Medications | Immunizations | Health Screening |Extreme Heat

Medications

Prescribed medications as well as over the counter medication (i.e.: cough drops, aspirin, allergy medication) will be administered at school only with the required Medical Authorization Form(s) signed by both physician and parent. Medications will be dispensed by authorized school personnel only. Medication must be in original container and kept in a locked area of the school office. Medication must not be kept in lunch boxes, desks, backpacks. Parents, not the child, must bring the medications(s) to school along with the authorization form. Parents are also responsible for maintaining adequate medication supplies at school. (Education Code 49423 and 49480). Students may only be given medication within one-half hour of the prescribed time.

Inhalers may be carried on campus with specific authorization from a physician and parental consent on file.

A new Medical Authorization Form must be completed for any change in dose, time, or method. It will be valid for the current school year or until a discontinuing date specified by the physician.

Medications must be picked up by the parent or guardian within one day of the end of the school year or they will be discarded.

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Immunizations

a   This number includes kindergarten boosters. If your child is 4-6 years old, entry requirements are met with only 3 polios and 4 DTPs if at least one polio and one DTP were after your child's fourth birthday.

b   For children 7-17 years old, entry requirments are met with only 3 polio and 3 DTP or DT/Td if at least one polio and one DTP or DT/Td were after your child's second birthday. For students age 7 years and older, pertussis immunization is not required.

c    A Td booster is recommended, but not required.

d    One dose on or after the first birthday is required for grades 1-6 and 8-12. Mumps immunization is not required for students age 7 years and older.

e   Two doses of the 2-dose formulation along with provider documentation that the 2-dose formulation was used for both doses and both doses were received at age 11-15 will also fulfill this requirement.

f    If child had chickenpox disease, ask your doctor to note on the immunization record to meet the requirement.

g    Required for children not enrolled in California schools before 1 July 2001. 1 dose required for grades K-12, for children 13-17 years old, 2 doses are needed if vaccine received after 13th birthday.

These immunizations are available through the military dependents clinic at the naval hospital, the San Bernardino County Public Health clinic at 63532 29 Palms Hwy in Joshua Tree (phone 366-5380 to confirm clinic dates & times), and through your private doctor. The cost for immunizations at the Health Department is $8.00. The next Public Health immunization clinics in 2001 will be held on:

10 September      17 September           1 October          15 October             5 November              19 November

3 December         17 December

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Health Screening

Our school nurses conduct state required hearing, vision, and scoliosis screening of students; maintain all required health records; consult with parents, students and staff; and communicate special health problems to school personnel.

SCOLIOSIS SCREENING: We test 7th grade girls and 8th grade boys for abnormal curvature of the spine, as required by state law. Parents will be notified if further evaluation is recommended. Further examinations are at parent expense.

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Extreme Heat

Disclaimer: These self-help measures are not a substitute for medical care but may help you recognize and respond promptly to warning signs of trouble. Your best defense against heat-related illness is prevention. Staying cool and making simple changes in your fluid intake, activities, and clothing during hot weather can help you remain safe and healthy.

Dangers of Extreme Heat

Each year more people in the United States die from extreme heat than from hurricanes, lightning, tornadoes, floods, and earthquakes combined. During 1979-1998, a total of 7,421 deaths that occurred in this country were attributed to excessive heat exposure. On average approximately 300 people die each year from exposure to heat. This year extreme heat is of particular concern because of the energy problems facing many areas of the country. Air conditioning is the number-one protective factor against heat-related illness and death. Brownouts that last a few hours will likely have little effect on people's health. However, some people may be fearful of high utility bills and limit their use of air conditioning. Such action can place people who are already at risk for heat illness at increased risk. You can help by learning the warning signs of heat stroke and heat exhaustion and then checking on your neighbors frequently.

Temperature Overload

People suffer heat-related illness when their bodies are unable to compensate and properly cool themselves. The body normally cools itself by sweating. But under some conditions, sweating just isn't enough. In such cases, a person's body temperature rises rapidly. Very high body temperatures may damage the brain or other vital organs.

Several factors affect the body's ability to cool itself during extremely hot weather. When the humidity is high, sweat will not evaporate as quickly, preventing the body from releasing heat quickly. Other conditions related to risk include age (the elderly and young children), obesity, fever, dehydration, heart disease, mental illness, poor circulation, sunburn, and prescription drug use and alcohol use.

Summer time activity, whether on the playing field or the construction site, must be balanced with measures that aid the body's cooling mechanisms and prevent heat-related illness.

This section contains information for people engaged in endurance-type activities (sports tournaments, marathon races, etc.) and may not apply to the person engaged in activities lasting one hour or less.

Additional information (sunburn, heat rash, heat stroke, etc.) is available from the Centers for Disease Control and Prevention at       http://www.cdc.gov/nceh/hsb/extremeheat/default.htm

Using Food & Fluids to run your body

during hot-weather day-long activities

ELECTROLYTES (a little background for the fluid replacement section later.)

Sodium is the major extracellular (outside of the cells) positive ion and a key factor for retaining body water. Almost all dietary sodium is absorbed. Depletion leads to muscle cramps, nausea, vomiting, dizziness, and later to shock and coma. Only when weight loss from perspiration exceeds 2% to 3% of total body weight (5-6 pounds for the "average" adult) should sodium losses raise concern. Even then, merely eating salty foods is sufficient to restore body sodium for most people.

Potassium performs many of the same functions as sodium, such as fluid balance and nerve impulse transmission. However, it operates inside, rather than outside cells. Intracellular fluids contain 95% of the potassium in the body. We absorb about 90% of the potassium we eat. Potassium shortages cause: fatigue, weakness (progressing in predominance from the legs to the arms, involvement of the respiratory muscles soon follows), cramps, nausea and vomiting, low blood pressure and ventricular arrhythmia's.

Potassium deficit related to heavy perspiration is most likely to occur in persons who are acclimated to heat since sweat glands in these individuals tend to excrete more potassium than those who are not acclimated to heat stress. This response helps the body conserve sodium.

Major contributors of potassium to the adult diet include milk, potatoes, beef, coffee, tomatoes and orange juice.

Chloride is the major extracellular negative ion. Nerve function, production of stomach acid, and some immune responses require chloride. As is the case with sodium, most of the body's chloride is excreted by the kidneys, some is lost in perspiration. Chlorinated water is a usable source, but we consume most chloride as salt added to food.

Calcium is essential for blood clotting, muscle contraction, and nerve function. If calcium levels fall below a critical point muscles cannot relax after contraction; the body stiffens and shows signs of tetany. Milk products, tofu, sardines and calcuim-fortified beverages provide most dietary calcium. The body is able to extract calcium from the bones when it is needed elsewhere in the body.

ENERGY

Carbohydrate intake for athletes should run about 60% or more of total daily calorie intake, rather than the 50% typical of most Americans. An athlete's plate should be about two-thirds grains and vegetables and one-third protein sources. Carbohydrate loading is an effective strategy for athletes planning on endurance events. Carbohydrate loading takes place over the 3 days prior to an endurance event and can increase glycogen levels by 50% - 85% above normal. Glycogen is the carbohydrate fuel stored inside muscle cells. Glycogen depletion is responsible for the phenomenon known as "hitting the wall" in endurance sports.

One advantage of carbohydrate loading for us desert dwellers is that some water is stored in the muscles along with the extra glycogen.

FLUID

A question that often arises is whether to drink water or a sports-type drink, such as All Sport, Exceed Energy Drink, Gatorade, PowerAde, and Amino Force, during competition. For sports that require less than 30 minutes of exertion or when total weight loss is less than 5 to 6 pounds, the primary concern is replacing the water lost in sweat, because losses of both carbohydrate stores and electrolytes (sodium, chloride, potassium, and other minerals) are not usually too great. Although electrolytes are lost in sweat, the quantities lost in exercise of brief to moderate duration can easily be replaced later by consuming normal foods, such as orange juice, potatoes, and tomato juice. Keep in mind that sweat is about 99% water and only 1% electrolytes and other substances.

The use of sports drinks is most critical for athletes engaged in sports events lasting longer than 60 to 90 minutes. Prolonged sweating results in large sweat losses and some of the fluid for sweating comes from the bloodstream. If plain water is used to replace the fluid lost from the blood, the concentration of essential electrolytes in the bloodstream may become too diluted. Thus when sports drinks are used to help maintain blood volume, they must contain small amounts of sodium and potassium to avoid electrolyte imbalance. Generally speaking, beverages for the endurance athlete must provide water for hydration, electrolytes to both enhance water and glucose absorption from the intestine and help maintain blood volume, and carbohydrate to provide energy. Beyond 2 to 4 hours of exertion, electrolyte and carbohydrate replacement become increasingly important, especially in hot weather. In fact, sports drinks that contain carbohydrates have been found to delay fatigue during endurance sports with exercise intensities of a 3-hour marathon pace.

The following is but one possible protocol for using sports drinks as part of fluid replacement: About 2 hours before endurance exercise, consume 2 cups of water.

Once exercise begins, consume 1/2 to 3/4 cup of a 6% to 8% carbohydrate solution (14 to 19 grams per cup of fluid) about every 15 minutes. The fluid should be cool to enhance palatability. The carbohydrate concentration of many common sports drinks is 6% to 8%, but check the label to be sure. If the exercise session is to last more than one hour, the goal for fluid replacement is to yield between 2 1/2 to 5 cups (600 to 1200 milliliters) of this fluid per hour. One liter bottle per hour (minimum) might be easier to remember.

After exercise about 2 cups of fluid should be consumed for every pound lost.

Comparisons of drinks containing glucose polymers (glucoses linked together more properly known as maltodextrins), glucose and sucrose show that all of these carbohydrates have similar positive effects on exercise performance and physiologic function as long as carbohydrate concentration is in the 6% to 8% range. Drinks in which fructose is the only carbohydrate source are the only exception to this rule. Fructose is absorbed from the intestine more slowly than glucose and often causes bloating and diarrhea.

For the most part, then, the decision to use a sports drink depends primarily on the duration of the activity. As the duration of continuous activity approaches 60 minutes or longer, the advantages of a sports drink over plain water begin to emerge

For a better "day after" a marathon activity in high heat conditions, we need to consider

CARBOHYDRATE INTAKE DURING RECOVERY FROM EXERCISE

Carbohydrate-rich foods yielding about 70 to 100 grams of carbohydrate should be consumed within 2 hours after extended (endurance) exercise - the sooner the better, because this is when glycogen synthesis is greatest. As well, some protein should be added to this meal, as this aids recovery. This process should then be repeated over the next 2 hours. Athletes who are training intensively can consume a simple sugar candy, sugared soft drink, fruit (for example, raisins) or fruit juice, or a sports-type carbohydrate supplement or gel immediately after training as they attempt to reload their muscles with glycogen. Lunch meats or nuts could provide the protein, or use of a sports bar or sweetened yogurt could provide both protein and carbohydrate.

At quick-service restaurants, athletes can order baked potatoes, thicker crust on pizza, and extra rolls and muffins.

Fluid and electrolyte (that is, sodium and potassium) intake is also an essential component of an athlete's recovery diet. Fluids and electrolytes help replenish body fluids as quickly as possible, which is especially important if the athlete works out twice a day and the environment is hot and humid. If food and fluid intake are sufficient to restore weight loss, they generally also supply enough electrolytes to meet needs during recovery from endurance activities.

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