FMS Health Services

Welcome to the FMS Health Services Website. Falmouth Middle School has one certified school nurse, Jean Barbour, who works full time during school hours. In order to provide the best care for your child, please remember to notify the health office of any new or updated health issues (allergies, concussions, injuries, illnesses, etc) or changes in medication.

Jean Barbour RN jbarbour@falmouthschools.org 207-781-1020, fax 207-781-1021

We recommend you program your cell phone to recognize this phone number as the FMS nurse.

FMS Health Policies & Guidelines

Concussion Information

Because concussions can have a more serious effect on a young developing brain, knowledge of a concussion's symptoms and appropriate management of the return to school process is of utmost importance. If you suspect your child has sustained a concussion you should contact your primary care provider for evaluation. Before your child returns to school, please contact your child's school nurse who will help manage the return to school plan and their recovery.

Falmouth School Department's Concussion Management Policy

Food Allergy Guidelines

Falmouth Middle School Food Allergy Management Plan

The philosophy of Falmouth Middle School allergy plan is to keep students safe while fostering self advocacy and independence. Falmouth Middle School informs all faculty members of students with allergies and trains faculty members on the symptoms and proper use of Epi Pens. An allergy alert symbol on the school’s computer system (PowerSchool) also alerts teachers of a student’s allergies. Classroom teachers will ensure that information about allergies is available in the substitute folder.

Education

We are committed to educating all students on the importance of taking responsibility for the safety of others with severe allergies.

Nurse’s Office

Epi Pens and other emergency medication will be stored in an organized fashion in the nurse’s office. Emergency action plans will be kept on file and updated annually.

Cafeteria

A nut free table is clearly marked and available for students in the cafeteria. This table is thoroughly cleaned after each snack and lunch break.

Any food containing nuts are clearly marked and individually wrapped to prevent contamination with other foods. Any lunch prepared by the cafeteria will not contain nuts.

Field Trips

A teacher or designated adult will be responsible for emergency medications and action plans during a field trip. The nurse reviews instructions with the teacher or designated adult when distributing the medications needed for the field trip.

Parent / Guardian’s Responsibilities

Notify the school nurse of your child’s allergies and their treatments.
Provide written medical documentation, instructions and medications as directed by a physician.
Continue to educate your child about their food allergy including information about safe and unsafe foods, and the importance of notifying an adult if they are experiencing an allergic reaction.
Review the cafeteria menu to be sure the foods offered are safe for your child.
Call the Food Service Director at 781-7429 for any questions you may have concerning menu ingredients.

General Illness Guidelines

Students who become ill during the school day will be assessed by the school nurse and receive appropriate care and supervision in the nurse’s office. The school nurse will dismiss the student only after a parent or other designated emergency contact has been informed. In accordance with Maine Department of Health and Human Services guidelines, a child should not attend school if he/she exhibits one or more of the following symptoms or infections:

Fever – fever is defined as having a temperature of 100.4 degrees F or higher.
Diarrhea – watery, foul-smelling, runny and/or bloody stools. Should be free from diarrhea episodes for 24 hours before returning to school.
Vomiting – in the last 24-hour period.
Rash – an unexplained rash with fever or behavioral change. Child can return to school if a physician has determined the illness is not communicable and fever is gone.
Bacterial infections requiring antibiotics. If your child is placed on antibiotics for any kind of infection please consult school nurse for return to school recommendations.

Students with these symptoms cannot comfortably participate in program activities and unnecessarily expose others to their illnesses. Students should be fever-free without the aid of fever-reducing medication, such as acetaminophen or ibuprofen for 24 hours before returning to school.

Immunization Requirements for 7th Graders (updated 2022)

The Maine Department of Health and Human Services and the Department of Education have revised the Immunization Requirements within the last few years. The changes further align Maine’s immunization rules with current national recommendations to better protect the health of all Maine people.

All students entering, advancing, or transferring into seventh (7th) grade will need to receive one dose of Tdap (tetanus, diphtheria, and pertussis) vaccine before attendance is allowed.
One dose of meningococcal vaccine MCV4 (serogroups A,C,W and Y) is required for all students entering 7th grade.
Two doses of varicella vaccine (chicken pox) are required for children in grades K-12 (new 9/1/21)

Pertussis (whooping cough) is a very contagious respiratory disease that can be severe and last for months. The immunity received from either early childhood immunization or pertussis disease weans off over time, leaving older students and adults susceptible to pertussis. Immunization with Tdap can protect students, schools and communities against whooping cough.
Meningococcal disease is a rare, but dangerous disease that strikes healthy young people without warning. It can affect all ages, but teens and young adults are at highest risk of getting the disease.
Many students have already received these vaccines.

Please provide Jean Barbour a copy of the Tdap and meningococcal vaccine documentation from your primary care provider. You may send a hard copy or electronic copy for your student’s health record. If you have any questions, please contact Jean Barbour or the Maine Immunization Program at 207-287-3746 or 800-867-4775 or by email at ImmunizeME.DHHS@maine.gov

Sports Physicals

Falmouth School Department requires a sports physical prior to participating in any middle school sponsored sport. A copy of this exam must be on file at FMS before a student can participate in the FMS school sport. The physical exam must be current within the 12 months of the date submitted to the school. Only one physical exam is needed when first participating in a middle school sports program and again when first participating in a high school sports program. Athletes sustaining a major injury or receiving a significant medical diagnosis are required to submit a new physical exam for clearance to participate in sports as stipulated by the school nurse and/or athletic trainer.

Please contact Jean Barbour if you are unsure if your physical is on file at Falmouth Middle School.

District Health Policies & Guidelines

Forms

Medications

Medication Administration

It is the Falmouth School Department’s policy that medications are given at home whenever it is medically feasible. In exceptional cases when the child needs the medication in order to be in school, the prescribing physician can order it during school hours. This policy was developed with the safety of your child in mind.

If medication is necessary the following policy must be followed:
1. Medication will be sent in the original bottle.
2. Written instructions with the following information:

Name of child
Name of medication
Reason for medication
Dosage
Time to be administered
Possible side effects
Termination date of medication

3. Parents will provide a signed informed consent.
4. Parents will provide a signed informed consent from the prescribing physician. Download the form for parental and physician signature.
5. Parents must bring controlled substances to the health room.
6. Parents will be responsible for informing the school nurse of any medication change.
7. Medication will be stored in a secure space in the health room.
8. Students cannot carry or self administer any medication at school except for inhalers, epipens, and insulin. In order to carry these medications, the student must first meet with the school nurse to review the administration of the medication in a manner directed by the physician. The student must be able to assess their medical need for the medication and understand any necessary follow up post administration. Download the form for medication self-administration.

This medication policy applies to all prescription and most over-the-counter medications including cough syrups, ointments and inhalers. Acetaminophen and Ibuprofen can be administered with a parent note. Note: All attempts will be made to administer medication within thirty minutes of the scheduled time. Parents will be notified of any deviation to this schedule. If you have any questions, please contact your School Nurse .

Immunizations

Maine School Immunization Laws require that all students produce an acceptable record/certificate of immunization or provide a written medical exemption to immunization. Immunization exemptions must be updated annually. The immunization dosage requirements upon entry into school are as follows:

5 Doses of any DTaP (diphtheria, tetanus, pertussis) containing vaccine, or 4 if the fourth dose is given on or after the 4th birthday.
4 Doses of OPV/IPV (Polio), or 3 if the third dose is given on or after the 4th birthday.
2 Doses of MMR (measles, mumps, rubella), #1 no sooner than 12 months of age, #2 at least 4 weeks after #1.
2 Dose of Varicella (chickenpox) or documented history of the disease by a health care provider or laboratory evidence demonstrating immunity.

In addition:
** 7th graders now require a Tdap booster and MCV4 vaccine (please see information below)
**12th graders now require two doses of MCV4 vaccine.
If the first dose of meningococcal vaccine was administered on or after the 16th birthday, a second dose is not required (please see information below for details).

Non-immunized students shall not be permitted to attend school or school activities unless one of the following conditions is met:

The parents/guardians provide the school written assurance that the child will be immunized within 90 days of enrolling in school or his/her first attendance in classes, whichever date is earlier. This option is available only once to each student during their school career; or
The parents/guardians provide a physician’s written statement each year that immunization against one or more diseases may be medically inadvisable (as defined by law/regulation); download the medical immunization exemption form; or

For additional information about vaccines and vaccine safety read the CDC Vaccine Information, the American Academy of Pediatrics, or the Immunization Action Coalition.

For further questions, please contact the Maine Immunization Program at 207-287-3746 or 800-867-4775 or by email at ImmunizeME.DHHS@maine.gov

Health Related Issues

GUIDANCE FOR RESPIRATORY ILLNESSES

COVID has been circulating in our community throughout the summer and consequently some cases are in our schools. Here is the CDC graphic guidance for respiratory illnesses, including COVID-19, flu, and RSV. CDC's respiratory virus guidance consists of 5 core and 3 additional prevention strategies. For further information please see the CDC website for respiratory viruses. Lee el diagrama en español

COVID-19

COVID Signs and Symptoms

The following list does not include all possible symptoms. Possible symptoms include:

Fever or chills

New loss of taste or smell

Nausea or vomiting

Cough

Learn more about symptoms of COVID-19 at cdc.gov

Preventing the Spread of Respiratory Viruses

Stay home and away from others if you have respiratory virus symptoms that aren;t better explained by another cause. These symptoms can include fever, chills, fatigue, cough, runny nose, and headache, among others.

You can go back to your normal activities when, for at least 24 hours, both are true:

Your symptoms are getting better overall, and

You have not had a fever (and are not using fever-reducing medication)

When you go back to your normal activities, take added precaution over the next 5 days. Learn more about preventing the spread of respiratory viruses when you're sick.

When to Seek Emergency Help

Emergency warning signs for COVID include:

Trouble breathing

Persistent pain or pressure in the chest

New confusion

Inability to wake or stay awake

Depending on the skin tone, lips, nail beds, and skin may appear pale, gray, or blue.

Influenza

As we strive to keep everyone healthy this school year, it it important that students and adults who are sick not go to school, work, or social activities. The following checklist can help determine if someone has influenza-like illness (ILI)

Flu Symptom Checklist for Families
Does your child have a fever of 100 degrees of more?
Does your child have a cough?
Does your child have a sore throat?

Should I keep my child home?
If you answered yes to:
Fever of 100 degrees or more
and
A cough or a sore throat
then your child has an influenza-like illness. Keep your child home for 24 hours after the fever resolves without the use of medication.

If you checked yes to only one of the questions above, or if your child is ill with other symptoms, keep your child at home at least one day to observe for additional symptoms. If additional symptoms develop, use the checklist questions again to decide whether to continue to keep the child home.

When should my child go to the doctor?
Call your doctor or seek medical care if your child has trouble breathing or has behavior changes including changes in eating or drinking habits. Call your health care provider if your child is ill enough that you would normally seek health care advice.

Head Lice

Identification: Head lice are tiny wingless insects that attach to a person's hair, where it feeds on extremely small amounts of blood from the scalp. Signs and symptoms include severe itching of the scalp and the presence of nits or lice. To determine if your child has head lice you need to check their hair and scalp in good light. Use of a comb or applicator sticks to separate the hair is also helpful. Nits (Eggs) may look like dandruff but they do not brush or flake off since they are cemented to the hair. They are tiny oval specks of grey or yellow-white attached to the hair shaft. Often you will find them behind the ear and at the nape of the neck. The louse is harder to detect. They are only 1-3 mm long, are grayish-white to reddish-brown and can move quickly in the hair. They do not fly, hop or jump. They do not live on animals, just humans. Lice are not dangerous and do not spread disease.

Treatment: Permethrin 1% (Nix) is currently the recommended treatment of choice by the American Academy of Pediatricians (AAP) for newly diagnosed cases of head lice. After treatment, remove the nits with a comb (see next paragraph). Wash bedding and clothing in hot water and dry in a hot dryer. Vacuum carpets and upholstered furniture. Those items that cannot be laundered (including stuffed animals) should be sealed in a plastic bag for 10 days. Continue checking your child’s head daily for a few weeks.
Although eliminating lice from your home is essential, the most important thing a parent can do is comb the hair after treatment. A special metal comb designed specifically to help remove lice and nits from the hair shaft is essential. Plastic combs are too flimsy and often break. Metal combs come into contact with nits and lice that are so tiny you may not be able to see them. The most highly recommended lice combs are the Licemeister, the Terminator and the Dual sided lice comb. Daily combing of the hair will allow you to greatly reduce the risk of reinfestation. The Robi Comb is another type of comb. It is an electronic comb used to detect and kill head lice. Robi Comb destroys lice on contact simply by combing it through dry hair. When the electronic Robi Comb touches lice, they get zapped, die and are combed out of the hair.

Other treatment: Occasionally head lice are resistant to Nix or other pediculicides. If some live lice are still found 8-12 hours after treatment but are moving more slowly than before, do not retreat. Comb dead and remaining live lice out of the hair. The medicine sometimes takes longer to kill the lice. If no dead lice are found 8-12 hours after treatment and lice seem as active as before, the medicine may not be working. Contact your healthcare provider for a different medication and follow their treatment instructions. Over the last few years, new treatments such as Sklice, and Natroba have become available. They all have different compounds and mechanisms which will lead to what's called redundant killing, where if one compound doesn't do the job, the other compound will. In addition, the new drugs typically are easier to apply, only needing one application instead of repeated doses and no nit combing. All are prescription drugs, so insurance coverage will vary depending on the insurance plan.

There are some “natural” methods to try to suffocate head lice that pediatricians recommend. One method is to coat the hair with Cetaphil skin cleanser. Complete directions and more information are found on this Cetaphil link. Another method is to coat the hair with a mixture of mayonnaise, and olive oil, cover the head with a shower cap and leave this on overnight. Wash this oily emulsion out with green Dawn dish detergent and vinegar. Use this treatment 4 nights in a row. After treatment, remove the nits with a comb or your fingernails. A third method is daily combing: Buy a cheap cream rinse and coat the hair from roots to end. Use a Licemeister or similar metal lice comb with 1 and 1/2 inch metal tines to comb out lice and nits thoroughly. Take one section of the hair at a time, pin up the rest and spend a fair amount of time on each section on the first comb-through. (It can take a couple of hours- plug in a DVD.) The lice and eggs will get trapped in the gobs of cream rinse each time the comb goes through the hair- wipe them off and throw into the trash. When finished, wash hair as usual with shampoo. You need to continue to do this daily until you do not find lice or eggs (up to 6 weeks).

Prevention: Avoid head to head contact, do not share combs, brushes, hats, etc. Head lice are frequently spread through sleepovers or sharing of headgear via sports teams. Check your child's head frequently when outbreaks of head lice have been reported.

Please contact the school nurse if you would like further information or guidance regarding head lice treatment. Anyone can get head lice. An infestation does not indicate poor hygiene and is nothing to be ashamed of.
Further Information can be found at:
Healthy Children resources

Mosquito-Borne Illnesses

The state of Maine is currently experiencing significantly elevated risks of mosquito-borne illness such as West Nile Virus, Eastern Equine Encephalitis and Jamestown Canyon Virus. Cumberland County is considered a high risk area. Prevention strategies are critical to keep students and families safe when participating in outdoor activities. Please consider applying insect repellent to your student prior to coming to school. Students may keep additional repellent in their backpacks for after school activities if needed. Helpful information on insect repellent can be found on the EPA's website at Using Insect Repellents Safely and Effectively

Mosquitoes are most prevalent from dusk until dawn when temperatures are greater than 50℉. If your student experiences flu-like symptoms, severe headache, behavior changes, or serious drowsiness, please call their health care provider.

Here is a fact sheet from maine.gov on mosquitoes and keeping your family safe: Mosquito Fact Sheet

Lyme Disease Information

Deer ticks carry the bacteria that cause Lyme disease. They cling to vegetation in brushy, wooded, or grassy areas and transmit Lyme disease by biting. Both immature ticks (nymphs) and adult ticks can transmit Lyme disease. It is believed that the tick needs to remain attached for at least 24 hours for infection to occur. The immature tick is very small and may not be immediately noticeable on the skin. Not all ticks carry Lyme disease; in fact the common dog tick has not been shown to do so. Even a bite by a deer tick does not mean that Lyme disease will occur.

One symptom of Lyme disease is a red, circular skin rash that occurs at the site of the bite but may spread to other areas. It begins about 7 to 10 days after the bite and gradually enlarges, often with partial clearing in the center so that it resembles a donut. Hives, swelling of the face, redness of the eyes, and flu like symptoms (fever, headache, stiff neck, muscle and joint aches, and fatigue) may also occur.

The only known way to get Lyme disease is from the bite of an infected tick. Avoiding areas where ticks are found and promptly removing attached ticks are the most important preventive measures. People living in or visiting areas where Lyme disease is known to occur should take the following preventive measures:

Don’t walk bare legged in tall grass, woods or dunes where ticks may be found. If you do walk in such areas, wear a long-sleeved shirt, long pants, high socks (with pants tucked into the socks), and sneakers. Light colors will help you spot ticks on clothing. Apply a commercial tick repellent on clothing, shoes and socks, after reading the label instructions carefully. Avoid applying high concentrations to the skin, particularly of children. Family pets may bring ticks into your house and it is important to discuss tick control for pets with your veterinarian.

Daily tick checks reduce your risk of contracting Lyme disease. Because of their small (poppy seed) size, nymph ticks present the greatest threat. You need to check yourself, your pets, and especially small children DAILY after outdoor activity. When showering or bathing, do a full body inspection for a rash or attached ticks. Remember that the nymph tick is about the size of the head of a straight pin. Pay special attention to checking favorite tick spots, such as backs of knees, groin, waist, armpits, and the scalp. You may be able to feel the tick even if it is too small to see.

To remove an embedded tick, use tweezers to grip its body as close to the skin as possible and pull gently but firmly until the tick lets go. Local pet stores sell a tool called Ticked Off. This simple to use tick remover is very effective at removing ticks safely. For further information visit Maine CDC page on Lyme Disease. Contact your physician if you have concerns about a tick bite.

Chronic Daily Headaches (CDH)

Headache specialists define CDH as at least 15 days of headache per month, with pain lasting longer than 3 to 4 hours daily, and a total headache duration of more than 3 months.

Internalized emotional stress can produce very real headache. A death of a loved one, abuse (verbal, physical, or sexual), change in school, or family discord can adversely affect a teen's life; when he or she is unable to recognize or cope with the stress, this may manifest as CDH. Students who are high achievers in scholastics or sports may be under immense stress to perform at their best and can develop CDH as a result.

What is your daily routine, and how do you sleep? Generalized stresses on the body can not only alter mood and energy but also trigger headaches. Hunger, dehydration, and lack of sleep are causes of headache that can be prevented. Having teenagers eat 3 balanced meals per day and take adequate hydration is a critical component of headache management. Monitoring caffeine intake is also essential; teenagers, like adults, are prone to caffeine withdrawal or overuse headaches from coffee or soft drinks.

Do you take any medications for your headache? How much and how often? Assessing medication use is the most important step in recognizing underlying causes of primary headache. Worldwide, medication overuse, usually with analgesics, is the most common cause of CDH in adolescents. Using analgesics (eg, ibuprofen, acetaminophen, aspirin) or abortive headache medications (eg, sumatriptan, ergots) more than 3 times per week predisposes individuals to medication-overuse headache. Unless these medications are discontinued with a 2- to 4-week washout period, a primary cause of headache cannot be evaluated.

Although these nonpharmacologic approaches might not be the prescription the teen is expecting, failure to implement these interventions is almost a guarantee for continued CDH.

Exercise has a 2-fold benefit: weight reduction in obese patients and improved mood-related symptoms in depressed patients. Learn to work through headache pain. High-impact aerobic activity can exacerbate headache pain; therefore use less rigorous exercises at first, such as walking, yoga, or swimming, which are relaxing and can be adjusted for all levels of physical capabilities.

Treating mood and stress issues. Depression and mood disorders are common problems in this population, and appropriate management with antidepressants or cognitive-based therapies should be employed. Both pharmacologic and nonpharmacologic treatments can be helpful in patients with CDH who also have mood disorders. Referral to a counselor, psychologist, or psychiatrist should be considered if indicated.

Just say no to most drugs! All abortive drugs should be stopped. No exceptions. Medication overuse is seen in up to 50% of children with CDH and may play a causative role in some cases. Once there has been a washout period for analgesic and rescue medications, allowing the patient to use over-the-counter medications such as ibuprofen and acetaminophen 2 times per week is permissible.

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