HEALTH CLINIC INFORMATION 2015­2016: KARRER MIDDLE SCHOOL School Nurse: Alicia Plymale, CPNP Phone Number: 614­718­8515 Fax Number: 614­873­1492 *​
Dublin City Schools employs 6 Certified School Nurses who rotate between assigned schools. For daily care and medication administration, there is a full­time trained Clinic Aide in each school clinic. Emergency Medical Authorization (EMA) Form on the ​
Parent Dashboard​
: ● In the event of an illness or emergency, we may release your child ​
ONLY​
to those people listed on your current EMA. ● Your child ​
will not ​
be able to attend field trips or participate in sports without a completed EMA. Please update contact information, medical concerns, and medications as changes arise and each school year. Illness or Injury: ● Students should be evaluated in the clinic if they become ill or injured at school. Clinic personnel must speak with the parent/guardian prior to discharging home. Students who drive may do so with parent/guardian permission (H.S. students only). ● The student must remain home with any symptoms of fever, diarrhea, or vomiting and cannot return until symptom­free for 24 hours without fever reducing medication. ● If communicable disease is suspected, clearance to return to school will need to come from a clinician. NEW MEDICATION PROCEDURE FOR 2015­2016 SCHOOL YEAR ● ALL​
medication to be administered by school personnel, ​
including non­prescription/over the counter ​
medications (cough drops and ointments included), requires a ​
parent/guardian​
​
authorization ​
AND​
an​
Ohio​
​
licensed prescriber​
’​
s or doctor’s signature​
​
on Dublin City School District’s “​
Request for Administration of Prescription and Nonprescription Medication by School Personnel” form​
. (Form 5330 F1) A new form must be completed and on file each school year for each medication. ● Parents must provide the desired medication to the clinic and it ​
must ​
be transported to and from the clinic by an adult. ● All medication to be administered by school personnel must be in it’s original container as dispensed by a physician, pharmacist, or manufacturer and will be stored in a locked compartment in the school clinic. ● Students may self­carry a one day dose of non­prescription (OTC) medication​
in its original container with a parent/guardian signed form on file in the clinic. ● All medications must be picked up on or before the last day school. Any medication left in the clinic will be discarded. ● Students may ​
self­carry​
emergency medications according to their medical needs: ○ Asthma ​
­ Student may self­carry a prescribed inhaler with “Request for Student to Carry and Administer Own Prescription Medication by Inhaler” (Form 5330 F2) completed and on file in the school clinic. Forms can be found at ​
dublinschools.net ○ Anaphylaxis​
­ Student may self­carry a prescribed Epinephrine auto­injector with “Allergy and Anaphylaxis Emergency Orders and Care Plan” (Form 5330A E F1) completed and on file in the school clinic. Please note, a second epinephrine auto­injector must be supplied to the school clinic. Forms can be found at ​
dublinschools.net. ○ Other emergency medications​
(Diastat, Glucagon, and Midazolam/Versed) ​
should be kept in the clinic​
. ● To access any of the above required forms, go to ​
dublinschools.net ○ select “​
Forms/Links​
”, then ○ select “​
Forms for Parents and Students”,​
then ○ select “​
Medical/Health Services Forms”​
, then ○ under “​
Medication Forms​
” select the appropriate form. Form 5330 F1 (​
Request for Administration of Prescription and Nonprescription Medication by School Personnel​
), Form 5330 F2 (Request for Student to Carry and Administer Own Prescription Medication by Inhaler), and Form 5330A E F1 (Allergy and Anaphylaxis Emergency Orders and Care Plan). Students with Special Health Care Needs: ● Please notify the School Nurse if your child has a heart condition, asthma, diabetes, life­threatening allergy, seizures, wheelchair dependency, or any other special health care need. Vision and Hearing Screen: ● ​
Required by the Ohio Department of Health, vision and hearing screening will be conducted routinely.