Appendix R-12
Fort Zumwalt School District
HEALTH CARE INFORMATION
Dear Parent or Guardian:
The Fort Zumwalt School District, with parent/guardian written consent, will provide basic treatment for minor illness and injury while at school. The district may also administer the following non-prescription, over-the-counter medications, based on nursing assessment, with parent/guardian consent:
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Anti-itch
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Eye Care
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Oral/Dental
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Wound care
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Benadryl cream
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Contact lens solution/lubricating drops
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Anbesol/Oragel
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Bactine/Wound care wash
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Isopropyl alcohol
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Caladryl/Calamine lotion
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Saline solution eye wash/irrigation
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Chapped lip ointment
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Burn cream
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Aloe Vera
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Hydrocortisone cream 0.5% & 1%
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Allergy eye drops
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Sore throat spray
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Triple Antibiotic ointment
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Baking Soda
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Salt for gargle
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Hydrogen peroxide
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Vaseline Petroleum
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Non salicylate muscle rub
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Dental wax
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Sting Kill (for insect bites)
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Antacids/Tums
Vaporub
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*generic version of all OTC medications are acceptable
Acetaminophen: – registered nurse can give acetaminophen ten (10) times only during the school year for a headache, pain, fever, injury or menstrual pain.
The parent/guardian must give verbal permission. If your student requires District provided acetaminophen more than 10 times, the parent will have to provide the medication.
Emergency Medication
In an effort to serve the students of the Fort Zumwalt School District, as well as meet the medication guidelines of the State of Missouri and policies set by the School Board, the following emergency medication should be available:
Albuterol: – (aerosol) for asthma related reactions in emergency, potentially life threatening situation
Benadryl tablets/liquid: - for allergic reaction
Age 5-11: Benadryl liquid 1-2 tsp. or 25 mg X1 for allergic reaction without signs of anaphylaxis if parents cannot be reached
Age 12 – 21: Benadryl 1 or 2, 25 mg capsules X 1 for allergic reaction without signs of anaphylaxis if parents cannot be reached
Epi-Pen: emergency use for allergic reaction/anaphylaxis
Glucose testing: supplies for emergency testing of diabetic students only
Oxygen: emergency use
*State law requires parental consent in order for the school nurse to treat your child*
*Please sign the “Health Inventory and Health Care Consent Form”*