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SCHOOLNURSEHAND BOOKFor Dealing With Sickle Cell DiseaseSICKLE CELL FOUNDATION OF ARIZONAP R E S E N T E D B Y

www.360SCDHub.orgTogether, we canimprove quality carethrough education,empathy andunderstanding.

EDUCATION | RESOURCES | COMMUNITIES TRAINING | TOOLS & TRACKERS | CONNECTIONSH O W T O S H A R E T H I S R E S O U R C E W I T H S T U D E N T S & F A M I L I E SS C H O O L N U R S E H A N D B O O KSCDSchool personnel and caregivers play an important role in astudent’s health and academic success. For students living with a chronic health condition like SCD,communication between parents and school officials isessential in supporting positive academic outcomes. As a result, we have developed this customizable booklet.We encourage teachers, students, and caregivers to read allsections and tailor the information that relates specifically to their situation.T H I S B O O K I S T O H E L PG U I D E S C H O O L N U R S E SO N H O W T O B E S T H A N D L ES T U D E N T S W I T H S I C K L EC E L L D I S E A S E

This booklet is a companion to the course in the app360 SCD HubBoth are intended to advance the training of school nurses in the clinical manifestations ofsickle cell trait and disease, how to manage it as part of the care team, and how to help educateyour patients, parents, staff and community. Please download the app here to fully participate in this trainingas well as have access to unique resources only offered here.The app is also appropriate for your staff, parents and students. Encourage them to download and use it. Connected CommunitiesLEARNINGMANAGEMENT SYSTEM (LMS)Trackers & ToolsH O W T O S H A R E T H I S R E S O U R C E W I T H S T U D E N T S & F A M I L I E SS C H O O L N U R S E H A N D B O O K

LEARNINGMANAGEMENT SYSTEM (LMS)Each of yourpatients may havetheir own training,learning, trackingand rewards area. Encourage them touse it with you andtheir primary caredoctors. H O W T O S H A R E T H I S R E S O U R C E W I T H S T U D E N T S & F A M I L I E SS C H O O L N U R S E H A N D B O O K

SICKLE CELL FOUNDATION OF ARIZONADEVELOPMENT TEAMROBER T GILLI OCHIEF MEDICA L OFFIC E R, LUCY HOWELLPROJE CT DIRE CTORKACEY NYQUIS TASSOC IATE DI RECTOR E X E C U T I V E T E A MMO SES A K PA NSC F A P R E SI D EN TSA RAH S P IE K ER MEI ERSC F A B O A RD ME M B E RKE VIN J O HN S TO NSC F A B O A RD ME M B E RC O N T R I B U T I N GO R G A N I Z A T I O N SSI C KL E C E L L F O UN D AT I ON OF A R I Z O NARE D C R OS S O F S OU T HE R N A RI Z O N AAR I ZO N A D E P A R T ME N T O F H EA L T HBA N NE R H E A L T H PL A NSAZ BL O OD A L L I A NC ETH E F O RC E F O R HE A LT H ® N ET W O R KC O N T R I B U T I N G A D V I S O R SFR A N AL T M A IE RKA T H E RI N E FU L L E RT O NME L I S SA D O MI N G U EZDR . N AO M I NE W M A NDR . S AN J A Y S H A HAK I L AFA T O U MA T A LLYV E T T E M I L LE RMA U R I CI O T IP P E T TCO U R T NE Y S LA N A K ER The 360 SCD Hub Project is funded by the Health Resources & ServiceAdministration (HRSA) grant and administered through the Sickle CellFoundation of ArizonaThe views expressed in thisplatform, and video contentare solely those ofthe creators and do not represent the views of the state of Ohio or federalMedicaid programs.F O R C E F O R H E A L T H |© 2 0 2 3 S I C K L E C E L L F O U N D A T I O N O F A R I Z O N AContent based on evidence based practices fromSubject matter experts. These are the primary sources for the informationshared in this manual and online app and course. Shook LM, Mosley C, Farrell CB, Connelly A, Jones CL. Educational Needs of SchoolNurses Regarding the Evidence-Based Management of Sickle Cell Disease. Int JEnviron Res Public Health. 2021 Nov 5;18(21):11641. doi: 10.3390/ijerph182111641.PMID: 34770153; PMCID: PMC8582712.CDC Fact sheets on SCD

EDUCATION | RESOURCES | COMMUNITIES TRAINING | TOOLS & TRACKERS | CONNECTIONS1ABOUT SICKLE CELL DISEASE3TIPS FOR PARENTS AND OTHER CAREGIVERS4MANAGING COMMON AND CRITICAL SCDMANIFESTATIONS5FORMS6CONCLUSIONT A B L E O F C O N T E N T SS C H O O L N U R S E H A N D B O O KSCD2TIPS FOR TEACHERS, NURSES, AND SCHOOLADMINISTRATORS

EDUCATION | RESOURCES | COMMUNITIES TRAINING | TOOLS & TRACKERS | CONNECTIONSC H A P T E R 1S C H O O L N U R S E H A N D B O O KSCD1C H A P T E RABOUT SICKLE CELLDISEASE

EDUCATION | RESOURCES | COMMUNITIES TRAINING | TOOLS & TRACKERS | CONNECTIONS1 . 1 U N D E R S T A N D I N G H B SS C H O O L N U R S E H A N D B O O KSCDSickle cell disease (SCD) is an inherited blood disorder (a blood disorderthat runs in families). People with SCD produce an abnormal type ofhemoglobin (called hemoglobin S (HbS) or sickle hemoglobin). Hemoglobin is a protein in red blood cells that carries oxygen from thelungs to the organs and tissues in the body. The abnormal hemoglobinin SCD can cause the red blood cells to have a sickle or banana shapeunder certain conditions. People with SCD often have a decreasednumber of red blood cells, a condition called anemia, which can causelack of energy, breathlessness, and pale color of the skin and lips.There are many forms of SCD and the most common type is Hb SS,known as sickle cell anemia, which is inherited when a child receives two“S” genes (one from each parent). Hb SC is a form of disease that isinherited when a child receives one sickle cell gene, “S” from one parentand from the other parent, a gene for an abnormal hemoglobin called“C”. Another type of SCD, sickle beta-thalassemia, occurs when a childinherits one sickle cell gene and one gene for beta thalassemia (anothertype of abnormal inherited hemoglobin that causes anemia).

EDUCATION | RESOURCES | COMMUNITIES TRAINING | TOOLS & TRACKERS | CONNECTIONS1 . 2 S I C K L E C E L L D I S E A S EI N T H E U N I T E D S T A T E SS C H O O L N U R S E H A N D B O O KSCDIn the United States, SCD is most commonly found among African-Americans or persons of African descent; however, people of allraces and ethnicities can have SCD. About 1 in every 365 African-American babies in the United States isborn with SCD; and worldwide, approximately 300,000 babies areborn with SCD each year. As more people move from areas highlyaffected by SCD to the United States, schools will become morediverse and there is a higher chance that teachers will encounter astudent with SCD in their classrooms. As with any student with achronic health condition, students with SCD may experience healthproblems during the school day. SCD can have a significant impact on the quality of life and mayrequire comprehensive medical management. Newborn screeningprograms in the U.S. aim to identify affected individuals early,enabling timely interventions and support. While advancements intreatment and care have improved outcomes, individuals with SCDstill face challenges, making ongoing research, education, andaccess to healthcare vital in addressing this inherited blooddisorder.

C H A P T E R 2S C H O O L N U R S E H A N D B O O KEDUCATION | RESOURCES | COMMUNITIES TRAINING | TOOLS & TRACKERS | CONNECTIONSSCD2C H A P T E RTIPS FOR TEACHERS,NURSES, AND SCHOOLADMINISTRATORS

2 . 1 S U P P O R T I N G S T U D E N T SW I T H S C DS C H O O L N U R S E H A N D B O O KEDUCATION | RESOURCES | COMMUNITIES TRAINING | TOOLS & TRACKERS | CONNECTIONSSCD1. Ensure adequate access to water/hydration. Staying wellhydrated by drinking plenty of water can help prevent painepisodes and other health problems. 2. Allow frequent bathroom breaks. Children with SCDproduce large amounts of dilute urine even when they aredehydrated. Do not restrict students with SCD from bathroombreaks.3. Allow accommodations during extreme temperatures andconditions. Cold or hot weather can trigger pain crises.Teachers should not assign a student with SCD a seat in draftylocations, directly in front of fans or under air conditioner vents.4. Allow accommodations during physical education andrecess activities. Most children with SCD can engage inmoderate exercise, however, teachers may modify curricula sothat a child experiencing health problems related to SCD canparticipate in physical education in roles that are less strenuous.

5. Take special care of injuries. Never apply a cold pack to aninjury or pain site. First aid measures that should be providedwhen necessary, include applying direct pressure for bleeding,wrapping with an ace bandage, or elevating a hurt limb.6. Watch for signs of stroke. Strokes may be difficult to detectwhen they affect a small portion of the brain, but they areextremely important to watch for because they are relativelycommon in the early school years among children with sicklecell disease.7. Be aware of emotional well-being. Not all children withSCD have outward signs of illness. These sometimes subtle,outward signs may make children living with SCD targets forteasing and bullying. 8. Maintain open lines of communication with parents. Teachers can help create a positive relationship with schooland build confidence when asking for help.2 . 1 S U P P O R T I N G S T U D E N T SW I T H S C DS C H O O L N U R S E H A N D B O O KEDUCATION | RESOURCES | COMMUNITIES TRAINING | TOOLS & TRACKERS | CONNECTIONSSCD

2 . 2 A C C O M M O D A T I O N S F O RS T U D E N T S W I T H S C DS C H O O L N U R S E H A N D B O O KEDUCATION | RESOURCES | COMMUNITIES TRAINING | TOOLS & TRACKERS | CONNECTIONSSCDStaying informed and up to date on current information fortreatment and responses for sickle cell is vital for ensurechildren's safety in school. It doesn’t stop there. Keeping records of when students aretaking medication on campus, what they were doing whena pain crisis occurs, as well as how you took action and howthe treatment plan worked can affect future treatment.Having a response plan in place is also essential forensuring the child receives effective treatment. This planmay include emergency contacts, doctors information, andpreferred hospital. All of which are important for ifsomething where to happen. Each child's needs may be different. Work with parents andproviders to decide how to best support the child.Document what changes and accommodations areneeded in the classroom and in activities.

2 . 3 A W A R E N E S S O F S T R O K EA N D L E A R N I N G D I F F I C U L T I E SS C H O O L N U R S E H A N D B O O KEDUCATION | RESOURCES | COMMUNITIES TRAINING | TOOLS & TRACKERS | CONNECTIONSSCD1. Stroke Risk Assessment: Transcranial Doppler (TCD) Screening:Schools should be aware if students with SCD have undergone TCDscreening, a non-invasive test to assess the risk of stroke by measuringblood flow in the brain's major arteries. Regular screenings help identifythose at higher risk, allowing for preventive measures.2. Recognizing Stroke Symptoms: Training Staff: School staff, includingteachers and nurses, should be trained to recognize the signs of stroke inchildren, such as sudden weakness, speech difficulties, or severeheadaches. Immediate action is crucial for timely medical intervention.3. Monitoring Academic Progress: Schools should closely monitor theacademic progress of students with SCD, as they may face learningchallenges due to complications, such as cognitive impairments resultingfrom strokes. Regular assessments and communication with parents andhealthcare providers can help identify and address these challenges.

3C H A P T E RTIPS FOR PARENTSAND OTHERCAREGIVERSC H A P T E R 3S C H O O L N U R S E H A N D B O O KEDUCATION | RESOURCES | COMMUNITIES TRAINING | TOOLS & TRACKERS | CONNECTIONSSCD

3 . 1 S E T T I N G U P A M E E T I N GW I T H S C H O O L S T A F FS C H O O L N U R S E H A N D B O O KEDUCATION | RESOURCES | COMMUNITIES TRAINING | TOOLS & TRACKERS | CONNECTIONSSet up a meeting to discuss SCD with your child’s teacher. It may beimportant for parents and teachers to meet at the beginning of eachschool year. Invite these school staff to an introductory meeting: yourchild’s teacher(s) including the physical education teacher, learningcoordinator, school nurse, principal, or counselor. During an introductory meeting, it may be helpful to describe what SCD isin broad terms (e.g., an inherited disorder that affects the amount ofoxygen carried in the bloodstream) and more specifically how SCDimpacts your child’s daily life. It may also be important to describe howyour child copes with having SCD and to discuss clearly how you wish tobe informed when your child has symptoms at school (e.g., call meimmediately, when to call paramedics, what hospital you prefer).Initiating an annual meeting with school staff is essential to ensure thateveryone is on the same page regarding your child's SCD. This provides anopportunity to educate school personnel about the condition, shareinsights into your child's specific needs, and establish effectivecommunication protocols in case of emergencies or symptom flare-ups.SCD

3 . 2 T A L K I N G A B O U T 5 0 4P L A N S O R I E P SS C H O O L N U R S E H A N D B O O KEDUCATION | RESOURCES | COMMUNITIES TRAINING | TOOLS & TRACKERS | CONNECTIONSDiscuss the possibility of a plan if your child has special healthcare needsthat impact their daily life. Work with school staff to develop a plan thatincludes accommodations such as extra books, frequent bathroombreaks, or access to water. Both an IEP and 504 plan should be updatedyearly to meet the student’s needs.A 504 plan is administered in schools that receive federal funds (i.e., publicschools) and is a written document that outlines reasonableaccommodations for individuals with disabilities. The 504 plan ensuresthat a child with SCD has equal access and is able to participate fully inschool activities; however it does not outline plans for remedialinstruction. The IEP addresses remedial instruction. When health problems related toSCD negatively impact a student’s academic performance, specialeducation services may be recommended. An IEP is a written documentdeveloped between school staff and families to assure specialized orremedial instruction. Additional federal funding is given to schools toprovide a wide range of services, depending on the needs of the child. SCD

3 . 3 D E V E L O P I N G A NI N D I V I D U A L I Z E D C A R E P L A NS C H O O L N U R S E H A N D B O O KEDUCATION | RESOURCES | COMMUNITIES TRAINING | TOOLS & TRACKERS | CONNECTIONSDevelop an individualized care plan. An individualized care plan is a writtendocument that can be tailored to the specific healthcare needs of a studentwith SCD. An individualized care plan requires input from the teacher, schoolnurse, the child, and the family. Plans should include emergency contactinformation, any special needs the student may have, and instructions for givingpain medication, including who is responsible for giving the medicine and howto decide which medication to give.An individualized care plan is a critical tool for providing consistent and tailoredcare to students with SCD. This plan should outline emergency procedures,medication administration guidelines, and any specific requirements your childmay have. Regular updates are essential to keep the plan current and effective.Comprehensive Care Plan: Work with the school nurse, teacher, and your childto create an individualized care plan that covers emergency contactinformation, special needs, and instructions for giving pain medication.Regular Updates: Ensure that the care plan is updated at least annually orwhenever there are changes in your child's healthcare needs. If the school lacksa dedicated nurse, coordinate with the school secretary or counselor for planmanagement.SCD

3 . 4 C O M M U N I C A T I N GH E A L T H C H A N G E SS C H O O L N U R S E H A N D B O O KEDUCATION | RESOURCES | COMMUNITIES TRAINING | TOOLS & TRACKERS | CONNECTIONSTell teachers about changes in your child’s health. Families cansupport their child’s school success by keeping in close contact withteachers. Parents should talk to teachers about plans in the eventtheir child misses' school before a period of illness occurs. When yourchild is sick, parents can inform the school, ask for lesson plans andhomework, or ask for homebound teachers to prevent the studentfrom falling behind in their coursework.As children grow, their ability to express their needs evolves. In theearly elementary school years, parents may discuss all of their child’shealthcare needs with teachers. As children get older it is importantto support them in becoming their own advocate. Parents can helptheir child understand their condition, help them to understand theways that the school is required to help them keep up with theircoursework and reduce the risk of health problems related to theircondition, and they can encourage their child to express his or hermedical needs clearly.SCD

3 . 5 A D D R E S S I N G C O M M O NQ U E S T I O N SS C H O O L N U R S E H A N D B O O KEDUCATION | RESOURCES | COMMUNITIES TRAINING | TOOLS & TRACKERS | CONNECTIONSSCD Q: Is sickle cell disease contagious?No, you cannot catch sickle cell disease like a cold. Sickle cell disease is agenetically inherited disorder, passed down from a person’s parents.Q: Are there specific TRIGGERS TO be aware of?Extreme temperatures and dehydration can sometimes triggersymptoms. We are cautious about managing these factors and keepingour child well-hydrated.Q: Why is your child out of school so often?They need to be seen by a doctor more frequently than other students, sothey may be at a doctor’s appointment. At other times, sickle cell diseasemay cause them to be in so much pain that he or she cannot attendschool.Q: Are there any limitations Physically?While our child can participate in most activities, we've been advised toavoid extreme physical exertion. We can provide a note from ourhealthcare provider outlining any necessary modifications.

4C H A P T E RMANAGING COMMONAND CRITICAL SCDMANIFESTATIONSC H A P T E R 4S C H O O L N U R S E H A N D B O O KEDUCATION | RESOURCES | COMMUNITIES TRAINING | TOOLS & TRACKERS | CONNECTIONSSCD

4 . 1 M O S T F R E Q U E N T S C DM A N I F E S T A T I O N SS C H O O L N U R S E H A N D B O O KEDUCATION | RESOURCES | COMMUNITIES TRAINING | TOOLS & TRACKERS | CONNECTIONSWhile normal red blood cells are round like donuts and move freely throughblood vessels, sickled blood cells clog the flow of blood and can break apart asthey move through blood vessels. Additionally, sickled red blood cells do notdeliver oxygen throughout the body as well as normal red blood cells do.Pain episodes, fever, weakness, and fatigue are common manifestations of SCD.It's crucial for school nurses to recognize when these symptoms are severe orindicative of a serious complication. Prompt action, including seekingemergency care or contacting parents, can help manage these manifestationseffectively. .Pain Episodes (Vaso-Occlusive Crises): Pain is a hallmark of SCD and can occuranywhere in the body. When a student complains of severe pain, take itseriously. Allow the student to rest in a quiet, comfortable place and monitortheir pain level using a 1-10 scale. If pain is severe or worsening, or if the student'susual level of pain significantly increases, seek immediate medical attention.Weakness or Fatigue: If a student experiences sudden weakness on one side oftheir body (not due to pain), inability to speak, or difficulty with memory, thesecould be signs of a stroke. Act promptly by calling 911 and notifying the student'sparents.SCD

ACS and stroke are among the most dangerous manifestations of SCD. Schoolnurses must be vigi lant in identifying these symptoms and acting swiftly.Immediate medical attention is crucial to prevent further complications andensure the safety of the student.Acute Chest Syndrome (ACS): ACS is a life-threatening complication of SCD,characterized by chest pain, coughing, and difficulty breathing. If a studentexhibits these symptoms, treat it as a medical emergency. Call 911 immediatelyand inform the student's parents. Avoid applying cold packs to the chest, as thiscan worsen the condition. In addition to recognizing symptoms promptly, it iscrucial to provide supportive care while awaiting emergency medical assistance.Keep the student calm and comfortable, encourage deep breathing exercises,and ensure an oxygen supply is available if possible. Stroke: SCD is a leading cause of childhood stroke. Signs of stroke in a studentmay include severe headaches, dizziness, visual changes, sudden weakness inone limb or side of the face, numbness, inability to speak, or seizures. Recognizethese signs and call 911 without delay. Notify the student's parents and, ifnecessary, initiate a chronic care plan for stroke prevention.4 . 2 M O S T D A N G E R O U S S C DM A N I F E S T A T I O N SS C H O O L N U R S E H A N D B O O KEDUCATION | RESOURCES | COMMUNITIES TRAINING | TOOLS & TRACKERS | CONNECTIONSSCD

4 . 3 W H E N A N D H O W T O S E E KE M E R G E N C Y H E L PS C H O O L N U R S E H A N D B O O KEDUCATION | RESOURCES | COMMUNITIES TRAINING | TOOLS & TRACKERS | CONNECTIONSWhenever a student with SCD exhibits severe or worsening symptoms, such asexcruciating pain, high fever, or ACS, do not hesitate to call 911. Timely interventionis vital to saving lives in these critical situations.Urgent Care Referral: For less severe but concerning symptoms, such as moderatepain or mild fever, contact the student's parents immediately. Suggest urgent carereferral for medical evaluation to address the symptoms promptly and preventescalation.Chronic Care Plan Implementation: Work closely with the student's parents andhealthcare provider to develop and implement a chronic care plan tailored to thestudent's specific needs. This plan should outline medication administration,emergency contact information, and guidelines for managing symptoms duringschool hours. A well-structured chronic care plan is a valuable tool for managingSCD in school. It provides clear guidance on how to handle routine care, medicationadministration, and emergency situations. Work with the student's parents and healthcare provider to ensure the chronic careplan is comprehensive and tailored to the student's needs. Regularly review andupdate the plan as needed, especially if there are changes in the student's healthstatus or treatment regimen. Educate school staff about the plan and providetraining on how to administer medications or perform specific interventionsoutlined in the plan.SCD

5C H A P T E RFORMSC H A P T E R 5S C H O O L N U R S E H A N D B O O KEDUCATION | RESOURCES | COMMUNITIES TRAINING | TOOLS & TRACKERS | CONNECTIONSSCD

STUDENTINFORMATIONPERSONAL INFORMATIONEMERGENCY CONTACT DETAILSTREATMENT PLANOther Treatments :Medications (list Dosage, Frequency, and administration method) : Symptoms and Triggers (Ie common issues the child experiences) :Symptoms Management (Ie. when to administer medication, use comfort measures,or seek medical attention) :ACTION PLANWhat to do when child is experiencing Signs of Acute Chest Syndrome (ACS) : What to do when child is experiencing Signs of a stroke : Sickle Cell Type:Gender : Full Name : Date Of Birth: MaleFemaleGrade : Name:Health Care Provider Name : Provider Number : Phone Number : Relation: I, give consent for the school nurse and designated school personnel toadminister the medications and treatments as outlined in this Individualized HealthPlanSignature : Date :

SICKLE CELL INFORMATIONPERSONAL INFORMATIONEMERGENCY CONTACT DETAILSMEDICAL TRIGGERSKnown Triggers for Sickle Cell Crises and Typical Symptoms Exhibited by the Student:Signs of Medical Distress to Wat ch For : ACCOMMODATIONSPhysical Activity Limitations and Modifications : Other accommodations the student may need : Sickle Cell Type:Full Name: Gender : Date Of Birth: MaleFemaleGrade: Name:Health Care Provider: Provider Number: Phone Number: Relation: Signature: Date:

1SEVERE PAIN:DESCRIPTION: SUDDEN, INTENSE PAIN, OFTEN IN BONES OR JOINTS.ACTION: IF THE STUDENT COMPLAINS OF SEVERE PAIN OR SHOWSSIGNS OF DISTRESS, ESPECIALLY IN THE ABDOMEN, CHEST, OR LIMBS,CONSIDER IT AN EMERGENCY.2UNEXPLAINED FATIGUE:DESCRIPTION: PROFOUND TIREDNESS OR WEAKNESS THAT IS NOTALLEVIATED BY REST.ACTION: IF THE STUDENT APPEARS UNUSUALLY FATIGUED ORLETHARGIC, ESPECIALLY IF IT'S ACCOMPANIED BY PALENESS,INVESTIGATE FURTHER.3FEVER:DESCRIPTION: ELEVATED BODY TEMPERATURE.ACTION: MONITOR FOR FEVER, WHICH MAY INDICATE ANINFECTION OR THE ONSET OF A SICKLE CELL CRISIS.4SHORTNESS OF BREATH:DESCRIPTION: DIFFICULTY BREATHING OR LABORED BREATHING.ACTION: TAKE IMMEDIATE ACTION IF THE STUDENT EXPERIENCESSUDDEN OR SEVERE SHORTNESS OF BREATH, AS THIS COULD BEA SIGN OF A SERIOUS COMPLICATION.5SWELLING OF HANDS AND FEET:DESCRIPTION: NOTICEABLE SWELLING IN THE EXTREMITIES.ACTION: SWELLING, ESPECIALLY IN CONJUNCTION WITH PAIN,MAY SIGNAL A CRISIS. EVALUATE THE SEVERITY AND INFORM THESCHOOL NURSE PROMPTLY.R E F E R T O C H I L D S E M E R G E N C Y P L A N F O R A N Y Q U E S T I O N S O R C O N C E R N SKEY SYMPTOMS OF ASICKLE CELL EMERGENCYUse this cheat sheet to understand if your child is having a sickle cell emergency and howto respond accordingly.

6PALE OR JAUNDICED APPEARANCE:DESCRIPTION: PALENESS OR YELLOWING OF THE SKIN AND/OREYES.ACTION: A SUDDEN CHANGE IN COLOR MAY INDICATE ANEMIAOR LIVER INVOLVEMENT. SEEK MEDICAL ATTENTION PROMPTLY.7DIZZINESS OR FAINTING:DESCRIPTION: FEELING LIGHTHEADED OR LOSINGCONSCIOUSNESS.ACTION: IF A STUDENT COMPLAINS OF DIZZINESS OR FAINTS, ITCOULD BE A SIGN OF REDUCED OXYGEN FLOW. SEEK IMMEDIATEMEDICAL ASSISTANCE.8VISION CHANGES:DESCRIPTION: BLURRED VISION OR OTHER VISUALDISTURBANCES.ACTION: ANY SUDDEN CHANGES IN VISION SHOULD BEADDRESSED URGENTLY, AS IT MAY BE RELATED TO BLOODVESSEL COMPLICATIONS.9DIFFICULTY SPEAKING:DESCRIPTION: SLURRED SPEECH OR DIFFICULTY FORMINGWORDS.ACTION: IF THE STUDENT EXPERIENCES SUDDEN DIFFICULTYSPEAKING, IT COULD BE INDICATIVE OF A NEUROLOGICALCOMPLICATION. SEEK MEDICAL HELP PROMPTLY.10ABDOMINAL PAIN:DESCRIPTION: PAIN IN THE STOMACH OR ABDOMEN.ACTION: ABDOMINAL PAIN CAN BE A SIGN OF A SICKLE CELLCRISIS OR OTHER COMPLICATIONS. EVALUATE THE SEVERITYAND INVOLVE THE SCHOOL NURSE.R E F E R T O C H I L D S E M E R G E N C Y P L A N F O R A N Y Q U E S T I O N S O R C O N C E R N SR E F E R T O C H I L D S E M E R G E N C Y P L A N F O R A N Y Q U E S T I O N S O R C O N C E R N S

6C H A P T E RCONCLUSION C H A P T E R 6S C H O O L N U R S E H A N D B O O KEDUCATION | RESOURCES | COMMUNITIES TRAINING | TOOLS & TRACKERS | CONNECTIONSSCD

-23 -I n c o n c l u s i o n , S i c k l e C e l l D i s e a s e ( S C D ) i s a c o m p l e xc o n d i t i o n t h a t c a n i m p a c t a s t u d e n t ’ s d a i l y l i f e a n de d u c a t i o n . S c h o o l n u r s e s p l a y a c r u c i a l r o l e i n s u p p o r t i n gs t u d e n t s w i t h S C D b y r e c o g n i z i n g , m a n a g i n g , a n dp r e v e n t i n g c o m p l i c a t i o n s . T h i s m a n u a l h a s p r o v i d e de s s e n t i a l i n f o r m a t i o n a n d p r a c t i c a l t i p s f o r s c h o o l n u r s e st o n a v i g a t e v a r i o u s a s p e c t s o f S C D c a r e i n a s c h o o ls e t t i n g .U n d e r s t a n d i n g t h e f u n d a m e n t a l s o f S C D , i n c l u d i n g i t sd i f f e r e n t f o r m s a n d p r e v a l e n c e a m o n g d i v e r s ep o p u l a t i o n s , i s v i t a l f o r s c h o o l n u r s e s . E q u a l l y i m p o r t a n ti s r e c o g n i z i n g t h e m o s t f r e q u e n t m a n i f e s t a t i o n s , s u c h a sp a i n e p i s o d e s a n d f e v e r , a n d b e i n g p r e p a r e d t o r e s p o n dp r o m p t l y . A d d i t i o n a l l y , b e i n g v i g i l a n t f o r t h e m o s td a n g e r o u s c o m p l i c a t i o n s l i k e A c u t e C h e s t S y n d r o m e( A C S ) a n d s t r o k e i s e s s e n t i a l , a s t i m e l y i n t e r v e n t i o n c a nb e l i f e s a v i n g .C o l l a b o r a t i o n w i t h p a r e n t s , t e a c h e r s , a n d h e a l t h c a r ep r o v i d e r s i s a c o r n e r s t o n e o f e f f e c t i v e S C D m a n a g e m e n ti n s c h o o l s . B y f o l l o w i n g t h e g u i d e l i n e s a n d t i p s p r o v i d e di n t h i s m a n u a l , s c h o o l n u r s e s c a n e n h a n c e t h e w e l l - b e i n ga n d e d u c a t i o n a l e x p e r i e n c e o f s t u d e n t s l i v i n g w i t h S C D . I ti s o u r h o p e t h a t t h i s r e s o u r c e e m p o w e r s s c h o o l n u r s e s t op r o v i d e e x c e p t i o n a l c a r e a n d s u p p o r t f o r t h e s e s t u d e n t s ,u l t i m a t e l y c o n t r i b u t i n g t o t h e i r a c a d e m i c s u c c e s s a n do v e r a l l q u a l i t y o f l i f e . 2 . 1 S U P P O R T I N G S T U D E N T SW I T H S C DS C H O O L N U R S E H A N D B O O KEDUCATION | RESOURCES | COMMUNITIES TRAINING | TOOLS & TRACKERS | CONNECTIONSSCD