Dear Families,

It is my goal that your children feel healthy and able to participate fully in school activities. Here are a few considerations for the 2023-2024 school year:

Please look at the DPS Health Services and Greenlodge Health Services websites for health updates.

Health Conditions: if your student is new to Greenlodge or has a change in their health status, please contact me and send in medical paperwork so we can collaborate on health planning for the year.

Food Allergies: We have several students at Greenlodge with life-threatening food allergies. NO OUTSIDE FOOD MAY BE BROUGHT IN FOR CLASSROOM TREATS. NO EXCEPTIONS! Teachers will offer alternative celebrations for holidays such as ‘party in a bag’. We generally do not restrict students from bringing any foods from home for lunch/snack e.g. nut butter. Families will be Each classroom has allergen-safe tables and does hand-washing after eating. In the case of a school-sponsored event with outside foods, I will send home permissions slips for students with allergies. 

Health Portal: it is preferred that families use the SNAP Health Portal for communication and documentation. Please see the DPS Health Office website for information on logging in, uploading medical information, giving permission for Tylenol/Acetaminophen and Motrin/ibuprofen (OTC medications) at school, and communicating securely with your school nurse.

Medication Administration: If your child needs medication during school hours, we require new medical orders each school year. Please sign them for parental permission as well. You can drop off medication daily at 8:30 a.m. in the original packaging, unexpired, no more than a 30-day supply. Medication will not be administered until documentation is complete and received. 

Accommodations: Signed medical orders are also mandatory whenever students require accommodations or restrictions during their school day; i.e., crutches, elevator use, daily medications, no PE participation, etc. 

OTC Medication Approval: with your permission via SNAP, I can give Tylenol and Motrin for minor injuries or discomfort. I always try to call first to check if they already had some. All other OTC medications require a pediatrician order/letter, including creams, ointments, and even sunscreen.

Service Dog: The Dedham Police Department Community Service Dog named Ruby visits us often with School Resource Officers. Please let me know if your student is not allowed to pet Ruby. 

Physical Exams: Please send in updated physical forms from the pediatrician whenever your student has an annual visit. We are required by state regulation to ensure 4th grade students receive a physical exam.

Health Screening: The state mandates routine health screening in school, including vision, hearing, height/weight, and scoliosis. More information will follow about which screening your student receives by grade. 

Feel free to reach out if you have any questions or concerns.

General Student Illness 

To minimize the spread of infectious diseases/illnesses and to provide for a safe environment, students should be kept home from school for: 

• Fever greater than 100 within the last 24 hours (fever should be under 100 for 24 hours without the use of fever reducing medications before returning to school) 

• Vomiting/diarrhea within the last 24 hours 

• A communicable disease (ok to return 24 hours after start of antibiotics for strep throat)

• An upper respiratory illness with significant coughing and/or nasal discharge

 • Pain that requires the use of narcotic medications 

If a child is dismissed due to fever, vomiting, or diarrhea, that student must stay home for at least 24 hours from the last temp/event.  If a student is not able to participate in school learning, they should stay home to rest.

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Covid-19 Symptoms: see DPS Health Services Page for Guidance

• Please keep your child home if s/he/they are sick!

  • Fever (100.0 Fahrenheit or higher), chills, or shaking chills

  • Difficulty breathing or shortness of breath

  • New loss of taste or smell

  • Muscle aches or body aches

  • Cough (not due to other known cause, such as chronic cough)

• <When In Combination With Other Symptoms>

  • Sore throat

  • Nausea, vomiting

  • Headache

  • Fatigue

  • Nasal congestion or runny nose (not due to other known causes, such as allergies)

Nurse Duckworth will begin the state-mandated health screenings in late autumn and continue on an ongoing basis until they are completed. 

*Parents/guardians may opt out of the health screenings via email or SNAP message to the School Nurse and should provide an updated physical exam form that the screenings have been completed by the PCP.

Screenings by grade are as follows (and I conduct them in this order):

• 5th Grade: Vision (Far, Near); Postural Screening (a separate communication will go out before postural screening begins in Spring)

• 4th Grade: Vision (Far, Near); Height & Weight (BMI)

• 3rd Grade: Vision (Far, Near, Stereopsis); Hearing

• 2nd Grade: Vision (Far, Near, and Stereopsis); Hearing

• 1st Grade: Vision (Far, Near, and Stereopsis); Hearing; Height & Weight (BMI)

All screenings are performed in accordance with the Commonwealth of Massachusetts regulations. Students may also be screened at any time during the year at a teacher or parent’s request. A referral letter is sent home if the student does not meet the vision, hearing, and postural screening parameters, recommending evaluation by your physician or vision professional.  

QUESTIONS AND ANSWERS ON POSTURAL SCREENING

Q. Why should postural screening be done in the schools? Why annually?

A. Unfortunately, not all children have medical checkups regularly, and when they do, they are not usually checked for early signs of

scoliosis or kyphosis. The physical educators and school nurses see these children routinely and are knowledgeable about the

musculo-skeletal system as well as growth and development. Screening must be done annually in grades 5 through 9 because young

people in this age range are in a growth spurt, and mature at different rates. Minor signs can become major problems quickly with

the rapid growth in this age range.

Q. What percentage of the population has scoliosis or kyphosis?

A. About 3.5% of the population has a curve that requires treatment. A higher percentage of the population has some degree of

curve, but not enough to warrant treatment.

Q. Are scoliosis and kyphosis painful?

A. Not when they are developing, however, if untreated, severe cases do lead to severe pain in later years.

Q. Can poor posture cause some curvatures?

A. Poor posture does not cause scoliosis or kyphosis or affect the progress of the curves.

Q. Is there any way to prevent scoliosis and kyphosis from occurring?

A. The best way to prevent these curves from becoming severe problems is early detection and prompt treatment. Treatment may

include observation and exercises for mild curves, bracing and exercises for moderate curves, and surgery for severe curves. The

goal is to obtain treatment when curves are minor and whenever possible prevent them from becoming severe.

Q. Can parents refuse to have their children screened?

A. The Massachusetts Department of Public Health recognizes the parental right to refuse screening services offered through a

comprehensive school health program. Postural screening is a mandated program. The statute (M.G.L. c71, s57) states that "...Any

child shall be exempt on religious grounds from these examinations upon written request of parent or guardian on condition that

the laws and regulations relating to communicable diseases shall not be violated."; If a parent refuses to allow the school to

posturally screen their child for reasons other than on religious grounds as stated in the statute, it is recommended that the parent

provide the school nurse (R.N.) with written documentation that their child has been posturally screened by the family physician.

The documentation should include the date of the screening, the findings and the signature of the physician. 

If you have any questions about the details of school health screenings, please refer to the Massachusetts State School Health Screening Site.

Massachusetts physicians, including the American Academy of Pediatrics regional branch, are warning about an uncharacteristic early surge in RSV, a common respiratory illness that is keeping hospitals, clinics, and doctor’s offices busy.  

What is RSV?   RSV, which is not a new virus, stands for Respiratory Syncytial Virus.  It can infect the lungs and airway.  RSV can be serious for the very young, the elderly, and those with weakened immune systems.  For some, RSV can cause Bronchiolitis (inflammation and congestion of the small airways of the lungs) and Pneumonia (infection of the lungs), two lower respiratory infections.   Also, it is possible to have a co-infection such as RSV and the Flu.  

What are the symptoms?  Symptoms can include runny nose, sneezing, congestion, cough, wheezing or difficulty breathing, fever, headache, poor appetite, sore throat and/or fatigue.  For most people, it usually takes a week or two for full recovery. 

With the easing of the COVID precautions and with schools back to full capacity, many young students are getting exposed to RSV for the first time.  According to the CDC, the RSV rate in Massachusetts has more than quadrupled since September.  The upcoming holiday season will be busy with social and family gatherings which will also increase our exposure to viruses, like RSV, the Flu, and COVID.  And we have not even entered the winter season yet. 

How is RSV spread?   RSV is highly contagious and can spread when someone coughs or sneezes and the virus droplets get in your eyes, nose, or mouth.  Some people can also get exposed by touching something that’s been contaminated like a doorknob 

Prevention:

• Practice good hand hygiene and role model for your kids

• Cover your mouth and nose with a tissue when coughing or sneezing.  And throw the tissue out in the trash.  Or cough into your elbow. Teach your children to do the same.  

• Avoiding touching your face.

• Sanitize high touch areas, especially when there is an illness.

• There is no vaccine for RSV at this time.  But vaccinating for COVID-19 and Influenza offers protection against other illnesses.  

Treatment: as with other respiratory illnesses, some simple home remedies include:

• Rest - lots of rest helps the body heal by strengthening the immune system

• Hydration - stay hydrated to help loosen congestion,  replenish any fluids lost to fever or vomiting, and help with your body’s immune response.

• Good nutrition - healthy foods to help boost immunity and preserve strength 

Remember to call your doctor or emergency services  with any concerning symptoms like a high fever or difficulty breathing.  

Dear Families,

The DPS Nurses are seeing an early surge of some typical late autumn & winter viruses already this school year. This is not unexpected after the years of COVID exposure and safety protocols. 

At Greenlodge, we have noticed a small uptick in upper respiratory illnesses and GI viruses including the stomach bug/flu. And we are bracing ourselves for the start of flu season. *Please note, even though our SNAP Health Program allows permission for cough drops, we do not have them here at Greenlodge due to being a choking hazard.

Some preventative measures to reduce the spread of illnesses:

• Encourage your children to wash their hands with soap and water, lathering for at least 20 seconds, ideally before and after they eat, after using the bathroom and after blowing their noses, coughing or sneezing. 

• Teach your children to cough and sneeze into their elbows rather than into their hands.   And be a role model for your children.

• Teach to avoid touching your eyes, nose, and mouth with unwashed hands.

• And please keep sick students home.  (I know I sound like a broken record.) I advise parents to keep children home if they have contagious symptoms or if they are too tired or distracted by their illness to participate in school fully. 

• Most doctors recommend a COVID test even with mild symptoms. We can also test for COVID at school if given permission with this link https://docs.google.com/forms/d/e/1FAIpQLSdp5kVtjVcbEE_OdKjntt9uEK-0x4aCyVvKX5O-982FVlJvzQ/viewform

If your child is sick at school, please have them picked up as soon as possible.  The nurse’s office is a busy place and sick kids do not rest well here.

• What is it? The SNAP Health Portal is the Electronic Health Record (EHR) we use in the Dedham schools to store and communicate health information. I use it to track physicals and immunizations and document office visits with students. Families can use SNAP to give permission for Tylenol/Motrin at School and view their students' annual vision/hearing screenings among other things.

• Why use SNAP? It’s a secure way to share private health information. Families can upload physicals and doctor’s orders without sending papers in the backpack. It’s also efficient; the software allows me to send emails to a whole class or group of students at once about a health matter.

• How do I log on? All families have an account. The email to get into SNAP is usually the same one used for Powerschool. Not sure what email to enter? Send me a note and I can let you know. With the right email, you can reset your password and start using SNAP.

• Log in to the SNAP Health Portal (see above instructions) 

• In the menu of options on the left of the screen, hover on "Medications" then click on "OTC"

• Check the box to "opt in" for Acetaminophen and/or Ibuprofen to give the nurse permission to dispense

• The nurse will always endeavor to call parents/guardians before giving a student these medications; in any case, we need permission to give them.