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Highland Terrace Health Office
206-361-4344 Fax 206-361-4341 Meet your Highland Terrace Nurses  
Chris Narkevitz
9:00am - 3:30pm
Monday, Thursday, Friday
Please use the links below
to access information
Medications  Permission to Administer Medications at School forms must be completed by parents and physicians for what medications?
o Tylenol, Ibuprofen, Advil
etc.
o Tums o Cough
Drops
? Does that mean we have to make a special trip to our health care providers office to get this completed?
? How long are the completed forms valid?
? My student gets occasional headaches, cramps or upset stomachs etc… what can we do?
? May my student carry medications with them in class?
Permission To Administer Medications at School forms need to be completed for those emergency medications. Please refer to Shoreline School District Policy Manual #3416 and #3416P Forms may be downloaded by going to the Documents button on the top left of this page. Return to top Free and Reduced Lunch  New Free and Reduced Lunch Applications must be completed at the beginning of EACH school year. Students that attended any school in the Shoreline School District the previous school year and qualified for Free or Reduced Lunces will have a 30 day "Grace" period at the beginning of the school year. It is very important for families to complete the new applications and turn them in as early as possible in September of each school year so there will not be any disruption of services. Applications are mailed to all families in August and there are extra copies available all year long in the Highland Terrace office. Please complete an application at any time during the school year as family needs change. Forms translated into 21 languages may be downloaded by going to the Documents button on the top left of this page. return to top Life Threatening Conditions  Substitute House Bill (SHB) 2834 mandates students with life-threating health conditions may not attend school until they have medication and/or treatment orders and a nursing plan in place. These plans and orders need to be completed before the beginning of each school year even if there have been no changes in the plans from the previous year. There are treatment order forms in the documents area of this site. We provide them as a potentially useful framework for physician orders. They provide step by step orders that trnaslate well into emergency care plans for students. Physicians are free to write orders within a different format. Diabetes and any student requiring orders for Epi-Pens for allergies are considered to have life threatening conditions. Students with asthma that have been hospitalized two or more times in the past year because of their asthma are considered to have a life threatening condition at least for that school year. Students with asthma that are controlled with medication and have not required hospitalization in the past 12 months are not automatically considered to have a life threatening condition. Some students with seizure disorders are considered to have life threatening conditions, please consult with the nurses about your student if they have seizures. Life threatening conditions are not limited to the above conditions, please consult the nurses if your student has health concerns that would be considered life threatening. Our goal is to keep all of our students safe and healthy. Parents are an important piece in formulating this plan for their students. The treatment plans this process produces help insure the best care for students. Available for Download:
Forms may be downloaded by going to the Documents button on the top left of this page. return to top Immunizations  Immunizations Required for
Attending School 2006/2007
Kindergarten Hepatitis B - 3 doses DTP/DtaP – 4 doses with the 4th dose given on or after their 4th birthday Polio – 3 doses with the last dose given on or after their 4th birthday MMR – 2 doses given on or after their 1st birthday and at least 28 days apart Varicella – 1 dose given on or after their 1st birthday Return to top 1st, 2nd, 3rd, 4th and 5th Grades Hepatitis B - 3 doses DTP/DtaP – 3 doses with the 3rd dose given on or after their 4th birthday Polio – 3 doses with the last dose given on or after their 4th birthday MMR – 2 doses given on or after their 1st birthday and at least 28 days apart  Just what does this all
mean? There are way too many letters mixed up in different
ways....
I am sooo confused!  Tdap is a NEW immunization. Your child has NOT had this variation of Tetanus Diphtheria and Pertussis immunization before. All students entering 6th grade September 5th 2007 are required to have had the Tdap immunization IF:
Return to top The following is the letter sent home with fifth grade report cards March 30th, 2007 informing parent of new immunization requirements for entering the 6th grade September 5th, 2007. March 28, 2007 Dear Parent or Guardians of 5h grade Students, Subject: Tetanus, diphtheria, and pertussis (Tdap) Vaccination Requirement Chickenpox Vaccine (varicella) documentation or Disease Varifacation A new vaccine is available that can protect adolescents against tetanus, diphtheria, and pertussis (Tdap). The Tdap vaccine is recommended for all children aged 11 years and older. This vaccine should replace one tetanus-diphtheria (td) booster. Starting July 1, 2007, children attending the sixth grade, and 11 years old by the 1st day of school will be required to show proof of Tdap vaccination if it has been five years since receiving a tetanus-containing vaccine (DTaP, DT or TD). New last year, all 6th grade students must provide the date of the chickenpox (varicella) vaccine or the date of having the disease. Complete the Certificate of Immunization Certificate on the back of this page. Please provide either: • The date your child received one dose of tetanus, diphtheria and pertussis (Tdap) vaccine • The date your child received one dose of Varicella Vaccine (Chickenpox) or • Verification of the disease. Please include the month and year of the disease. • Sign personal exemption if you want your child exempt because of philosophical, medical or religious reasons. Please remember, your child’s school must have updated documentation of these immunizations before the first day of school September 5, 2007. A health check-up that includes vaccinations is recommended for all children aged 11-12 years. Talk to your child’s doctor, nurse, or clinic for more information on the Tdap vaccine, or visit: www.doh.wa.gov/cfh/immunize/schools.htm Sincerely, Kimi Reiner RN Nancy Dalan LPN Return to top 6th Grade Hepatitis B - 3 doses DTP/DtaP/DT – 3 doses with the 3rd dose given on or after their 4th birthday Polio – 3 doses with the last dose given on or after their 4th birthday MMR – 2 doses given on or after their 1st birthday and at least 28 days apart Varicella – 1 dose given on or after their 1st birthday
Immunizations are available
from your private physician or licensed health care
provider.
If you don’t have a doctor, please call your local health department or public clinic listed below. North Public Health Center  10501 Meridian Ave N. Seattle, WA 98133 206-296-4990 return to top What is DTaP? The DTaP vaccine protects your child against three diseases: diphtheria, tetanus, and pertussis (whooping cough). What is DTP? This is the old vaccine that protects against diphtheria, tetanus and pertussis. Physicians are now using the newer DTaP vaccine which has fewer side effects. • diphtheria — a serious infection of the throat that can block the airway and cause severe breathing difficulty • tetanus (lockjaw) — a nerve disease, which can occur at any age, caused by toxin-producing bacteria contaminating a wound • pertussis (whooping cough) — a respiratory illness with cold symptoms that progress to severe coughing (the "whooping" sound occurs when the child breathes in deeply after a severe coughing bout); serious complications of pertussis can occur in children under 1 year of age. Children under 6 months old are especially susceptible. What is DT? Diphtheria Tetanus immunization Return to top What is IPV? Inactivated Poliovirus Vaccine Until recently, the oral poliovirus vaccine (OPV) was given in the United States. Updated recommendations by the Advisory Committee on Immunization Practices now call for IPV injections. This change eliminates the previous small risk of developing polio after receiving the live oral polio vaccine. What is MMR? Measles, Mumps and Rubella • Measles o Measles (also
known as rubeola) is a highly contagious respiratory infection
that's caused by a virus. It causes a total-body skin rash and
flu-like symptoms, including a fever, cough, and runny
nose.
• Mumps o Mumps is a
disease caused by a virus that usually spreads through saliva and
can infect many parts of the body, especially the parotid salivary
glands. These glands, which produce saliva for the mouth, are found
toward the back of each cheek, in the area between the ear and
jaw. In cases of mumps, these glands typically swell and
become painful. Complications may increase as the age of
onset increases and may include all parts of the
body.
• Rubella o Rubella —
commonly known as German measles or 3-day measles — is an
infection that usually affects the skin and lymph nodes. It is
caused by the rubella virus (not the same virus that causes
measles). Rubella is usually transmitted by droplets
from the nose or throat that others breathe in. It can also
pass through a pregnant woman's bloodstream to infect her unborn
child. As this is a generally mild disease in children, the primary
medical danger of rubella is the infection of pregnant women, which
may cause birth defects in developing babies.
Return to top What is Hepatitis B? Hepatitis B virus (HBV) affects the liver. Those who are infected can become lifelong carriers of the virus and may develop long-term problems such as cirrhosis (liver disease) or cancer of the liver. 2nd dose given 1-3 months after the 1st dose 3rd dose given 2-6 months after 2nd dose BUT 3rd dose not given less than 4 months after 1st and 3rd dose not be given before 24 weeks of age Forms may be downloaded by going to the Documents button on the top left of this page. return to top
Six Common Misconceptions about
vaccination
A great deal of information about vaccinations is available to parents. This is good, because parents should have access to any information that will help them make informed decisions about vaccination. However, information is sometimes published that is inaccurate or can be misleading when taken out of context. Following are six misconceptions that appear in literature about vaccination, along with explanations of why they are misconceptions. 1. Diseases had already begun to disappear before vaccines were introduced, because of better hygiene and sanitation. 2. The majority of people who get a disease have been vaccinated. 3. There are "hot lots" of vaccine that have been associated with more adverse events and deaths than others. 4. Vaccines cause many harmful side effects, illnesses, and even death. 5. Vaccine-preventable diseases have been virtually eliminated from the United States. 6. Giving a child multiple vaccinations for different diseases at the same time increases the risk of harmful side effects and can overload the immune system. 1. Diseases had already begun to disappear before vaccines were introduced, because of better hygiene and sanitation. Statements like this are very common in anti-vaccine literature, the intent apparently being to suggest that vaccines are not needed. Improved socioeconomic conditions have undoubtedly had an indirect impact on disease. Better nutrition, not to mention the development of antibiotics and other treatments, have increased survival rates among the sick; less crowded living conditions have reduced disease transmission; and lower birth rates have decreased the number of susceptible household contacts. But looking at the actual incidence of disease over the years can leave little doubt of the significant direct impact vaccines have had, even in modern times. Here, for example, is a graph showing the reported incidence of measles from 1950 to the present. A graph showing the reported incidence of measles from 1950 to the present. There were periodic peaks and valleys throughout the years, but the real, permanent drop coincided with the licensure and wide use of measles vaccine beginning in 1963. There were periodic peaks and valleys throughout the years, but the real, permanent drop coincided with the licensure and wide use of measles vaccine beginning in 1963. Graphs for other vaccine-preventable diseases show a roughly similar pattern, with all except hepatitis B* showing a significant drop in cases corresponding with the advent of vaccine use. Are we expected to believe that better sanitation caused incidence of each disease to drop, just at the time a vaccine for that disease was introduced? *The incidence rate of hepatitis B has not dropped so dramatically yet because the infants we began vaccinating in 1991 will not be at high risk for the disease until they are at least teenagers. We therefore expect about a 15 year lag between the start of universal infant vaccination and a significant drop in disease incidence. Hib vaccine is another good example, because Hib disease was prevalent until just a few years ago, when conjugate vaccines that can be used for infants were finally developed. (The polysaccharide vaccine previously available could not be used for infants, in whom most of cases of the disease were occurring.) Since sanitation is not better now than it was in 1990, it is hard to attribute the virtual disappearance of Hib disease in children in recent years (from an estimated 20,000 cases a year to 1,419 cases in 1993, and dropping) to anything other than the vaccine. Varicella can also be used to illustrate the point, since modern sanitation has obviously not prevented nearly 4 million cases each year in the United States. If diseases were disappearing, we should expect varicella to be disappearing along with the rest of them. But nearly all children in the United States get the disease today, just as they did 20 years ago or 80 years ago. Based on experience with the varicella vaccine in studies before licensure, we can expect the incidence of varicella to drop significantly now that a vaccine has been licensed for the United States. Finally, we can look at the experiences of several developed countries after they let their immunization levels drop. Three countries - Great Britain, Sweden, and Japan - cut back the use of pertussis vaccine because of fear about the vaccine. The effect was dramatic and immediate. In Great Britain, a drop in pertussis vaccination in 1974 was followed by an epidemic of more than 100,000 cases of pertussis and 36 deaths by 1978. In Japan, around the same time, a drop in vaccination rates from 70% to 20%-40% led to a jump in pertussis from 393 cases and no deaths in 1974 to 13,000 cases and 41 deaths in 1979. In Sweden, the annual incidence rate of pertussis per 100,000 children 0-6 years of age increased from 700 cases in 1981 to 3,200 in 1985. It seems clear from these experiences that not only would diseases not be disappearing without vaccines, but if we were to stop vaccinating, they would come back. Of more immediate interest is the major epidemic of diphtheria now occurring in the former Soviet Union, where low primary immunization rates for children and the lack of booster vaccinations for adults have resulted in an increase from 839 cases in 1989 to nearly 50,000 cases and 1,700 deaths in 1994. There have already been at least 20 imported cases in Europe and two cases in U.S. citizens working in the former Soviet Union. Return to top 2. The majority of people who get disease have been vaccinated. This is another argument frequently found in anti-vaccine literature - the implication being that this proves vaccines are not effective. In fact it is true that in an outbreak those who have been vaccinated often outnumber those who have not - even with vaccines such as measles, which we know to be about 98% effective when used as recommended. This apparent paradox is explained by two factors. First, no vaccine is 100% effective. To make vaccines safer than the disease, the bacteria or virus is killed or weakened (attenuated). For reasons related to the individual, not all vaccinated persons develop immunity. Most routine childhood vaccines are effective for 85% to 95% of recipients. Second, in a country such as the United States the people who have been vaccinated vastly outnumber those who have not. How these two factors work together to result in outbreaks in which the majority of cases have been vaccinated can be more easily understood by looking at a hypothetical example: In a high school of 1,000 students, none has ever had measles. All but 5 of the students have had two doses of measles vaccine, and so are fully immunized. The entire student body is exposed to measles, and every susceptible student becomes infected. The 5 unvaccinated students will be infected, of course. But of the 995 who have been vaccinated, we would expect several not to respond to the vaccine. The efficacy rate for two doses of measles vaccine can be as high as >99%. In this class, 7 students do not respond, and they, too, become infected. Therefore 7 of 12, or about 58%, of the cases occur in students who have been fully vaccinated. As you can see, this doesn't prove the vaccine didn't work - only that most of the children in the class had been vaccinated, so those who were vaccinated and did not respond outnumbered those who had not been vaccinated. Looking at it another way, 100% of the children who had not been vaccinated got measles, compared with less than 1% of those who had been vaccinated. Measles vaccine protected most of the class; if nobody in the class had been vaccinated, there would probably have been 1,000 cases of measles.  Return to top 3. There are "hot lots" of vaccine that have been associated with more adverse events and deaths than others. Parents should find the numbers of these lots and not allow their children to receive vaccines from them. This misconception got considerable publicity recently when vaccine safety was the subject of a television news program. First of all, the concept of a "hot lot" of vaccine as it is used in this context is wrong. It is based on the presumption that the more reports to VAERS (Vaccine Adverse Event Reporting System) a vaccine lot is associated with, the more dangerous the vaccine in that lot; and that by consulting a list of the number of reports per lot, a parent can identify vaccine lots to avoid. This is misleading for two reasons: A report made to VAERS does not mean that the vaccine, or other vaccines from the same group or lot caused the event. VAERS is a national system for reporting health problems that happen around the same time of the vaccination. Only some of the reported health conditions are side effects related to vaccines. A certain number of VAERS reports of serious illnesses or death do occur by chance alone among persons who have been recently vaccinated. VAERS reports have many limitations since they often lack important information, such as laboratory results, used to establish a true association with the vaccine. For all serious and other clinically significant events (life-threatening events, hospitalization, permanent disability, death), follow-up with the health care provider and/or the parent or vaccinated individual is conducted in an attempt to collect supplemental information on the reports. Because of the limitations of this type of reporting system, causality is difficult to determine. Regardless of the cause, VAERS is interested in hearing about any health concerns that happen around the time of vaccination. In summary, scientists are not able to identify a problem with a vaccine lot based on VAERS reports alone without scientific analysis of other factors and data. 2. Vaccine lots are not the same. The sizes of vaccine lots might vary from several hundred thousand doses to several million, and some are in distribution much longer than others. Naturally a larger lot or one that is in distribution longer will be associated with more adverse events, simply by chance. Also, more coincidental deaths are associated with vaccines given in infancy than later in childhood, since the background death rates for children are highest during the first year of life. So knowing that lot A has been associated with x number of adverse events while lot B has been associated with y number would not necessarily say anything about the relative safety of the two lots, even if the vaccine did cause the events. Reviewing published lists of "hot lots" will not help parents identify the best or worst vaccines for their children. If the number and type of VAERS reports for a particular vaccine lot suggested that it was associated with more serious adverse events or deaths than are expected by chance, the Food and Drug Administration (FDA) has the legal authority to immediately recall that lot. To date, no vaccine lot in the modern era has been found to be unsafe on the basis of VAERS reports. All vaccine manufacturing facilities and vaccine products are licensed by the FDA. In addition, every vaccine lot is safety-tested by the manufacturer. The results of these tests are reviewed by FDA, who may repeat some of these tests as an additional protective measure. FDA also inspects vaccine-manufacturing facilities regularly to ensure adherence to manufacturing procedures and product-testing regulations, and reviews the weekly VAERS reports for each lot searching for unusual patterns. FDA would recall a lot of vaccine at the first sign of problems. There is no benefit to either the FDA or the manufacturer in allowing unsafe vaccine to remain on the market. The American public would not tolerate vaccines if they did not have to conform to the most rigorous safety standards. The mere fact is that a vaccine lot still in distribution says that the FDA considers it safe. Return to top 4. Vaccines cause many harmful side effects, illnesses, and even death - not to mention possible long-term effects we don't even know about. Vaccines are actually very safe, despite implications to the contrary in many anti-vaccine publications (which sometimes contain the number of reports received by VAERS, and allow the reader to infer that all of them represent genuine vaccine side-effects). Most vaccine adverse events are minor and temporary, such as a sore arm or mild fever. These can often be controlled by taking acetaminophen before or after vaccination. More serious adverse events occur rarely (on the order of one per thousands to one per millions of doses), and some are so rare that risk cannot be accurately assessed. As for vaccines causing death, again so few deaths can plausibly be attributed to vaccines that it is hard to assess the risk statistically. Of all deaths reported to VAERS between 1990 and 1992, only one is believed to be even possibly associated with a vaccine. Each death reported to VAERS is thoroughly examined to ensure that it is not related to a new vaccine-related problem, but little or no evidence suggests that vaccines have contributed to any of the reported deaths. The Institute of Medicine in its 1994 report states that the risk of death from vaccines is "extraordinarily low." DTP Vaccine and SIDS One myth that won't seem to go away is that DTP vaccine causes sudden infant death syndrome (SIDS). This belief came about because a moderate proportion of children who die of SIDS have recently been vaccinated with DTP; and on the surface, this seems to point toward a causal connection. But this logic is faulty; you might as well say that eating bread causes car crashes, since most drivers who crash their cars could probably be shown to have eaten bread within the past 24 hours. If you consider that most SIDS deaths occur during the age range when 3 shots of DTP are given, you would expect DTP shots to precede a fair number of SIDS deaths simply by chance. In fact, when a number of well-controlled studies were conducted during the 1980's, the investigators found, nearly unanimously, that the number of SIDS deaths temporally associated with DTP vaccination was within the range expected to occur by chance. In other words, the SIDS deaths would have occurred even if no vaccinations had been given. In fact, in several of the studies children who had recently gotten a DTP shot were less likely to get SIDS. The Institute of Medicine reported that "all controlled studies that have compared immunized versus nonimmunized children have found either no association . . . or a decreased risk . . . of SIDS among immunized children" and concluded that "the evidence does not indicate a causal relation between [DTP] vaccine and SIDS." But looking at risk alone is not enough - you must always look at both risks and benefits. Even one serious adverse effect in a million doses of vaccine cannot be justified if there is no benefit from the vaccination. If there were no vaccines, there would be many more cases of disease, and along with them, more serious side effects and more deaths. For example, according to an analysis of the benefit and risk of DTP immunization, if we had no immunization program in the United States, pertussis cases could increase 71-fold and deaths due to pertussis could increase 4-fold. Comparing the risk from disease with the risk from the vaccines can give us an idea of the benefits we get from vaccinating our children.
Risk from Disease
versus Risk from Vaccines
If You have the DISEASE, the number of children that develop complications Measles Pneumonia: 6 in 100 Encephalitis: 1 in 1,000 Death: 2 in 1,000 Rubella Congenital Rubella Syndrome: 1 in 4 (if woman becomes infected early in pregnancy) If you have the VACCINE the number of students that develop complications MMR Encephalitis or severe allergic reaction: 1 in 1,000,000 If You have the DISEASE, the number of children that develop complications Diphtheria Death: 1 in 20 Tetanus Death: 2 in 10 Pertussis Pneumonia: 1 in 8 Encephalitis: 1 in 20 Death: 1 in 200 If You have the VACCINE, the number of children that develop complications DTaP Continuous crying, then full recovery: 1 in 1000 Convulsions or shock, then full recovery: 1 in 14,000 Acute encephalopathy: 0-10.5 in 1,000,000 Death: None proven The fact is that a child is far more likely to be seriously injured by one of these diseases than by any vaccine. While any serious injury or death caused by vaccines is too many, it is also clear that the benefits of vaccination greatly outweigh the slight risk, and that many, many more injuries and deaths would occur without vaccinations. In fact, to have a medical intervention as effective as vaccination in preventing disease and not use it would be unconscionable. Research is underway by the U.S. Public Health Service to better understand which vaccine adverse events are truly caused by vaccines and how to reduce even further the already low risk of serious vaccine-related injury. Return to top 5. Vaccine-preventable diseases have been virtually eliminated from the United States, so there is no need for my child to be vaccinated. It's true that vaccination has enabled us to reduce most vaccine-preventable diseases to very low levels in the United States. However, some of them are still quite prevalent - even epidemic - in other parts of the world. Travelers can unknowingly bring these diseases into the United States, and if we were not protected by vaccinations these diseases could quickly spread throughout the population, causing epidemics here. At the same time, the relatively few cases we currently have in the U.S. could very quickly become tens or hundreds of thousands of cases without the protection we get from vaccines. We should still be vaccinated, then, for two reasons. The first is to protect ourselves. Even if we think our chances of getting any of these diseases are small, the diseases still exist and can still infect anyone who is not protected. A few years ago in California a child who had just entered school caught diphtheria and died. He was the only unvaccinated pupil in his class. The second reason to get vaccinated is to protect those around us. There is a small number of people who cannot be vaccinated (because of severe allergies to vaccine components, for example), and a small percentage of people don't respond to vaccines. These people are susceptible to disease, and their only hope of protection is that people around them are immune and cannot pass disease along to them. A successful vaccination program, like a successful society, depends on the cooperation of every individual to ensure the good of all. We would think it irresponsible of a driver to ignore all traffic regulations on the presumption that other drivers will watch out for him or her. In the same way we shouldn't rely on people around us to stop the spread of disease; we, too, must do what we can. Return to top 6. Giving a child multiple vaccinations for different diseases at the same time increases the risk of harmful side effects and can overload the immune system. Children are exposed to many foreign antigens every day. Eating food introduces new bacteria into the body, and numerous bacteria live in the mouth and nose, exposing the immune system to still more antigens. An upper respiratory viral infection exposes a child to 4 - 10 antigens, and a case of "strep throat" to 25 - 50. According to Adverse Events Associated with Childhood Vaccines, a 1994 report from the Institute of Medicine, "In the face of these normal events, it seems unlikely that the number of separate antigens contained in childhood vaccines . . . would represent an appreciable added burden on the immune system that would be immunosuppressive." And, indeed, available scientific data show that simultaneous vaccination with multiple vaccines has no adverse effect on the normal childhood immune system. A number of studies have been conducted to examine the effects of giving various combinations of vaccines simultaneously. In fact, neither the Advisory Committee on Immunization Practices (ACIP) nor the American Academy of Pediatrics (AAP) would recommend the simultaneous administration of any vaccines until such studies showed the combinations to be both safe and effective. These studies have shown that the recommended vaccines are as effective in combination as they are individually, and that such combinations carry no greater risk for adverse side effects. Consequently, both the ACIP and AAP recommend simultaneous administration of all routine childhood vaccines when appropriate. Research is under way to find ways to combine more antigens in a single vaccine injection (for example, MMR and chickenpox). This will provide all the advantages of the individual vaccines, but will require fewer shots. There are two practical factors in favor of giving a child several vaccinations during the same visit. First, we want to immunize children as early as possible to give them protection during the vulnerable early months of their lives. This generally means giving inactivated vaccines beginning at 2 months and live vaccines at 12 months. The various vaccine doses thus tend to fall due at the same time. Second, giving several vaccinations at the same time will mean fewer office visits for vaccinations, which save parents both time and money and may be less traumatic for the child. Reference: Vaccines, 4th Edition By Stanley A. Plotkin, MD and Walter A. Orenstein, MD Approx. 1696 pages, Copyright 2004 http://www.us.elsevierhealth.com/product.jsp?isbn=0721696880 6th Grade Camp  PLEASE TAKE THE TIME TO FILL OUT THE HEALTH INFO ON THE PERMISSION SLIP. While students are at Camp Orkila, they will be subject to the Shoreline School District medication policy. 1. NO MEDICATION can be given without the Camp version of the “Permission to Administer Medication at School” form filled out completely. 2. THIS INCLUDES OVER THE COUNTER MEDICATION like Tylenol or Benadryl. 3. We will need your signature AND YOUR DOCTOR’S SIGNATURE on the form for ALL MEDICATION. We can FAX the form to your doctor for signing. 4. The medication will need to be in the ORIGINAL CONTAINER (no baggies or envelopes with self-labeling). 5. All Medications must be turned in by. Students without medications by this deadline will not be able to have any medication at camp. NO MEDICATIONS WILL BE ACCEPTED ON THE DAY OF DEPARTURE. 6. Students who already have a "Permission to Administer Medication at School" form for daily medication NEED TO FILL OUT A NEW FORM FOR CAMP ORKILA DUE TO DIFFERENT HOURS IN ATTENDANCE. Please try to predict any medication your child may benefit from for allergies, motion sickness, headache, minor pain etc. as THERE WILL NOT BE ACCESS TO MEDICATION AT CAMP EXCEPT AS ABOVE. Remember that there are many allergens at camp, and even children who, for instance, have not had an asthma attack for years, may have one there. 7. ALL CAMPERS NEED PROOF OF INSURANCE. Don't forget to attach a photocopy of both sides of the insurance card or medical coupon that covers the student if you have not already turned one in. If your student does not have medical insurance, please contact one of your nurses as soon as possible. There are options avaialbe so all students may be covered and attend camp. You may complete the forms at any time during the school year before camp. Your nurses would be thrilled to have your completed forms turned in by February! Camp "sneaks" up on us very quickly after mid winter break so having some steps completed early will make your life easier as well. There are a lot of steps to get to Camp. Thanks for your patience and promptness in sorting through all of the information and then filling everything out and getting it back quickly. Much Appreciated!! Forms may be downloaded by going to the Documents button on the top left of this page. Return to top Head Lice Two words that make parents cringe when they hear them! There are the live lice  And their egg sacks called Nits  Remember, head lice do not fly or jump, they crawl. ANYONE can be infected with head lice. It is not about being clean, just about being in the right palce at the right time for a louse to walk on to your head or be transferred there by :
There are chemical shampoos available but
frankly,
we do not recommend using them, especially on children. The head lice have become resistant to the pestisides and often the harsh chemical treatments are not effective.
The most effective way of removing all nits
(eggs) and live lice is to use a
long tooth lice comb.  Comb your student's hair until you no longer can find any more nits or lice. It is also recommended to use the lice comb at least daily for up to two weeks to be sure no new eggs have hatched and your student has not become re-infested. Below, you will find the directions for a shampoo that has been effective in helping to remove head lice safely. All Natural
Lice Shampoo
I Cup Apple Cider Vinegar - DO NOT USE WHITE VINEGAR ¼ Cup shampoo – any kind will do How to use: Wet hair with warm water Add 2 ounces of vinegar/shampoo mixture to hair and massage for 5 minutes – DO NOT RINSE Add 2 more ounces and massage 5 more minutes. DO NOT RINSE Leave product on hair and scalp for 15 minutes With shampoo still in the hair, comb through the hair with any fine tooth comb to assist in removing the nits that have been released. Rinse thoroughly with a strong spray of very warm water. The lice and the nits will rinse out Inspect under bright light This shampoo does not contain harsh chemicals and should not harm your child. It is recommended that you use this shampoo mixture every day until all nits and lice are removed from the hair. You may download these insturctions by going to the Documents button on the top left of this page. The shampoo and cider vinegar solution helps to loosen the grip the nits have on the hair shafts so it will be easier to comb out with the fine, long tooth comb. Using the special comb frequently for the first 3 days and then at least daily for then next two weeks is the most effective way of controlling head lice.  There are countless suggested
ways to rid one of these dreaded infestations. We ask you to
use a large dose
of common sense as you come across unique suggestions. Please
DO NOT EVER use a flamable substance on your student's head or body
as a treatment.What else do we need to do? Cleaning Household Items to Get Rid
of the Lice
Reinfestation of lice usually does not come from household items such as carpets or furniture. Nothing beats nit picking when it comes to effectively removing nits from the hair. Remember... * Off the head, adult lice usually cannot survive for more than a day or two. Nits off the hair will die within hours of hatching if they can't find a meal (blood). So, there is no point in cleaning every nook and cranny. * Pets do not carry human head lice. They do not need any special cleaning. * Evidence shows that lice sprays are not effective in killing lice or nits. They only put poisons into the air. Save your money and avoid buying lice sprays! Things to wash in a washing machine: * Bath towels * Coats * Washable rugs, hats and scarves * Sheets, blankets, and pillow cases * Stuffed animals in contact with head and neck Wash items using very hot water or dry items in the dryer using high heat for 30 minutes. The heat will help kill the lice and nits. Things to sanitize: * Brushes, combs, and special nit loosening combs * Barrettes, other hair holders * Detachable foam pads inside bike and sport helmets To sanitize these items, soak the item in 1/4 cup bleach to 1 quart cold water for one hour. Things to vacuum: * Rugs and carpets * Car seats * Chairs and couches * Pillows from a couch or bed (wash the pillowcases) * Bed mattresses * Stuffed animals in contact with head and neck You may download these insturctions by going to the Documents button on the top left of this page. Another cleaning option: Items exposed to lice, such as stuffed animals, should be placed in a plastic bag and closed tightly for two weeks. During these two weeks the lice and nits will not have food (blood) and will die. It is very annoying and extremely time consuming to rid your student and home of nits and lice. Comb, Comb, Comb using the special lice comb - it is the best defense and offense against head lice. Rather than think if it as a chore, think of it as an opportunity to spend time with your son or daughter. We are all so busy and rarely get to spend larger blocks of time with individual children. Good luck and don't hesitate to call the health office if you have further questions. Return to top Home Hospital  Home/Hospital instruction is provided to students who are temporarily unable to attend school for an estimated period of four weeks (20 consecutive school days) or more because of a physical and/or mental disability or illness. The program does not provide tutoring to students caring for an infant or a relative who is ill. This program allows students to continue their education through a School District tutor that contacts the student’s teacher(s) for assignments and then goes to the student's home or to the hospital to deliver and pick up assignments and assist where needed. Home Hospital is a state wide program that has guidelines we must follow (WAC 392-182-218). The maximum amount of time a student may use these services within a single school year is 18 weeks. The physician must state that the student may need to be out of school for at least 20 consecutive school days (4 weeks) in order for us to process an application for this program. The student may return to school before the 20 days is up if their recovery takes less time then anticipated with no penalty. Student’s may also come to school for partial days as their condition improves and continue to remain getting Home Hospital services. There are 4 forms needed to complete the application process:
1. Shoreline Public Schools Special Programs Request for Home/Hospital Instruction. This is the form that is filled out by the student's physician. The physician MUST state that the student will be out for at least 20 consecutive school days (4 weeks) or we may not process the application. This form is returned to the nurses office. 2. Application for HomelHospital Instruction This is filled out by the student's parent/guardian and returned to the nurses office. 3. Authorization for Exchange of Confidential Information This allows the nurses to speak directly to your student’s physician to coordinate services and needs. We commonly limit the scope of our contact to the current concern that is keeping the student out of school. This form is returned to the nurses office. 4. Nurses Report for Home Hospital Instruction This report is completed by your nurses from the information gathered from the physician and parent completed forms. We then fax the forms to the School District person at the central office who manages the Home Hospital program. The Home Hospital tutor will be contacted by them on the day the paperwork is turned in. Forms may be downloaded by going to the Documents button on the top left of this page. Return to top Health Screening 
Return to top Resources Crisis Clinic  24 hour line 866-427-4747 206-461-3222 This is a wonderful resource for persons who are actually in a crisis and it is also extremely helpful for anyone who is concerned about someone they feel may be in crisis but not currently seeking help. The people taking the calls can help you with possible ways to assist someone you are concerned about. They are a resource that nurses and counselors use for suggestions. Please don't hesitate to call them. The Crisis Clinic web site is a fantastic resource for a multitued of concerns as well as a great resource for many local services. Please check it out. http://www.crisisclinic.org/main.html Return to Top Teen Link - Crisis Clinic  This is a help line for teens who would like to speak anonymously and confidentially to another teen about anything you want to talk about. 206-461-4922 1-888-431-8336 Teen Link Hours - Daily 6pm-10pm Use the regular Crisis Clinic line for help when Teen Link is not available 206-461-3222 24 hour Line 1-866-427-4747 Return to Top Poison Control  Please call them before you begin any treatment. An improper treatment can make possible damage much worse. 1-800-222-1222 They also have a great web site you should check out! www.wapc.org Return to Top Health and Food Resources-  Parents work hard to provide for their families. Sometimes they need a little help. ParentHelp123 can help you find out if your family may qualify for health insurance and food programs in Washington State! www.parenthelp123.org/ Return to Top Shoreline Police - Non Emergency  206-546-6730 Return to Top The Works  The Works - The PTA Council Clothing Room- Now located at the Shoreline Center 18560 1st Ave. NE The Works is solely operated by the Shoreline PTA Council. 18560 1st Ave. NE Shoreline, Wash 98155 No appointment necessary Open EVERY WEDNESDAY from 6:30pm to 8:30pm for the Month of September The Works is closed when the Shoreline Schools are closed  Return to top North Seattle Health Center North Seattle Health Center- 10501 Meridian Ave N Seattle, WA 206- 296-4838 Monday, Wed.-Fri., 8:00 AM to 5:00 PM Tuesday, 8:00 AM to 8:00 PM http://www.metrokc.gov/health/sts_svs/north.htm Return to top Ballard CSO CSO - Community Service Office- The Ballard office is the one used for this area 907 NW Ballard Way Seattle, Washington 98107 The office is on the 1st floor 206-341-7424 Hours: 7am to 5:30pm https://fortress.wa.gov/dshs/f2ws03esaapps/onlinecso/cover.asp  Return to Top Center for Human Services 17018 15th Ave. NE Shoreline, WA. 98155 206.362.7282 http://WWW.CHS-NW.ORG/index.html They provide support for families by: Providing information of all kinds Education - especially English classes They help with connecting families and individuals with resources and referrals that are accessible to our very diverse community
Their Substance Abuse program includes the following: * Outpatient Treatment * Assessments * Individual and Family Counseling * Consultation and Training * First Time Offender Program -- Case management, counseling, and parent education program for at-risk youth entering the juvenile court system for the first time. The goal is to prevent youth from becoming further involved in the juvenile justice system. Youth ages 11-17. Medical coupons accepted. * STARS Program - Students Taking Addiction Recovery Seriously * Off-site services at Scriber Lake High School in Snohomish County. Assessments, Intensive Outpatient, and Outpatient treatment * CDDA - Drug Court Wraparound outpatient treatment and case management * Drug testing  Return to top Hopelink - Shoreline Emergency Services  18220 96th Ave NE Bothell, WA 98011 Mailing: PO Box 25103, Seattle, WA 98125 http://www.hope-link.org/ Phone: (425) 485-6521 Fax: (425) 483-5251 Service Area: Cities of Shoreline and Lake Forest Park Service by ZIP: 98133, 98155 and 98177 (North of 145th Street) Office Hours: 8:30am - 5pm Bus Routes: Metro #312, 341, 342, 372; Sound Transit #522 * Financial assistance for rental needs (eviction prevention and move-in costs), utility needs (shut-off prevention), prescriptions * Energy Assistance (LIHEAP: Low Income Home Energy Assistance Program) * Referrals  Return to Top Food Bank  Shoreline Free Methodist Church: 510 175th Street Shoreline, WA 98155 Located kitty corner from the Shoreline Library on the northeast corner of 175th Street and 5th Avenue Hours: Tuesdays - llam-2pm The 2nd and 4th Monday of each month - 5:30-6:30pm  Return to Top Child Abuse Reporting  1-800-379-3395 Return to Top Teen Hope  206-546-1010 915 N 199th Street Shoreline, WA 98133 Free Shelter for teens The objective of shelter services is to offer a safe alternative to the streets while providing the supports needed to link teens with more stable living situations. They also offer the Peace Table which is a mediation process for teens and families experiencing conflict. The fee is on a sliding scale. Return to Top Metro Trip Planner  How do I get there from here? Enter the address you are at and the address of where you want to go. The trip planner will tell you which bus to take and direct you to the bus schedule. Return to top Healthy Options Washington State Children's health insurance 1-800-204-6429 http://www.wa.gov/dshs/dshsforms/forms/eforms.html Select form number 13-664 to download the application form for healthy options You may also select from a number of languages the forms has been translated into Cambodian | Chinese | Korean | Laotian | Russian | Spanish | Vietnamese https://wws2.wa.gov/dshs/onlinecso/childrens_medical.asp This site explains what medical services are available for children and families and also gives income levels for eligability. https://wws2.wa.gov/dshs/onlineapp/introduction_1.asp This site offers an on line application process https://wws2.wa.gov/dshs/onlinecso/services.asp Explains the many services DSHS offers Return to Top Suicide Information  Suicide is about Pain, overwhelming pain. 1. Take it seriously. Myth: “The people who talk about it don't do it.” Studies have found that more than 75% of all completed suicides did things in the few weeks or months prior to their deaths to indicate to others that they were in deep despair. Anyone expressing suicidal feelings needs immediate attention. Myth: “Anyone who tries to kill himself has got to be crazy.” Around 10% of all suicidal people are psychotic or have delusional beliefs about reality. Most suicidal people suffer from the recognized mental illness of depression; but many depressed people adequately manage their daily affairs. The absence of “craziness” does not mean the absence of suicide risk. Myth: “Those problems weren't enough to commit suicide over” Those words are often said by people who knew someone who completed suicide. You cannot assume that because you feel something is not worth being suicidal about, that the person you are with feels the same way. It is not how bad the problem is, but how badly it's hurting the person who has it. 2. Remember: suicidal behavior is a cry for help. Myth: “If a someone is going to kill themselves, nothing can stop them.” The fact that a person is still alive is sufficient proof that part of them wants to remain alive. The suicidal person is ambivalent - part of him wants to live and part of him wants not so much death as they want the pain to end. It is the part that wants to live that tells another “I feel suicidal.” If a suicidal person turns to you it is likely that they believe that you are more caring, more informed about coping with misfortune, and more willing to protect their confidentiality. No matter how negative the manner and content of their talk, they are doing a positive thing and have a positive view of you. 3. Be willing to give and get help sooner rather than later. Suicide prevention is not a last minute activity. Unfortunately, suicidal people are afraid that trying to get help may bring them more pain: being told they are stupid, foolish, sinful, or manipulative; rejection; punishment; suspension from school or job; written records of their condition; or involuntary commitment. You need to do everything you can to reduce pain, rather than increase or prolong it. Constructively involving yourself on the side of life as early as possible will reduce the risk of suicide. 4. Listen. Give the person every opportunity to unburden their troubles and vent their feelings. You don't need to say much and there are no magic words. If you are concerned, your voice and manner will show it. Give them relief from being alone with their pain; let them know you are glad they turned to you. Patience, Sympathy, Acceptance. Avoid arguments and advice giving. 5. ASK: “Are you having thoughts of suicide?” Myth: “Talking about it may give someone the idea.” People already have the idea; suicide is constantly in the news media. If you ask a despairing person this question you are doing a good thing for them: you are showing them that you care about them, that you take them seriously, and that you are willing to let them share their pain with you. You are giving them further opportunity to discharge pent up and painful feelings. If the person is having thoughts of suicide, find out how far along his plan has progressed. 6. If the person is acutely suicidal, do not leave them alone. If the means for the suicide are present, pills, fire arm etc., try to get rid of them. Detoxify the home. 7. Urge professional help. Persistence and patience may be needed to seek, engage and continue with as many options as possible. In any referral situation, let the person know you care and want to maintain contact. 8. No secrets. It is the part of the person that is afraid of more pain that says “Don't tell anyone.” It is the part that wants to stay alive that tells you about it. Respond to that part of the person and persistently seek out a mature and compassionate person with whom you can review the situation such as calling the Crisis Clinic 24 hour Line 1-866-427-4747. (You can get outside help and still protect the person from pain causing breaches of privacy.) Do not try to go it alone. Get help for the person and for yourself. Distributing the anxieties and responsibilities of suicide prevention makes it easier and much more effective. 9. From crisis to recovery. Most people have suicidal thoughts or feelings at some point in their lives; yet less than 2% of all deaths are suicides. Nearly all suicidal people suffer from conditions that will pass with time or with the assistance of a recovery program. There are hundreds of modest steps we can take to improve our response to the suicidal person and to make it easier for them to seek help. Taking these modest steps can save many lives and reduce a great deal of human suffering. WARNING SIGNS A person may have one or many of the warning signs. There is not a specific number a person has to have before being considered at serious risk. Conditions associated with increased risk of suicide * Death or terminal illness of relative or friend. * Broken relationship, Divorce, Separation, Stress on family. * Loss of health (real or imaginary). * Loss of self-esteem, personal security, job, home, money, status, * Alcohol or drug abuse. * Depression. In the young depression may be masked by hyperactivity or acting out behavior. In the elderly it may be incorrectly attributed to the natural effects of aging. • Depression that seems to quickly disappear for no apparent reason is cause for concern. The early stages of recovery from depression can be a high risk period. • Recent studies have associated anxiety disorders with increased risk for attempted suicide. Emotional and behavioral changes associated with suicide * Overwhelming Pain: pain that threatens to exceed the person's pain coping capacities. Suicidal feelings are often the result of longstanding problems that have been made worse by recent events. There may be new pain or the loss of pain coping resources. * Hopelessness: the feeling that the pain will continue or get worse; things will never get better. * Powerlessness: the feeling that one's resources for reducing pain are exhausted. * Feelings of worthlessness, shame, guilt, self-hatred, “no one cares”. Fears of losing control, harming self or others. * Personality becomes sad, withdrawn, tired, apathetic, anxious, irritable, or prone to angry outbursts. * Declining performance in school, work, or other activities. (Occasionally the reverse: someone who volunteers for extra duties because they need to fill up their time.) * Social isolation; or association with a group that has different moral standards than those of the family. * Declining interest in friends, or activities previously enjoyed. * Neglect of personal welfare, deteriorating physical appearance. * Alterations in either direction in sleeping or eating habits. (Particularly in the elderly) Self-starvation, dietary mismanagement, disobeying medical instructions. Suicidal Behavior * Previous suicide attempts, “mini-attempts”. * Explicit statements of a suicidal plan or feelings. * Development of suicidal plan, acquiring the means, pills, firearm etc., “rehearsal” behavior, setting a time for the attempt. * Self-inflicted injuries, such as cuts, burns, or head banging. * Reckless behavior. * Giving away favorite possessions or making out a will . * Inappropriately saying goodbye. * Verbal behavior that is ambiguous or indirect: “I'm going away on a real long trip.” “You won't have to worry about me anymore.”, “I want to go to sleep and never wake up.” “I'm so depressed, I just can't go on.” “Does God punish suicides?” “Voices are telling me to do bad things.” Requests for euthanasia information Inappropriate joking Stories or essays on morbid themes. The above suicide prevention information is from the following web site. http://www.metanoia.org/suicide/whattodo.htm The following are great resource sites for more information: http://www.yspp.org/ Return to Top Helpful Health Information What is the best way to prevent colds, the flu, almost any illness? 
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You want lots of soap bubbles and gently scrub your hands together for as long as it take you to sing Happy Birthday to yourself. We do not recommend using an antibacterial soap for two main reasons. They often cause the skin to dry and crack making it easier for germs to enter our body. Germs are very good at adapting to conditions, we don't want to contribute to making "better bugs". We use a very mild dishwashing soap diluted with water in a foaming pump dispenser in the Shorecrest health office to wash hands as well as clean minor wounds. It is that time of year again! Colds and the Flu are Viruses Drink lots of water Get lots of rest Most people recover in a week but symptoms can last up to 14 days. High fever, significantly swollen glands, severe facial pain in the sinuses, and a cough that produces a colored mucus, may indicate a complication or more serious illness requiring a doctor's attention. Antibiotics do not kill viruses. The medical community recommends that these prescription drugs should be used only for bacterial complications, such as sinusitis or ear infections, that can develop as secondary infections. The use of antibiotics "just in case" will not prevent secondary bacterial infections. The American Academy of Pediatrics recommends children and teenagers not be given aspirin or any medications containing aspirin when they have any viral illness, such as a cold, the flu and chickenpox. Several studies have linked the use of aspirin to the development of Reye's Syndrome. Children with Reye's syndrome start vomiting and become drowsy within a few days of becoming sick. The disorder can affect all body organs and lead to brain damage and death. Some medicine labels may refer to aspirin as salicylate or salicylic acid. Be sure to educate your student, who may take over-the-counter (OTC) medicines without your knowledge. A solution of 1 part bleach mixed with 10 parts cool water is very effective in killing viruses on surfaces. This is an extremely effective and yet inexpensive way to kill viruses on counter tops, door knobs, floors, toys toddlers put in their mouths etc. If you smell the bleach, you have too much in your solution. Spray on surfaces and let set at least 1 minute before drying, or just let air dry. The solution needs to be prepared daily. Return to Top |