HERE’S TO YOUR HEALTH WINTER NEWSLETTER
Publication of the Braintree School Nurses
Volume 6, Issue 2
February, 2016
Welcome back to the 2015 – 2016 school year!
The school nurses wish you a happy and healthy 2016!
Winter Fun in the Sun
Use Sunscreen - Although it might seem odd in the winter, you need to use sunscreen (with a minimum
SPF of 15) when you're skiing, sledding, skating, or snowboarding. Sunlight reflects off all that bright
white snow and ice and back onto your face — so cover up with sunscreen, and put on some lip balm
that contains sunscreen (even when it's cloudy outside).
Dress for Cold Temperatures: Frostbite and hypothermia are potential dangers. Make sure your kids
wear the right clothing to keep them warm and safe.
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Wear sensible winter clothing, hats, gloves, mittens, snow pants, and winter jackets, snow boots
that are waterproof and warm. Change into something dry if clothing gets wet.
Make your kids wear helmets, especially if they are 12 years old or younger. Helmets that are
made for winter sports are best, but if you don’t have one, make sure they wear a bike helmet
or something similar.
Safety Tips: Sledding
Sledding is a favorite outside winter activity for children of all ages. Though it seems like harmless fun,
sledding accidents send thousands of kids and teens to hospital emergency rooms each year. Head
injuries are the most common sledding injuries seen in emergency rooms. Most sledding injuries involve
collisions with objects or people. You can keep your kids safe, by following these safety tips.
Choose the Right Sledding Hill: Hills that are coated with snow look like great places for sledding, but be
careful when picking a place for your kids to sled. Not all hills are safe.
Here are a few guidelines to follow when it comes to picking the right spot to sled:
 Select a hill that is not too steep and has a long flat area at the bottom for your kids to glide to a
stop
 Avoid hillsides that end near a street or parking lot
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Avoid hillsides that end near ponds, trees, fences, or other hazards.
Make sure the hill is free of obstacles such as jumps, bumps, rocks, poles, or trees before your
kids start sledding.
Pick hills that are snowy not icy. Icy slopes make for hard landings if kids fall off a sled.
Always sled during the daytime, when visibility is better. If they do go sledding at night make
sure the hillside is well lit and all potential hazards are visible.
Get the Right Kind of Sled: The best sleds can be steered by their riders and have brakes to slow them
down. Avoid sleds that can’t be steered, such as tubes, saucers, or toboggans, and never use a sled
substitute like a lunch tray or cardboard box. Good sleds are relatively inexpensive to buy and are well
worth the extra money.
Some Simple Sledding Safety Rules:
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Be sure a responsible adult is present to supervise. In the event someone does get injured there
should always be an adult on hand to administer first aid, and if necessary take the injured
person to the emergency room. Call 911 for serious injuries, including neck or head injuries.
Young kids (5 and younger) should sled with an adult, and kids under age 12 should be watched
at all times.
Children should always sit face-forward. Never let them sled down a hill backwards, or while
standing, and make sure they don’t go down the hill face-first, as this greatly increases the risk
of head injury.
Insist that kids go down the hill one at a time and with only one person per sled (except for
adults with young kids).
Don’t let kids build an artificial jump or obstacle on the sledding hill.
Remind kids to keep their arms and legs within the sled at all times. If they fall off the sled, tell
them to move out of the way. Teach them that if they are on a sled that won’t stop, to roll off it
and get away from it.
Encourage your child to walk up the side of the hill and leave the middle open for others
sledding down
Never allow a child to ride on a sled that is being pulled by a moving vehicle.
Don’t wear scarves or any clothing that may get caught in a sled and pose a risk of strangulation.
While it is unlikely that kids will be injured when sledding, the possibility definitely exists. Just take a
little extra time to dress them properly and make sure they follow these safety guidelines. They will
have a better time, and you will rest easier knowing that you have less to worry about.
Skiing and Snowboarding
Before you hit the slopes to ski or snowboard, make sure you have the right equipment — and that it fits
you correctly. Many kids get injured because the equipment they use is too big for them. It may have
belonged to an older brother or sister and they are hoping that they can "grow into it." Equipment that
is too big will make it hard for you to stay in control.
Helmets are a must for skiing and snowboarding. Goggles will protect your eyes from bright sunlight and
objects that could get in the way and poke you in the eye (like tree branches). Just like with inline
skating, snow boarders’ need knee pads and elbow pads. Some snow boarders who are just learning
wear specially padded pants to cushion their falls!
Participating in winter sports is a lot of fun. But…………
Getting hurt is not. Take these five steps to prevent injuries so you can stay in the game:
1. Wear protective gear, such as helmets, protective pads, and other gear.
2. Warm up and cool down.
3. Know the rules of the game and follow all safety rules!
4. Watch out for others.
5. Don't participate when you are injured.
Source: http://kidshealth.org/parent/firstaid_safe/outdoor/safety_sledding.html
http://kidshealth.org/kid/watch/out/winter_sports.html
Submitted by: Cheryl Campbell, RN, Morrison; Ellen Wright, RN and Ellen Stenmon RN, South Middle
FROSTBITE
Frostbite is an injury that occurs when the skin and underlying tissues
freeze. When this happens the skin becomes cold and red, numb, and then hard
and pale. The most common parts of the body where frostbite occurs are the
fingers, toes, nose, ears, cheeks and chin. When the skin is exposed to cold windy
weather, it is the most vulnerable to frostbite. Frostbite can also happen on skin
that is protected by gloves and other clothing.
The first stage of frostbite is frostnip and does not cause permanent skin
damage. Very mild frostbite can be treated with something as simple as rewarming
one’s skin. Medical intervention is required to treat any more involved frostbite as
it can be very damaging to the skin, tissues, muscle and bones; in severe cases it
can cause infection and nerve damage.
The following are signs and symptoms of frostbite:
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Cold prickly feeling skin
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Numbness
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Red, white, bluish-white or grayish yellow skin
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Waxy-looking or hard skin
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Joint and muscle stiffness
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In severe cases, blistering after warming
Frostbite occurs in numerous phases:
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Frostnip. Frostnip is very mild and the first stage of
frostbite. During this stage, the skin feels very cold and turns
red. Prickling feeling and numbness will occur in the affected
areas with continued exposure. Pain and tingling may ensue as
the skin warms; skin is not permanently damaged from frostnip.
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Superficial Frostbite. During the second stage of frostbite,
the skin becomes reddened white or pale in color. Although the
skin may feel soft, ice crystals may form in the tissue. If the
skin begins to feel warm it could be a sign of serious skin
involvement. Treating frostbite with warming at this stage may
make the skin appear mottled, blue or purple; burning, swelling
or stinging may also occur. Fluid-filled blisters can appear 2436 hours after rewarming the skin.
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Severe (deep) Frostbite. Frostbite affects all layers of the
skin as it progresses. One may experience pain, discomfort,
loss of sensation and numbness in the area affected. In
extreme cases, one may also lose use of muscles and joints. 2448 hours after rewarming, large blisters occur which then turn
black and hard as the tissue dies.
Seek medical attention when the following are experienced:
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Signs and symptoms of superficial or deep frostbite
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Increased swelling, pain redness or discharge in the frostbitten
area
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Temperature
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Additional unexplained symptoms
If hypothermia (a condition in which one’s body loses heat faster than it’s
produced) is suspected, get emergency medical care.
Signs and symptoms of
hypothermia include the following:
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Extreme shivering
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Speech that is slurred
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Loss of coordination and drowsiness
Source: Mayo Clinic Staff/ Submitted by Judy Sellon RN, Flaherty School
Why Is Sleep Important?
Sleep plays a vital role in good health and well-being throughout your life. Getting enough quality sleep
at the right times can help protect your mental health, physical health, quality of life, and safety.
The way you feel while you're awake depends in part on what happens while you're sleeping. During
sleep, your body is working to support healthy brain function and maintain your physical health. In
children and teens, sleep also helps support growth and development.
The damage from sleep deficiency can occur in an instant (such as a car crash), or it can harm you over
time. For example, ongoing sleep deficiency can raise your risk for some chronic health problems. It also
can affect how well you think, react, work, learn, and get along with others.
Healthy Brain Function and Emotional Well-Being
Sleep helps your brain work properly. While you're sleeping, your brain is preparing for the next day. It's
forming new pathways to help you learn and remember information.
Studies show that a good night's sleep improves learning. Whether you're learning math, how to play the
piano, how to perfect your golf swing, or how to drive a car, sleep helps enhance your learning and
problem-solving skills. Sleep also helps you pay attention, make decisions, and be creative.
Studies also show that sleep deficiency alters activity in some parts of the brain. If you're sleep deficient,
you may have trouble making decisions, solving problems, controlling your emotions and behavior, and
coping with change. Sleep deficiency also has been linked to depression, suicide, and risk-taking
behavior.
Children and teens that are sleep deficient may have problems getting along with others. They may feel
angry and impulsive, have mood swings, feel sad or depressed, or lack motivation. They also may have
problems paying attention, and they may get lower grades and feel stressed.
Physical Health
Sleep plays an important role in your physical health. For example, sleep is involved in healing and repair
of your heart and blood vessels. Ongoing sleep deficiency is linked to an increased risk of heart disease,
kidney disease, high blood pressure, diabetes, and stroke.
Sleep deficiency also increases the risk of obesity. For example, one study of teenagers showed that with
each hour of sleep lost, the odds of becoming obese went up. Sleep deficiency increases the risk of
obesity in other age groups as well.
Sleep helps maintain a healthy balance of the hormones that make you feel hungry (ghrelin) or full
(leptin). When you don't get enough sleep, your level of ghrelin goes up and your level of leptin goes
down. This makes you feel hungrier than when you're well-rested.
Sleep also affects how your body reacts to insulin, the hormone that controls your blood glucose (sugar)
level. Sleep deficiency results in a higher than normal blood sugar level, which may increase your risk for
diabetes.
Sleep also supports healthy growth and development. Deep sleep triggers the body to release the
hormone that promotes normal growth in children and teens. This hormone also boosts muscle mass and
helps repair cells and tissues in children, teens, and adults. Sleep also plays a role in puberty and fertility.
Your immune system relies on sleep to stay healthy. This system defends your body against foreign or
harmful substances. Ongoing sleep deficiency can change the way in which your immune system
responds. For example, if you're sleep deficient, you may have trouble fighting common infections.
Daytime Performance and Safety
Getting enough quality sleep at the right times helps you function well throughout the day. People who
are sleep-deficient are less productive at work and school. They take longer to finish tasks, have a slower
reaction time, and make more mistakes.
After several nights of losing sleep—even a loss of just 1–2 hours per night—your ability to function
suffers as if you haven't slept at all for a day or two.
Lack of sleep also may lead to microsleep. Microsleep refers to brief moments of sleep that occur when
you're normally awake.
You can't control microsleep, and you might not be aware of it. For example, have you ever driven
somewhere and then not remembered part of the trip? If so, you may have experienced microsleep.
Even if you're not driving, microsleep can affect how you function. If you're listening to a lecture, for
example, you might miss some of the information or feel like you don't understand the point. In reality,
though, you may have slept through part of the lecture and not been aware of it.
Some people aren't aware of the risks of sleep deficiency. In fact, they may not even realize that they're
sleep-deficient. Even with limited or poor-quality sleep, they may still think that they can function well.
For example, drowsy drivers may feel capable of driving. Yet, studies show that sleep deficiency harms
your driving ability as much as, or more than, being drunk. It's estimated that driver sleepiness is a factor
in about 100,000 car accidents each year, resulting in about 1,500 deaths.
Drivers aren't the only ones affected by sleep deficiency. It can affect people in all lines of work, including
health care workers, pilots, students, lawyers, mechanics, and assembly line workers.
As a result, sleep deficiency is not only harmful on a personal level, but it also can cause large-scale
damage. For example, sleep deficiency has played a role in human errors linked to tragic accidents, such
as nuclear reactor meltdowns, grounding of large ships, and aviation accidents.
Source: www.nhlbi.nih.gov/.../why
Submitted by Jane Bagley, RN, Hollis School
Flu Symptom Check List for Families, Schools and Child Care
Programs
Flu season in Massachusetts usually starts in the fall and runs through the spring. The main symptoms of
influenza (flu) include fever in combination with a cough and/or sore throat.
Some people may also have a runny nose, body aches, headache, chills, and feel tired. Some people
(especially young children) may also have diarrhea and vomiting.
To keep flu from spreading in the community it is important to keep your sick child at
home when he or she has the flu. Use this form as a guided during flu season to determine whether your
child should attend school or child care.
Should I keep my child home?
Flu Like Illness: Should I Keep My Child Home? Yes/No
1) Has your child had a fever of 100.4 degrees F or higher in the past 24
hours? (Note: 100.4° F is the same as 38° C).
If you answered Yes to the question above, keep your child home for at least another
day to observe for additional symptoms.
2) Does your child have a cough OR sore throat?
If you answered YES to both questions above, keep your child home. Your child
has an influenza-like illness (fever and cough or sore throat). If your child has a cough
or sore throat without fever, he or she may be well enough to go to school or child care.
Your child’s school or child care program may have additional guidance.
After thmy child return to school or child e?
After the Flu: Can my child return to School?
Yes/No
1) Has your child had a fever of 100.4 degrees F or higher in the past 24
hours? (Note: 100.4° F is the same as 38° C).
If you answered Yes to the question above, keep your child home for at least another
day to observe for additional symptoms.
2) Has your child had acetaminophen (Tylenol) or ibuprofen (Motrin or Advil)
to reduce fever in the past 24 hours?
If you answered YES to either question above, keep your child home for at least
another day to observe for additional symptoms. Then use the check list questions
again to decide whether you should continue to keep your child home.
If you answered NO to both questions above, and your child appears well,
your child can return to school or child care.
Where can I find more information about influenza?
www.mass.gov/flu; www.cdc.gov/flu
Call the Massachusetts Department of Public Health at 617-983-6800 or Braintree Board of
Health at 781-794-8094. Massachusetts Department of Public Health, 2015
Concussion and the role of the School Nurse
Braintree Public Schools has a concussion policy in place to ensure that students
who have sustained a head injury and/or concussion will receive proper medical
treatment and academic accommodations so that healing will occur and students will
maintain optimal learning.
The policy states that students who have suffered a head injury and exhibit
signs/symptoms of a concussion, must be evaluated by a medical doctor. Students
must have the medical documentation listing academic and physical activity restrictions
upon his/her return to school.
The Braintree Public Schools have a color-coded concussion form listing stages of
recovery and the academic modifications teachers will make during each stage. These
forms are given out to parents to bring to their doctor by the school nurse when the
injury occurs during school hours and by the athletic trainer when the injury occurs
during after school sports.
As soon as the school nurse is notified that a student has been diagnosed with a
concussion, teachers, administrators, guidance counselors and the athletic department
are notified. At the High School, notification is done initially by e-mail. Additionally,
copies of the concussion paperwork listing academic and sports restrictions are sent to
teachers, administrators, guidance counselors, and the athletic department on the day
the nurse receives the written documentation.
As the student goes through the stages of recovery medical updates are sent to
the appropriate people regarding concussion status. When the student is cleared by
his/her doctor, the student will then work with the athletic trainer in the gradual return
to play protocol. This means that the student will resume physical activities slowly
under the supervision of the athletic trainer. When the student is cleared by the
athletic trainer, he/she may resume physical education and sports. This phase is
important because concussion symptoms may reoccur upon introduction of physical
activity.
Submitted by Fran Barron, RN, BHS
February – Heart Month and Dental Heath Month
February is healthy heart awareness month. It is never too early or too late to take care of your heart to
ensure good health for you or a family member. According to the American Heart Association (AHA),
“a healthy diet and regular physical activity are secret weapons to preventing heart disease. Changes in
lifestyle can improve heart health by up to 80%.” Some tips to a healthy heart:
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Quit smoking, if you don’t smoke, DON’T START! Talk to your children about the dangers of
smoking. Not only does it affect your heart but it can lead to different cancers and lung disease.
If you are having trouble quitting smoking, talk with your doctor.
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Healthy eating: Increase your consumption of fresh fruits and vegetables. Monitor your fats
intake. Not all fats are created equal. Some fats are good for you and necessary for your body.
“Monounsaturated and polyunsaturated fats are healthy fats because they do not raise the
“bad” LDL cholesterol in your body and may actually help raise your “good” HDL cholesterol,”
says Dr. Rachel Johnson, Robert L. Bickford Jr. Green and Gold Professor of Nutrition at the
University of Vermont. Some examples of healthy fats are olive oil, canola oil, nuts like almonds
(dry roasted or raw), avocados, and fish (salmon, trout, and tuna are good options). Be careful
with calories though, some healthy fat foods are high in calories, monitor your portions. For
example just grab a handful of nuts. “The American Heart Association recommends people eat
foods with monounsaturated fats and polyunsaturated fats instead of saturated and trans fat.
Aim for healthy fats to not exceed 35 percent of your total daily calories. Reduce your sodium
intake. According to the AHA, the average American consumes 3000 mg of sodium. It is
recommended limiting sodium intake to less than 1500 mg daily. Some big offenders of high
sodium are processed (deli), canned or frozen foods, pizza, and fast foods. Opt for fresh foods
and home cooking. READ labels, choose foods that say low sodium or no sodium.
 Sleep and rest are contributing factors to ensure good heart health. It is recommended that
adults get an average of 6-8 hours of sleep, school age children 10-11 hours, teens 8-10 hours.
A good night’s sleep helps reduce blood pressure and decreases stress.
 Regular exercise or activity can improve your quality of life. Exercise can improve your mental
alertness, decrease stress and anxiety and improve self-image. The AHA recommends 40
minutes of rigorous or aerobic exercise 3-4 times a week. You don’t have to go to gym, brisk
walking, dancing, or playing outside with your children are great options. If it is winter or the
weather is bad, play active indoor games with your children. Some examples are freeze dance,
hide and seek, make tunnels and forts with blankets and furniture and do timed races. Just put
down the electronic devices and use your bodies for some indoor fun. Talk with your physician
before starting any exercise regimen.
 See a doctor regularly and have your blood pressure monitored. High blood pressure or
hypertension increases your risk for heart disease. If your blood pressure is high, it puts a strain
on your heart, arteries, and your kidneys. If you follow the above tips for a healthy heart you
can reduce your risk for high blood pressure.
With some lifestyle changes for you and your family, good habits early will contribute to a healthy heart
and life. For more information see the AHA website at www.heart.org or www.goredforwomen.org
Remember to Celebrate National Wear Red Day with Go Red for Women on Friday, Feb. 5, 2016
Submitted by Julie Moran RN, MSKC; Adapted from the American Heart Association
February is National Dental Health Month
Tooth decay is the most common childhood disease affecting millions of
children nationwide. Having your child free of dental disease is not only
important for their growth, development, and self esteem, but also their ability
to concentrate in school!
**Reminder to parents of students in grade 3 – a local area dentist will be
coming to your child’s class one day during the month February. The
dentist will provide dental education and a screening.
If you do not wish your child to have a screening, please send a note to
your child’s school nurse.
SAVE THE DATES:
1. Wednesday March 9th “Helping Your Student Develop
Healthy Coping Skills for Life” by Lujuana Milton MSW,
LICSW at South Middle School 7PM for all Parents and Guardians
2. Wednesday April 6th “No First Time and Hidden in Plain
Sight” By Stephanie and John Green and Trooper John Fanning
at Braintree Town Hall 7 PM for all Parents and Guardians
th
3. Thursday, May 12 “The Amazing Healthy Race” Making a
Difference - Community Event 4 – 6 PM Location TBD
For all students, parents, guardians and community
members.
All Programs Presented by Braintree Alliance for Safe and
Healthy Youth