Notes from the Nurse

nurseSteps for Non-Medical Exemption Changes

If your student has an exemption that is no longer valid due to recent changes in the law you have already received either an email, letter or voice message with instructions.

If all that communication has so buried you that you don’t know what to do here’s a handy link to “Steps for Non-Medical Exemption”:

http://www.4j.lane.edu/wp-content/uploads/2014/06/Immunization-Steps-for-Non-Medical-Exemption.pdf

 

A Touchy Subject – Head Lice

I know how sensitive the whole head lice topic is, and completely understand that even the mere mentioning of the word can make people’s (sometimes even mine!) head itch. I also know what a huge inconvenience it can be to get rid of them, and how annoying and exhausting a persistent or recurring case may be. However, my goals as a School Nurse in this area are to keep families and staff aware of the latest research that will help squash the stigma around head lice, and even more importantly minimize disruptions to precious class time that our students need.

Below is a chart showing common myths and truths about head lice that I found in a recent journal article. See the Nurses page on the McCornack website for:

  • What the 4J Health Services team head lice recommendations are
  • Checking for head lice
  • Treatment information

 

Lice 101: Myths and Realities about Head Lice

Definitions
Lice: More than one louse. Nit: Eggs, dead or alive, of a louse
Louse: Small insect that lives on the scalp. Parasite: Lives off another, in this case the blood of humans.
Pediculosis: Having an infestation of lice. Infestation: Having an insect present, in this case, in your head.
Myths Truths
Head lice are easy to get. Lice are spread only mainly by head-to-head contact. They are much harder to get than a cold, flu, ear infection, pink eye, strep throat, food poisoning, or impetigo.
You can get lice from your dog, guinea pig, or other animal. Lice are species-specific. You can only get human lice from another human. You cannot get another animal’s lice.
You can get head lice from hats and helmets. Rarely, but possible. Hairbrushes, pillows, and sheets are also uncommon modes of transmission.
School is a common place for lice transmission. School is an unlikely source of transmission. Much more common are family members, overnight guests, and playmates who spend a large amount of time together.
Poor hygiene contributes to lice. Hygiene makes absolutely no difference. You get lice by close personal head-to-head contact with someone else that has lice, not by being dirty.
Lice can jump or fly from one person to another. Lice can only crawl. They can neither fly nor jump. They must crawl from one person to another.
Any nits left in the hair can cause lice to come back. Any nits farther away than one quarter to one half inch on the hair shaft are ALREADY HATCHED and pose no risk to others.
Eggs or nits can fall out of the hair, hatch, and cause lice in another person. Nits are cemented to the hair and very hard to remove. They cannot fall off. Newly hatched lice must find a head quickly or will die.
Lice can live a long time. Lice live only 1 to 2 days off the head. Each louse only lives about 30 days on the head.
All members of a family should be treated if one person has lice. Only the person with lice should be treated. Lice shampoos are INSECTICIDES and can be dangerous if used incorrectly or too frequently. Household members and close contacts should be checked, but only treat those who actually have lice. The house should NOT be sprayed with insecticide, nor used on clothing or other items.
Checking a classroom when one student has lice can prevent lice from spreading. Classroom transmission is EXCEEDINGLY RARE and checking students is a waste of valuable teaching time. Checking family members and close playmates is much more appropriate.
Avoiding lice is important as they spread disease. Head lice do not spread any known disease. They are annoying and irritating, but not dangerous.

Source: Pediatric Nursing, 40(5), 226-235. Retrieved March 15, 2015, from https://www.pediatricnursing.net/ce/2016/article4005226235.pdf

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Based on a review of the research 4J Health Services recommends the following practices in regards to managing head lice in school:

  • Routine student body or class room screenings are avoided as they bring undue attention to children with lice, disrupt the educational process, and may needlessly alarm families.
  • Head checks should be done by a competent screener only when a student demonstrates symptoms (usually excessively itching scalp, obvious presence of adult lice or nits), or by request.
  • We usually send a student with live lice home at the end of the day with treatment information and a check the following morning to insure no live lice remain.
  • Students with nits only aren’t sent home. Parents are notified and encouraged to treat and comb.
  • Rechecks, if used, should be based on the life cycle of the louse, and performed no more often than every 7-10 days.
  • We avoid sending notes home and rely on either one-to-one communication with those affected families or general information like newsletters or website postings.

Checking for head lice:

Many people may not experience symptoms. Some common symptoms of head lice include:

  • Tickling feeling on the scalp or in the hair
  • Itching (caused by the bites of the louse)
  • Irritability and difficulty sleeping (lice are more active in the dark)
  • Sores on the head (caused by scratching, which can sometimes become infected)

When looking for head lice you may see several different forms: eggs, baby lice and adult lice. The eggs, also called nits, are tiny, teardrop- shaped eggs that attach to the hair shaft. They are often found around the nape of the neck or the ears. Nits may appear yellowish or white, and can look similar to dandruff. Nymphs, or baby lice, are smaller and grow to adult size in one to two weeks. Adult lice are the size of a sesame seed and tan to grayish-white.

Finding a live nymph or adult louse on the scalp or in the hair is a good indication of an infestation. Head lice move quickly and avoid light, so they can be hard to see. Misdiagnosis is common. Therefore, you may want to contact your school nurse, pediatrician or family physician if you suspect an infestation.

Head Lice Treatment Information:

There are a number of available treatments, including new prescription treatment options that are safe and do not require combing out nits from your child’s hair. You may want to remove nits for aesthetic reasons. Other things to consider in selecting and starting treatment include:

  • Follow treatment instructions. Using extra amounts or multiple applications of the same medication is not recommended, unless directed by a healthcare professional.
  • Resistance to some over-the-counter head lice treatments has been reported, but the prevalence of resistance is not known.
  • There is no scientific evidence that home remedies are effective treatments.
  • Family bed linens and recently used clothes, hats and towels should be washed in very hot water.
  • Personal articles, such as combs, brushes and hair clips, should also be washed and sanitized or thrown away if they were exposed to a person with head lice.
  • All household members and other close contacts should be checked, and those with evidence of an active infestation should also be treated at the same time.
  • The school has lice treatment available if purchasing treatment products is difficult.

 

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