Health Corner

St. Nicholas believes that an integrated and coordinated approach to education must include providing health services and information to students, parents, faculty, and staff. April Denton is the St. Nicholas School Nurse. As a partner in the St. Nicholas educational experience, Ms. Denton advocates, coordinates, and manages the St. Nicholas health program by providing onsite basic health care for, and consultation to, students and faculty. Additionally, she is a medical resource for parents, promoting healthy living for families and students. 

With her experience working with children as a pediatric nurse for 11 years, Ms. Denton is eager to forward information to parents that will improve student health and reduce barriers to learning. Therefore, she researches information for families, teachers, and students with the purpose of encouraging practices that address the challenges faced by school environments.  Below is information she hopes will assist families in remaining healthy and safe throughout the upcoming school year.

About Sleep for Children

According to most of the articles, elementary age students need 9-10 hours of sleep a night .those who sleep less are often hyperactive. Deficits in sleep over time tend to have escalating and perhaps long term effects on brain function. Healthy sleep positively affects neurological development and appears to be the right medicine for prevention of many learning and behavioral problems.

Handwashing for Prevention

At St. Nicholas, each cottage, and the cafeteria are well supplied with hand sanitizers. Teachers always emphasize the importance of handwashing as one solution to protecting students from colds and the flu.  
Below are tips for remaining healthy during the months when schools have the most absences.

  • Keep your distance.
  • Colds and flu are most easily spread during the first three days of infection. Try to keep a 3-foot distance between you and someone who is sick.
  • Wash your hands frequently, and keep your fingers away from your face.  One of the best ways to transfer cold  viruses is from hands to the nose and eyes.  From the eyes, viruses migrate down the tear ducts into the nose.  Once in the nose, they go to the back of the throat, and attach to cells in the adenoid region. Carry an  alcohol-based hand sanitizer, and keep an extra bottle of sanitizer at your desk.
  • Get immunized.

Are Stitches Needed?

“If you ask yourself that question, it probably does,” says Red Cross adviser Jonathan Epstein.
     There’s no firm rule about how big or bloody a cut needs to be to require immediate professional care. “But if it’s gaping open and continuing to bleed heavily … or if you see fatty tissue or muscle, you definitely need medical attention,” says dermatologist Ranella Hirsch.
     And, she notes, there’s good news for needle-fearing folks: Many doctors now use a medical superglue to close minor wounds. There’s no painful stitching, and the wounds heal just as well, she says: “It’s a win-win for everybody.”
     Puncture wounds, including animal and human bites, always warrant at least a call to a health care provider, says infectious-disease specialist Henry Masur. 

Seasonal Flu Key Facts

Flu is a contagious disease (virus) that is spread by coughing, sneezing, and close contact with an infected person.  Flu season is typically from October to May. Influenza can lead to pneumonia, and worsen existing medical problems.  Receiving a yearly flu vaccine is the best defense against the flu.

~ Symptoms:  Fever, chills, headache, runny nose, nasal congestion, cough, fatigue, aches, and sore throat.
~ Treatment: Flu is a virus, so antibiotics won’t help. Sometimes a child is treated with antiviral medication that can shorten the duration of symptoms. 

To decide whether or not to send your child to school, please consider the guidelines from Nurse April. 


To view Flu Prevention Facts from the Hamilton County Health Department.

Influenza information from CDC:

Influenza information from Hamilton CountyHealth Department:

Strep Throat

Strep throat can be passed from person to person. When a person who has strep throat breathes, coughs, or sneezes, tiny droplets with the strep bacteria go into the air. These droplets can be breathed in by other people. If you come into contact with strep, it will take 2 to 5 days before you start to have symptoms.

  • How is strep throat diagnosed?
  • Your doctor will do a physical exam, ask you about your symptoms and past health, and do a rapid strep test to diagnose strep throat.
  • If the rapid strep test says that you don’t have strep (the test is negative) but your symptoms suggest that you do, your doctor may want to do a throat culture to be sure. This is because rapid strep tests are not always accurate. To do a throat culture, the doctor will swab a sample of cells from the back of your throat. The sample will go into a special cup (culture) where the strep bacteria can grow over time. If strep bacteria grow, the doctor knows that you have strep.
  • If the rapid strep test is positive and says that you do have strep, there’s no need to do the throat culture.
  • How is it treated?
Strep throat will go away in 3 to 7 days with or without treatment. Doctors usually treat strep throat with antibiotics even though they may not make you well faster. Antibiotics shorten the time you are able to spread the disease to others (are contagious) and lower the risk of spreading the infection to other parts of your body.
You are contagious while you still have symptoms. Most people stop being contagious 24 to 48 hours after they start antibiotics. If you don’t take antibiotics, you may be contagious for 2 to 3 weeks, even if your symptoms go away.
Your doctor may also advise you to take an over-the-counter medicine like acetaminophen (such as Tylenol) or ibuprofen (such as Advil or Motrin) to help with pain and lower your fever. Do not give aspirin to anyone younger than 20. It has been linked to Reye's syndrome, a serious illness.
How do you prevent strep throat?
To avoid getting strep throat, it is a good idea to avoid contact with anyone who has a strep infection. If you are around someone who has strep, wash your hands often. Don’t drink from the same glass or use the same eating utensils, and don’t share toothbrushes.
Bacteria can live for a short time on doorknobs, water faucets, and other objects. It’s a good idea to wash your hands regularly.
If you have a strep infection, there are things you can do to avoid spreading it to others. Use tissues you can throw away instead of handkerchiefs, wash your hands often, and do not sneeze or cough on others. Antibiotics can shorten the time that you are contagious. It is a good idea to stay home from work or school until 24 hours after you have started antibiotics. 

Head Lice

Although you are not required by law to notify us of a case of lice, we gratefully appreciate notification.

Examine your child’s head for nits once a week.  Sit your child under a bright light, and use a fine tooth comb to comb through his/her hair.  Be certain to scrutinize areas that are considered hot spots for lice.  These areas are the nape of neck, the part line in the hair, and the area behind the ears.

  • Do not share combs, brushes, sporting equipment, headphones, pillows, or hair bows/ties with others.
  • Use the same sleeping mat for young children who are napping during the day. 
  • Store extra clothes, which are sent to school for  emergencies, in a bag.
  • Consider wearing long hair in a ponytail or braid.
  • Wash and dry clothes and bedding in hot water when treating for lice.

(1)    Itching of scalp.
(2)    Nits or eggs that look like tiny white grains usually lay at the base of the hair shaft near the scalp.
(3)    Adult lice that cling to scalp hairs, eyelashes or eyebrows.
TREATMENT: For children two years of age or older:
Pharmacists still recommend the product Nix (Permethrin) 1% lotion cream rinse as effective in our area. (Read follow-up instructions on the product.)
Use regular shampoo then apply Nix cream rinse and leave on for 30 minutes (although the instructions may read 10 to 20 minutes).  
Section off hair and comb through with nit comb, using the nit comb for several hours to get rid of the eggs (combing out nits is a vital part in getting rid of the lice). This single application kills the active lice as well as the nits.
Inspect head nightly for one week.
If a toy, stuffed animal, pillow, etc. can't be washed, put it in a trash bag and leave for two weeks. 

Pink Eye

Q: My 6-year-old has a “pink eye.” I was told that it is not contagious. But when I took my son to school, they would not accept him. Please help me get the record straight. 
A: Even though you are partially right, you lose out on this one. As you will read from the following segment, not all pink eye is contagious; there is no way a school has the ability to differentiate between the good one and the bad one. Unless you are willing to go to a doctor and get a release, I do not blame the school for taking the position they are taking.
Q: What is pink eye?
A: Pink eye is also known as conjunctivitis. It is caused by bacterial, viral or all allergic factors. Pink eye causes redness, irritation or inflammation of the conjunctiva.
Q: What is the difference among the three types of conjunctivitis?
A: Viral conjunctivitis is caused by viruses that spread from other ailments like colds, sore throats, respiratory infections and others. Bacterial conjunctivitis is caused by certain bacteria like staphylococci or streptococcic. Allergic conjunctivitis is caused 
by allergic reactions to different substances such as cosmetics, medications or fumes.
Q: What are the symptoms of pink eye?
A: ~ Viral conjunctiva symptoms are watery eyes accompanied with discharge, irritation, and it’s contagious. It starts with one eye and can spread.
    ~ Bacterial conjunctiva symptoms are watery eyes with yellow or green discharge, irritation, and it’s contagious. It starts with one eye and can spread.
    ~ Allergic conjunctiva symptoms are heavy tearing, irritation and itchiness. It affects both eyes and is not contagious.
Q: What is the treatment for the three types?
A: ~ Viral conjunctivitis is treated in small children with a medication to reduce the inflammation.
     ~ Bacterial conjunctivitis is treated with antibiotics. Allergic conjunctivitis is prescribed anti-inflammatory medications, antihistamine medicine and eye drops that relieve redness and itching.
Q: How can pink eye be prevented?
A: There are several ways to prevent pink eye: Wash hands frequently; do not share towels, washcloths or other wipes; disinfect commonly touched areas such as door knobs, remotes, etc. Discontinue wearing contact lenses and replace the lenses. Avoid sharing objects such as eye drops, eyeliners, mascara, goggles or anything that comes in contact with the eyes.
Note from April Cooley, School Health Coordinator:
We at St. Nicholas School suggest staying home from 
school until treated if the pink eye is viral or bacterial. 

Fifth Disease

  • Symptoms: A rash usually begins on the cheeks as a “slapped cheek” appearance.  It may progress to  a pink or red “lacelike” rash on the extremities.  The rash may come and go for a few weeks.  Fifth Disease may cause low grade fever (less than 101), but typically the child is fever free. 
  • Contagiousness: Exposed children may begin with rash 10-14 days after exposure.  Because the disease is contagious the week before the rash appears, the child may attend school with the rash.
  • Treatment: None necessary.

Hand, Foot, and Mouth Disease

HFM is a virus that causes blisters on the hands, feet, mouth, and sometimes buttocks. 
Students should stay home until fever-free for 24 hours and until new blisters stop appearing.  

  • Contagiousness: HFM is spread through saliva in the mouth and from touching an infected person’s hands or feet.  A child will need to stay home until he/she is fever free for 24 hours.  Hand washing is key in preventing the spread of HFM.
  • Treatment: Painful mouth sores are sometimes treated by applying a mixture of Benadryl and Maalox to the sores (check with your child’s pediatrician before administering ).  The mixture helps to numb and coat the sores.  Pain medication and cold foods and liquids can help with pain. 

First Aid

“You can prevent minor cuts from becoming major pains.”
Scraped knees and minor cuts are not generally the stuff of medical drama. The squabbling TV doctors on House would never spend an hour debating the healing merits of adhesive bandages vs. fresh air. But at first-aid classes run by the American Red Cross, the proper care of cuts and scrapes is a “No.1 question,” says Jonathan Epstein, an emergency medical services administrator in Wakefield, Mass., and a Red Cross advisor. Ranella Hirsch, a Cambridge, Mass., dermatologist and spokeswoman for the American Society for Dermatologic Surgery, says: “I get more questions about this sort of thing than almost anything.”
     The truth is, most cuts and scrapes will heal just fine, whatever you do. But these days there’s good reason to take these injuries more seriously: Bacterial skin infections that are highly resistant to antibiotics – and capable of spreading throughout the body – are increasingly common. One such bug, MRSA (methicillin-resistant staphylococcus aureus), used to spread mostly in hospitals. But newer strains have become widespread in some communities, studies show. 
     Even such drug-resistant germs “rarely cause life-threatening diseases,” says Henry Masur, president of the Infectious Disease Society of America. “But it can happen.” That’s reason enough to fuss over any injury that breaks the skin. Promotion of healing and prevention of scarring are worthy goals, too.
Best advice:
1.  Make sure the minor injury really is minor: Check for broken bones or other, bigger injuries.
2.  Stop bleeding by applying pressure with a clean cloth or sterile pad. Paper towels are “not the best” because they can leave lint in the wound, Epstein says. “And don’t use the dish towel – that can be full of bacteria.”
3.  Clean the wound thoroughly, preferably with running water (not with hydrogen peroxide or anything else, except soap, if that’s available). Water from a hose or faucet is fine but water from an ocean, lake or pond could be contaminated, Masur says. If it’s an outdoor scrape, be sure to “flush out all the little pebbly, sandy stuff,” says Jeffrey Weiss, head of general pediatrics at Phoenix General Hospital.
4.  Now, forget anything you ever heard, even from your mother, about letting the wound “breathe” by leaving it dry and uncovered. “That’s definitely 100% the wrong thing to do,” Hirsch says. “Dry wounds do not heal as well as moist wounds.”
5.  To add moisture and arguably, some infection protection, you can apply a triple-antibiotic ointment as recommended in Red Cross guidelines. Studies show the medicated ointments aid healing, Epstein says. But some doctors say the ointments are unneeded and add a risk of allergic reaction. A good substitute is a plain ointment like Aquaphor, Hirsch says.
6.  Cover the wound with a sterile bandage. That will keep it clean and prevent sun exposure, which might worsen scarring, especially in darker-skinned people. 
7.  Change the bandage at least once a day and check for signs of infection, including increased tenderness, redness and fluid discharge. Fever and chills are especially ominous. “If things start getting worse rather than better,” call a health care provider, Masur says.
Absent such signs, Epstein says, just “keep it clean and keep it covered until it heals."

ST NICHOLAS SCHOOL 7525 Min Tom Drive | Chattanooga, Tennessee 37421 | ph: (423).899.1999 | fax: (423).899.0109 | [email protected]