleviate your child’s symptoms, including chronic dizziness, nausea and pain. Gastric pacing can also help relieve nausea and pain.
Bed bugs (Cimex lectularius) are small, flat, parasitic insects that feed solely on the blood of people and animals while they sleep. Bed bugs are reddish-brown in color, wingless, range from 1mm to 7mm (roughly the size of Lincoln’s head on a penny), and can live several months without a blood meal.
Where are bed bugs found?
Bed bugs are found across the globe from North and South America, to Africa, Asia and Europe. Although the presence of bed bugs has traditionally been seen as a problem in developing countries, it has recently been spreading rapidly in parts of the United States, Canada, the United Kingdom, and other parts of Europe. Bed bugs have been found in five-star hotels and resorts and their presence is not determined by the cleanliness of the living conditions where they are found.
Bed bug infestations usually occur around or near the areas where people sleep. These areas include apartments, shelters, rooming houses, hotels, cruise ships, buses, trains, and dorm rooms. They hide during the day in places such as seams of mattresses, box springs, bed frames, headboards, dresser tables, inside cracks or crevices, behind wallpaper, or any other clutter or objects around a bed. Bed bugs have been shown to be able to travel over 100 feet in a night but tend to live within 8 feet of where people sleep.
Do bed bugs spread disease?
Bed bugs are not known to spread disease. Bed bugs can be an annoyance because their presence may cause itching and loss of sleep. Sometimes the itching can lead to excessive scratching that can sometimes increase the chance of a secondary skin infection.
What health risks do bed bugs pose?
A bed bug bite affects each person differently. Bite responses can range from an absence of any physical signs of the bite, to a small bite mark, to a serious allergic reaction. Bed bugs are not considered to be dangerous; however, an allergic reaction to several bites may need medical attention.
What are the signs and symptoms of a bed bug infestation?
One of the easiest ways to identify a bed bug infestation is by the tell-tale bite marks on the face, neck, arms, hands, or any other body parts while sleeping. However, these bite marks may take as long as 14 days to develop in some people so it is important to look for other clues when determining if bed bugs have infested an area. These signs include:
- the bed bugs’ exoskeletons after molting,
- bed bugs in the fold of mattresses and sheets,
- rusty–colored blood spots due to their blood-filled fecal material that they excrete on the mattress or nearby furniture, and
- a sweet musty odor.
How do I know if I’ve been bitten by a bed bug?
It is hard to tell if you’ve been bitten by a bed bug unless you find bed bugs or signs of infestation. When bed bugs bite, they inject an anesthetic and an anticoagulant that prevents a person from realizing they are being bitten. Most people do not realize they have been bitten until bite marks appear anywhere from one to several days after the initial bite. The bite marks are similar to that of a mosquito or a flea — a slightly swollen and red area that may itch and be irritating. The bite marks may be random or appear in a straight line. Other symptoms of bed bug bites include insomnia, anxiety, and skin problems that arise from profuse scratching of the bites.
Because bed bug bites affect everyone differently, some people may have no reaction and will not develop bite marks or any other visible signs of being bitten. Other people may be allergic to the bed bugs and can react adversely to the bites. These allergic symptoms can include enlarged bite marks, painful swellings at the bite site, and, on rare occasions, anaphylaxis.
How did I get bed bugs?
Bed bugs are experts at hiding. Their slim flat bodies allow them to fit into the smallest of spaces and stay there for long periods of time, even without a blood meal. Bed bugs are usually transported from place to place as people travel. The bed bugs travel in the seams and folds of luggage, overnight bags, folded clothes, bedding, furniture, and anywhere else where they can hide. Most people do not realize they are transporting stow-away bed bugs as they travel from location to location, infecting areas as they travel.
Who is at risk for getting bed bugs?
Everyone is at risk for getting bed bugs when visiting an infected area. However, anyone who travels frequently and shares living and sleeping quarters where other people have previously slept has a higher risk of being bitten and or spreading a bed bug infestation.
How are bed bugs treated and prevented?
Bed bug bites usually do not pose a serious medical threat. The best way to treat a bite is to avoid scratching the area and apply antiseptic creams or lotions and take an antihistamine. Bed bug infestations are commonly treated by insecticide spraying. If you suspect that you have an infestation, contact your landlord or professional pest control company that is experienced with treating bed bugs. The best way to prevent bed bugs is regular inspection for the signs of an infestation.
BEDBUG PAGE - CDC
BEDBUG PAGE - EPA
BEDBUG PAGE - WAUKESHA COUNTY PUBLIC HEALTH
Chickenpox is a highly contagious disease caused by the varicella-zoster virus (VZV). It can cause an itchy, blister-like rash. The rash first appears on the chest, back, and face, and then spreads over the entire body, causing between 250 and 500 itchy blisters. Chickenpox can be serious, especially in babies, adolescents, adults, pregnant women, and people with a weakened immune system. The best way to prevent chickenpox is to get the chickenpox vaccine.
Chickenpox used to be very common in the United States. In the early 1990s, an average of 4 million people got chickenpox, 10,500 to 13,000 were hospitalized, and 100 to 150 died each year.
Chickenpox vaccine became available in the United States in 1995. Each year, more than 3.5 million cases of chickenpox, 9,000 hospitalizations, and 100 deaths are prevented by chickenpox vaccination in the United States.
CHICKENPOX PAGE - CDC
CHICKENPOX PAGE - WI DHS
CHICKENPOX PAGE - WAUKESHA COUNTY PUBLIC HEALTH
Traumatic brain injury (TBI) is a serious public health problem in the United States. Each year, traumatic brain injuries contribute to a substantial number of deaths and cases of permanent disability. In 2014, there were approximately 2.87 million TBI-related emergency department visits, hospitalizations, and deaths in the US, including over 837,000 of these health events among children.
A TBI is caused by a bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain. Not all blows or jolts to the head result in a TBI. The severity of a TBI may range from “mild,” i.e., a brief change in mental status or consciousness to “severe,” i.e., an extended period of unconsciousness or amnesia after the injury.
PRELIMINARY ACCOMMODATIONS FOR CONCUSSION - MNSD
CDC ISSUES NEW CONCUSSION GUIDELINES - SEPTEMBER 2018
Department of Public Instruction (DPI) Concussion site
Children's Hospital of Wisconsin Concussion Guideline
CONCUSSION PAGE - CDC
CDC RESOURCES:
Concussion Fact Sheet for Parents
Heads Up Youth Sports Initiative
Caring for Your Child's Concussion
Returning to School After a Concussion - Letter
Pediatric mTBI Guidepine - Diagnostic Recommendations
Pediatric mTBI Guideline - Management and Treatment Recommendations
WIAA CONCUSSION PAGE
CONCUSSION PAGE - BRAIN INJURY ASSOCIATION
Preston Plevretes Story
What is encopresis?
Encopresis is a problem that children can develop due to chronic (long-term) constipation. With constipation, children have fewer bowel movements than normal and the bowel movements they do have can be hard, dry and difficult to pass. Once a child becomes constipated, a vicious cycle can develop. The child may avoid using the bathroom to avoid discomfort. Stool can become impacted (packed into the rectum and large intestine) and unable to move forward. The rectum and intestine become enlarged due to the hard, impacted stool. Eventually, the rectum and intestine have problems sensing the presence of stool and the anal sphincter (the muscle at the end of the digestive tract that helps hold stool in) loses its strength. Liquid stool can start to leak around the hard, dry, impacted stool, soiling a child's clothing.
Which children develop encopresis?
Any child with chronic constipation may develop encopresis. Some of the situations that lead to constipation include the following:
- Eating a high-fat, high-sugar, "junk-food" diet.
- Drinking mainly soft drinks and sugared drinks and not drinking enough water and fruit juices.
- Lack of exercise.
- Reluctance to use public bathrooms.
- Stress in the family, with friends, or at school.
- Being too busy playing to take time to use the bathroom.
- Change in bathroom routine, such as when a child starts a new school year and bathroom breaks are less frequent than they were over the summer.
For unknown reasons, boys develop encopresis six times more than girls do. Even though family stress can be linked to constipation, there does not seem to be any association between developing encopresis and how many children are in a family, a child's birth order (i.e. first, middle, last), a child's age or the family's income.
Why is encopresis of concern?
Encopresis can cause both physical and emotional problems.
Impacted (backed up) stool in the intestine can cause abdominal pain, as well as loss of appetite. Some children develop bladder infections.
Other health problems may cause chronic constipation, including diabetes, hypothyroidism, Hirschsprung's Disease and inflammatory bowel disease.
Children with encopresis can certainly feel emotionally upset by the "accidents" they have when they soil their clothes. They usually do not have control of this leakage of stool. Their self-esteem and interactions with other people can be affected. Children are often ashamed or embarrassed. They may avoid going to school, playing with friends or spending the night away from home. Parents may feel guilt, shame, anger or distaste by the problem. The child will often be aware of a parent's feelings and become even more emotionally affected.
What are the symptoms of encopresis?
The following are the most common symptoms of encopresis. However, each child may experience symptoms differently. Symptoms may include:
- Loose, watery stools.
- Involuntary stooling, or needing to have a bowel movement with little or no warning, which may soil underwear when a child cannot get to the bathroom in time.
- Scratching or rubbing of the anal area due to irritation by watery stools.
- Withdrawal from friends, school or family.
Symptoms of encopresis may resemble other conditions or medical problems. Please consult your child's physician for a diagnosis.
How is encopresis diagnosed?
A physician or healthcare provider will examine your child and obtain a medical history. Imaging tests may also be done to evaluate the intestine and rule out other health problems. These tests may include:
- Abdominal x-ray - a diagnostic test to evaluate the amount of stool in the large intestine.
- Barium enema - a test that checks the intestine for obstruction (blockage), strictures (narrow areas and other abnormalities. A fluid that shows up well on x-ray called barium in given as an enema and then the intestine is looked at with an x-ray.
Treatment for encopresis:
Specific treatment for encopresis will be determined by your child's physician based on the following:
- The extent of the problem
- Your child's age, overall health and medical history
- The opinion of the physicians involved in the child's care
- Your opinion or preference
Treatment for encopresis may include:
- Removing the impacted stool. An enema may be prescribed by your child's physician to help remove the impacted stool. An enema is a liquid that is placed in your child's rectum and helps loosen the hard, dry stool. (DO NOT give your child an enema without the approval of a physician or healthcare provider.)
- Keeping bowel movements soft so the stool will pass easily. Your child's physician will often prescribe medications to help keep your child's bowel movements soft for several months. This will help prevent stool impaction from occurring again. Please do not give your child stool softeners without the approval of a physician.
- Retraining the intestine and rectum to gain control over bowel movements.
- Diet changes. Often, making changes in your child's diet will help constipation. Consider the following suggestions:
- Increase the amount of fiber in your child's diet by:
- Adding more fruits and vegetables.
- Adding more whole grain cereals and breads (check the nutritional labels on food packages for foods that have more fiber).
- Offer your child fruit juice instead of soft drinks.
- Encourage your child to drink more fluids, especially water.
- Limit fast foods and junk foods that are usually high in fats and sugars, and offer more well-balanced meals and snacks.
- Limit drinks with caffeine, such as cola drinks and tea.
- Limit whole milk to 16 ounces a day for the child over 2 years of age, but do not eliminate milk altogether. Children need the calcium in milk to help their bones grow strong.
- Plan to serve your child's meals on a regular schedule. Often, eating a meal will stimulate a bowel movement within 30 minutes to an hour. Serve breakfast early so your child does not have to rush off to school and miss the opportunity to have a bowel movement.
- Increase exercise. Increasing the amount of exercise your child gets can also help with constipation. Exercise aids digestion by helping the normal movements the intestines make to push food forward as it is digested. People who do not move around much are often constipated. Encourage your child to go outside and play rather than watch TV or engage in other indoor activities.
- Develop proper bowel habits. Have your child sit on the toilet at least twice a day for at least 10 minutes, preferably shortly after a meal. Make this time pleasant; do not scold or criticize the child if they are unable to have a bowel movement. Giving stickers or other small rewards, and making posters that chart your child's progress can help motivate and encourage him/her.
ENCOPRESIS PAGE - CHW
Treating Non-Retentive Encopresis with Rewarded Scheduled Toilet Visits
Food allergy is a serious and potentially life-threatening medical condition affecting 32 million Americans. One in every 13 children has a food allergy—that’s about 2 in every U.S. classroom. And every 3 minutes, a food allergy reaction sends someone to the emergency room.
Food allergy is among the diseases considered to be part of the Atopic March. Also known as the Allergic March, this term refers to the progression of allergic diseases in a person’s life: eczema, food allergy, allergic rhinitis and asthma. Not everyone will follow this progression, or experience every condition.
What Causes a Food Allergy?
The job of the body’s immune system is to identify and destroy germs (such as bacteria or viruses) that make you sick. A food allergy happens when your immune system overreacts to a harmless food protein—an allergen.
In the U.S., the eight most common food allergens are milk, egg, peanut, tree nuts, soy, wheat, fish and shellfish.
Family history appears to play a role in whether someone develops a food allergy. If you have other kinds of allergic reactions, like eczema or hay fever, you have a greater risk of food allergy. This is also true of asthma.
Food allergies are not the same as food intolerances, and food allergy symptoms overlap with symptoms of other medical conditions. It is therefore important to have your food allergy confirmed by an appropriate evaluation with an allergist.
Food Allergies Are Serious
Food allergy may occur in response to any food, and some people are allergic to more than one food. Food allergies may start in childhood or as an adult.
All food allergies have one thing in common: They are potentially serious. Always take food allergies—and the people who live with them—seriously.
Food allergy reactions can vary unpredictably from mild to severe. Mild food allergy reactions may involve only a few hives or minor abdominal pain, though some food allergy reactions progress to severe anaphylaxis with low blood pressure and loss of consciousness. PAST REACTIONS ARE NOT RELIABLY PREDICTIVE OF FUTURE REACTIONS.
- Once a serious allergic reaction (anaphylaxis) starts, the drug epinephrine is the only effective treatment.
- Epinephrine (also called adrenaline) should be injected within minutes of the onset of symptoms. More than one dose may be needed.
- Easy-to-use, spring-loaded syringes of epinephrine, called epinephrine auto-injectors, are available by prescription.
- Not treating anaphylaxis promptly with epinephrine increases the risk of a fatal reaction
Food Allergies Have No Cure
Currently, there is no cure for food allergies. The only way to prevent reactions is to completely avoid the food you are allergic to.
But research is making a difference. Every day, scientists are working toward a better understanding of food allergies—so we can find life-saving treatments.
NOROVIRUS - CDC
Do you think you have the stomach flu or a stomach bug?
It’s probably norovirus, a common virus that is not related to the flu. Norovirus is the most common cause of foodborne diarrhea and vomiting.
The most common symptoms of norovirus are:
- diarrhea
- vomiting
- nausea
- stomach pain
Other symptoms include:
- fever
- headache
- body aches
Norovirus causes inflammation of the stomach or intestines. This is called acute gastroenteritis.
A person usually develops symptoms 12 to 48 hours after being exposed to norovirus. Most people with norovirus illness get better within 1 to 3 days.
If you have norovirus illness, you can feel extremely ill, and vomit or have diarrhea many times a day. This can lead to dehydration, especially in young children, older adults, and people with other illnesses.
Symptoms of dehydration include:
- decrease in urination
- dry mouth and throat
- feeling dizzy when standing up
Children who are dehydrated may cry with few or no tears and be unusually sleepy or fussy.
ROTAVIRUS CDC
Rotavirus disease is most common in infants and young children. However, older children and adults also can get sick from rotavirus. Once a person has been exposed to rotavirus, it takes about 2 days for symptoms to appear.
Children who get infected may have severe watery diarrhea, vomiting, fever, or abdominal pain. Vomiting and watery diarrhea can last 3 to 8 days. Additional symptoms may include loss of appetite and dehydration (loss of body fluids), which can be especially dangerous for infants and young children.
Symptoms of dehydration include:
- decreased urination
- dry mouth and throat
- feeling dizzy when standing up
- crying with few or no tears and
- unusual sleepiness or fussiness.
Adults who get rotavirus disease tend to have milder symptoms.
Children, even those who are vaccinated, may get infected and sick from rotavirus more than once. That is because neither natural infection with rotavirus nor vaccination provides full protection from future infections. Children who are not vaccinated usually have more severe symptoms the first time they get rotavirus disease. Vaccinated children are less likely to get sick from rotavirus.
Hand, foot, and mouth disease is a common viral illness that usually affects infants and children younger than 5 years old. However, it can sometimes occur in older children and adults. It usually starts with
- a fever
- reduced appetite
- sore throat
- a feeling of being unwell (malaise)
One or two days after the fever starts, painful sores can develop in the mouth (herpangina). They usually begin as small red spots, often in the back of the mouth, that blister and can become painful.
A skin rash on the palms of the hands and soles of the feet may also develop over one or two days as flat, red spots, sometimes with blisters. It may also appear on the knees, elbows, buttocks or genital area.
Some people, especially young children, may get dehydrated if they are not able to swallow enough liquids because of painful mouth sores. You should seek medical care in these cases.
Not everyone will get all of these symptoms. Some people, especially adults, may become infected and show no symptoms at all, but they can still pass the virus to others.
Most people who get hand, foot, and mouth disease will have mild illness or no symptoms at all. But a small proportion of cases can be more severe.
HAND FOOT AND MOUTH - CDC
HAND FOOT AND MOUTH FACT SHEET - WI DHS
MONONUCLEOSIS - CDC
Infectious mononucleosis, also called “mono,” is a contagious disease. Epstein-Barr virus (EBV) is the most common cause of infectious mononucleosis, but other viruses can also cause this disease. It is common among teenagers and young adults, especially college students. At least one out of four teenagers and young adults who get infected with EBV will develop infectious mononucleosis.
Symptoms
Typical symptoms of infectious mononucleosis usually appear four to six weeks after you get infected with EBV. Symptoms may develop slowly and may not all occur at the same time.
These symptoms include:
- extreme fatigue
- fever
- sore throat
- head and body aches
- swollen lymph nodes in the neck and armpits
- swollen liver or spleen or both
- rash
Enlarged spleen and a swollen liver are less common symptoms. For some people, their liver or spleen or both may remain enlarged even after their fatigue ends.
Most people get better in two to four weeks; however, some people may feel fatigued for several more weeks. Occasionally, the symptoms of infectious mononucleosis can last for six months or longer.
Transmission
EBV is the most common cause of infectious mononucleosis, but other viruses can cause this disease. Typically, these viruses spread most commonly through bodily fluids, especially saliva. However, these viruses can also spread through blood and semen during sexual contact, blood transfusions, and organ transplantations.
Other infections that can cause infectious mononucleosis:
Prevention & Treatment
There is no vaccine to protect against infectious mononucleosis. You can help protect yourself by not kissing or sharing drinks, food, or personal items, like toothbrushes, with people who have infectious mononucleosis.
You can help relieve symptoms of infectious mononucleosis by—
- drinking fluids to stay hydrated
- getting plenty of rest
- taking over-the-counter medications for pain and fever
If you have infectious mononucleosis, you should not take penicillin antibiotics like ampicillin or amoxicillin. Based on the severity of the symptoms, a healthcare provider may recommend treatment of specific organ systems affected by infectious mononucleosis.
Because your spleen may become enlarged as a result of infectious mononucleosis, you should avoid contact sports until you fully recover. Participating in contact sports can be strenuous and may cause the spleen to rupture.
Diagnosing Infectious Mononucleosis
Healthcare providers typically diagnose infectious mononucleosis based on symptoms.
Laboratory tests are not usually needed to diagnose infectious mononucleosis. However, specific laboratory tests may be needed to identify the cause of illness in people who do not have a typical case of infectious mononucleosis.
The blood work of patients who have infectious mononucleosis due to EBV infection may show—
- more white blood cells (lymphocytes) than normal
- unusual looking white blood cells (atypical lymphocytes)
- fewer than normal neutrophils or platelets
- abnormal liver function
| Part of the body |
Name |
Medical name |
| Skin |
Ringworm |
Tinea corporis |
| Feet (soles) |
Athlete's foot |
Tinea pedis |
| Hands (palms) |
Ringworm |
Tinea manuum |
| Groin area |
Jock itch |
Tinea cruris |
| Nails |
Nail infection |
Tinea unguium or onychomycosis |
American Academy of Dermatology
CDC
Epilepsy and Seizures
Epilepsy is a disorder of the brain. People are diagnosed with epilepsy when they have had two or more seizures.
There are many types of seizures. A person with epilepsy can have more than one type of seizure.
The signs of a seizure depend on the type of seizure.
Sometimes it is hard to tell when a person is having a seizure. A person having a seizure may seem confused or look like they are staring at something that isn’t there. Other seizures can cause a person to fall, shake, and become unaware of what’s going on around them.
Major Types of Seizures
Seizures are classified into two groups.
- Generalized seizures affect both sides of the brain.
- Absence seizures, sometimes called petit mal seizures, can cause rapid blinking or a few seconds of staring into space.
- Tonic-clonic seizures, also called grand mal seizures, can make a person
- Cry out.
- Lose consciousness.
- Fall to the ground.
- Have muscle jerks or spasms.
The person may feel tired after a tonic-clonic seizure.
- Focal seizures are located in just one area of the brain. These seizures are also called partial seizures.
- Simple focal seizures affect a small part of the brain. These seizures can cause twitching or a change in sensation, such as a strange taste or smell.
- Complex focal seizures can make a person with epilepsy confused or dazed. The person will be unable to respond to questions or direction for up to a few minutes.
- Secondary generalized seizures begin in one part of the brain, but then spread to both sides of the brain. In other words, the person first has a focal seizure, followed by a generalized seizure.
Seizures may last as long as a few minutes.
2017 Seizure Classification - New
EPILEPSY FOUNDATION
EPILEPSY FOUNDATION - SOUTHEAST WI BRANCH
STREP THROAT - CDC
Bacteria Cause Strep Throat
Viruses are the most common cause of a sore throat. However, strep throat is an infection in the throat and tonsils caused by bacteria called group A Streptococcus (group A strep).
How You Get Strep Throat
Group A strep live in the nose and throat and can easily spread to other people. It is important to know that all infected people do not have symptoms or seem sick. People who are infected spread the bacteria by coughing or sneezing, which creates small respiratory droplets that contain the bacteria.
People can get sick if they:
- Breathe in those droplets
- Touch something with droplets on it and then touch their mouth or nose
- Drink from the same glass or eat from the same plate as a sick person
- Touch sores on the skin caused by group A strep (impetigo)
Rarely, people can spread group A strep through food that is not handled properly. Experts do not believe pets or household items, like toys, spread these bacteria.
Pain and Fever without a Cough Are Common Signs and Symptoms
In general, strep throat is a mild infection, but it can be very painful. The most common symptoms of strep throat include:
- Sore throat that can start very quickly
- Pain when swallowing
- Fever
- Red and swollen tonsils, sometimes with white patches or streaks of pus
- Tiny, red spots (petechiae — pronounced pi-TEE-kee-eye) on the roof of the mouth (the soft or hard palate)
- Swollen lymph nodes in the front of the neck
Other symptoms may include a headache, stomach pain, nausea, or vomiting — especially in children. Someone with strep throat may also have a rash known as scarlet fever (also called scarlatina).
The following symptoms suggest a virus is the cause of the illness instead of strep throat:
- Cough
- Runny nose
- Hoarseness (changes in your voice that makes it sound breathy, raspy, or strained)
- Conjunctivitis (also called pink eye)
It usually takes two to five days for someone exposed to group A strep to become ill.
A sore throat that starts quickly, pain with swallowing, and fever are some of the common signs and symptoms of strep throat.
Children and Certain Adults Are at Increased Risk
Anyone can get strep throat, but there are some factors that can increase the risk of getting this common infection.
Strep throat is more common in children than adults. It is most common in children 5 through 15 years old. It is rare in children younger than 3 years old. Adults who are at increased risk for strep throat include:
- Parents of school-aged children
- Adults who are often in contact with children
Close contact with another person with strep throat is the most common risk factor for illness. For example, if someone has strep throat, it often spreads to other people in their household.
Infectious illnesses tend to spread wherever large groups of people gather together. Crowded conditions can increase the risk of getting a group A strep infection. These settings include:
- Schools
- Daycare centers
- Military training facilities
Strep Throat: More Common in Children
- Up to 3 in 10 children with a sore throat have strep throat
- About 1 in 10 adults with a sore throat has strep throat
A Simple Test Gives Fast Results
Only a rapid strep test or throat culture can determine if group A strep is the cause. A doctor cannot tell if someone has strep throat just by looking at his or her throat.
A rapid strep test involves swabbing the throat and running a test on the swab. The test quickly shows if group A strep is causing the illness. If the test is positive, doctors can prescribe antibiotics. If the test is negative, but a doctor still suspects strep throat, then the doctor can take a throat culture swab. A throat culture takes time to see if group A strep bacteria grow from the swab. While it takes more time, a throat culture sometimes finds infections that the rapid strep test misses. Culture is important to use in children and teens since they can get rheumatic fever from an untreated strep throat infection. For adults, it is usually not necessary to do a throat culture following a negative rapid strep test. Adults are generally not at risk of getting rheumatic fever following a strep throat infection.
Someone with strep throat should start feeling better in just a day or two after starting antibiotics. Call the doctor if you or your child are not feeling better after taking antibiotics for 48 hours.
Antibiotics Get You Well Fast
Doctors treat strep throat with antibiotics. Either penicillin or amoxicillin are recommended as a first choice for people who are not allergic to penicillin. Doctors can use other antibiotics to treat strep throat in people who are allergic to penicillin.
Benefits of antibiotics include:
- Decreasing how long someone is sick
- Decreasing symptoms (feeling better)
- Preventing the bacteria from spreading to others
- Preventing serious complications like rheumatic fever
Someone who tests positive for strep throat but has no symptoms (called a “carrier”) usually does not need antibiotics. They are less likely to spread the bacteria to others and very unlikely to get complications. If a carrier gets a sore throat illness caused by a virus, the rapid strep test can be positive. In these cases it can be hard to know what is causing the sore throat. If someone keeps getting a sore throat after taking the right antibiotics, they may be a strep carrier and have a viral throat infection. Talk to a doctor if you think you or your child may be a strep carrier.
Serious Complications Are Not Common but Can Happen
Complications can occur after a strep throat infection. This can happen if the bacteria spread to other parts of the body. Complications can include:
Protect Yourself and Others
People can get strep throat more than once. Having strep throat does not protect someone from getting it again in the future. While there is no vaccine to prevent strep throat, there are things people can do to protect themselves and others.
Good Hygiene Helps Prevent Group A Strep Infections
The best way to keep from getting or spreading group A strep is to wash your hands often. This is especially important after coughing or sneezing and before preparing foods or eating. To practice good hygiene you should:
- Cover your mouth and nose with a tissue when you cough or sneeze
- Put your used tissue in the waste basket
- Cough or sneeze into your upper sleeve or elbow, not your hands, if you don’t have a tissue
- Wash your hands often with soap and water for at least 20 seconds
- Use an alcohol-based hand rub if soap and water are not available
You should also wash glasses, utensils, and plates after someone who is sick uses them. These items are safe for others to use once washed.
Wash your hands often to help prevent germs from spreading.
Antibiotics Help Prevent Spreading the Infection to Others
People with strep throat should stay home from work, school, or daycare until they:
- No longer have a fever
- AND
- Have taken antibiotics for at least 24 hours
Take the prescription exactly as the doctor says to. Don’t stop taking the medicine, even if you or your child feel better, unless the doctor says to stop.
Wash your hands often to help prevent germs from spreading.
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WHAT A GREAT TEAM WE HAVE! |
MNSD Staff: Complete this form to request that staff receive training related to:
1. FIELD TRIPS - a participating student with a health condition requiring condition-specific emergency intervention training (ex. seizure disorder, diabetes). This includes but is not limited to the following emergency medications: Glucagon, Midazolam, Diastat, and Stimate. Please identify a staff member that will be accompanying the student on the field trip. Please provide adequate notice to allow for the training to be completed.
2. NEW STAFF - require the all-staff Health Emergency Training which includes a review of Anaphylaxis, Diabetic and Seizure Emergencies plus Epinephrine administration.
3. SPED and/or other staff - who working closely with a student that has a health condition requiring condition-specific emergency intervention training (ex. seizure disorder, diabetes). This includes but is not limited to the following emergency medications: Glucagon, Midazolam, Diastat, and Stimate.
The District Nurse will receive the submission and will reach out to the identified staff member to coordinate.
MNSD Staff - Complete this form to communicate student health conditions such as communicable diseases and/or other health concerns that you feel may need further attention.
This forms sends an email to the District Nurse and is useful for mandatory reporting, statistical analysis, and early identification of health conditions trends.
Data Tracking Range: 9/3/2019 through 6/11/2020
MNSD Staff - Complete this form to request a vision or hearing screening for a student. The request is forwarded to the District Nurse for coordination.
- In the event of a life threatening or serious work related injury CALL 911.
- Inform your supervisor or office personnel IMMEDIATELY, once you have tended to your injury.
- If it is necessary for you to leave work to seek medical attention, and you are unable to drive, you may not have another employee drive you. Call 911 for ambulance transport.
- Complete all areas on the following forms, which are available in your school office, and forward to Human Resources. (Be specific as to the part of your body that has been injured including the top, bottom or side):
- Muskego-Norway School District - Student/Staff/Volunteer Incident Report (list witnesses if any)
- Employer’s First Report of Injury or Disease
- Do not apply work-related injury medical or pharmacy bills to your own health insurance. If it is necessary for you to have a prescription filled due to your injury, you must pay for the prescription and submit receipts to Human Resources, for submission to the worker’s compensation insurance provider. Some pharmacies will bill the insurance company for work comp cases – not all. When necessary, Liberty Mutual will provide you with a temporary insurance card for your physician and pharmacy.
- Inform your physician’s office that this is a worker’s compensation injury. Our current worker’s compensation insurance provider is United Heartland. Your physician’s office may contact Human Resources at 262-971-1800 x 2118 if they do not already have submission information on file. Do Not Provide Personal Insurance Information.
- You will be required to keep Human Resources informed as to your condition during any extended time off work due to your injury. Forward all physician notes regarding certification for time off work, as well as any release to return to work information immediately. Your release to return to work must include any restrictions or limitations you may have as a condition of your release, and must be presented to your building office personnel before you will be allowed to resume your position. Please advise your physician that we do have a light duty program and will make every attempt to work within your restrictions, whenever possible.
- If you are involved in a motor vehicle accident while driving a district vehicle, you must complete a Vehicle Accident Report in addition to the Employer’s First Report of Injury or disease and the District Student/Staff Incident Report.
- The District will continue your wages as outlined in your collective bargaining agreement during any time off work due to a work-related injury. Should you receive reimbursement for lost wages directly from the insurance company, in addition to receiving your regular wages, you must sign the insurance reimbursement check over to the District.
Questions may be directed to Michelle Wikel at 262-971-1800 ext. 2118.
Or,
You may contact the Wisconsin Department of Workforce Development at: http://dwd.wisconsin.gov/
FORMS:
MNSD Work Related Employee Injury Procedures
MNSD Incident Report
WFD - Employer's First Report of Injury or Disease
MNSD Slip and Fall Form
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CARING FOR A CHILD WITH A G-TUBE - CHW
UNDERSTANDING FEEDING TUBES - CHW VIDEO
CHW G-TUBE CARE WEBSITE
HOW TO DEAL WITH PROBLEMS
WHAT IS A GASTROSTOMY TUBE (G-TUBE)?
A gastrostomy tube is a small tube that passes through the skin and abdominal wall into the stomach. It is also called a G-tube. This tube may be used for feeding and/or venting of the stomach. A G-tube is a safe way to feed your child because it stays in place all the time. It is clamped (closed off) when it is not being used. Some children may be able to eat by mouth and use the G-tube only when needed. Other children can only be fed through the tube. This all depends on the reason for your child’s G-tube.
WHAT IS A GASTROJEJUNAL TUBE (GJ-TUBE)?
A GJ-tube is a feeding tube that is placed into the stomach. It goes through a gastrostomy tract and ends in a part of the small intestine called the jejunum. Feedings go directly into the intestines (jejunum) and bypass the stomach. A GJ-tube is placed when your child has difficulty accepting feedings into the stomach
TYPES OF G-TUBES:
Low profile/button types:
Long indwelling types:
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