Managing Chronic Conditions

Allergies can range from mild discomfort to life-threatening reactions. Clear documentation and communication are essential to ensure student safety during the school day.

Families must notify the school nurse of all diagnosed allergies before the school year begins or as soon as the allergy is identified. All reported food allergies will be shared with the student’s classroom teacher(s) at the beginning of the school year to support awareness and safety planning.

Food Allergies

Students with diagnosed food allergies or severe allergic reactions must provide the following required documentation:

• A completed Medication Authorization Form signed by a medical provider if medication is necessary at school
• Prescribed allergy medication (such as epinephrine or antihistamines) in original pharmacy packaging
• A current Allergy Action Plan
• A completed Food Substitution Form if dietary accommodations are required

In the event of Epinephrine (Epipen) administration, 911 will be called immediately, in accordance with North Carolina law and emergency medical guidelines. The parent will always be notified after the 911 call has been initiated.

While we strongly encourage a nut-free environment, we cannot guarantee that our school is completely nut-free as students are allowed to bring food from home. All school-provided lunch and breakfast meals do not contain nuts but do contain wheat.

Families concerned about accidental exposure should notify the school nurse. If requested, arrangements may be made for the student to sit in a designated allergen-aware section during meals.

To reduce the risk of accidental exposure:

• Students are prohibited from sharing food, drinks, utensils, or snacks.
• Any food brought to school for classroom celebrations must be nut-free, store-bought, and in its original packaging with a clearly printed ingredient label. Homemade foods are not permitted for classroom celebrations.

These guidelines help staff review ingredient labels and support a safer environment so that all students can participate as safely as possible.

Environmental Allergies

Environmental allergies may include sensitivities to:

• Pollen
• Grass
• Mold
• Dust
• Animal dander
• Insect stings
• Strong odors or cleaning products

While many environmental allergies cause mild symptoms (sneezing, congestion, watery eyes), some students may experience more serious reactions, including breathing difficulty or worsening asthma symptoms.

If medication is required during school hours (such as antihistamines or inhalers), a completed Medication Authorization Form and properly labeled medication in original packaging must be provided. Students with severe insect sting allergies must also provide an Allergy Action Plan and prescribed emergency medication, if applicable.

Although the school takes reasonable steps to reduce exposure to common allergens, we cannot eliminate all environmental triggers. Animals may be present in classrooms for educational purposes, and outdoor exposure to pollen, grass, and other allergens is sometimes unavoidable. If your child has specific triggers or needs accommodations related to environmental allergies, please notify the school nurse so appropriate planning can occur.

This section addresses chronic health conditions not otherwise covered in separate health pages. Examples may include, but are not limited to, gastrointestinal disorders, migraines, autoimmune conditions, cardiac conditions, blood disorders, renal/urological conditions, skin conditions, and menstrual health concerns.

Required Health Information

Students with ongoing or chronic health conditions should have appropriate medical documentation on file with the school. This may include:

• A provider-completed care plan or written medical orders outlining the student’s condition and treatment needs
• Specific instructions for care during the school day
• Any activity restrictions or accommodations
• Guidance on when to notify parents/guardians or seek emergency care

Medications and Supplies

If a student requires medication during the school day:

• A completed medication authorization form signed by both the parent/guardian and healthcare provider is required
• Medications (including topical treatments) must be provided in their original, labeled containers and not expired
• Examples:
  • Skin conditions (eczema, psoriasis, etc.): Students may have prescribed topical medications available at school for symptom management or for on-going comfort
  • Pain management (dysmenorrhea, migraines, etc.): Students may benefit from access to provider-approved pain relief medication during the school day
  • Autoimmune or inflammatory conditions: Students may require scheduled or as-needed medications for pain, inflammation, or symptom management
  • Gastrointestinal conditions (Crohn’s disease, ulcerative colitis, GERD):Students may require medications such as antacids, anti-nausea medication, or other prescribed treatments during the school day
  • Mental health conditions (Panic disorders, anxiety, depression, ADHD, etc): Students may take prescribed medications during the school day as ordered by their healthcare provider
• For students with conditions that may impact attendance, documentation from a healthcare provider must be provided if medically necessary absences or accommodations are requested.

Ongoing Treatments and Specialized Needs

Some students may have chronic health conditions that require scheduled or routine treatments during the school day. In these cases, advance planning and clear medical guidance are essential to ensure safe and appropriate care.

Examples of school-day treatments may include, but are not limited to:

• Enteral feedings (e.g., G-tube feedings)
• Ostomy care (including ostomy bag emptying or changes)
• Wound care or dressing changes
• Catheterization or other urological care needs
• Monitoring or treatments related to complex medical conditions

For students requiring these types of services:

• A detailed provider order or care plan must be on file outlining specific procedures, timing, and supplies needed
• Families are responsible for providing necessary equipment and supplies
• The school nurse will collaborate with the family and healthcare provider to determine how care will be safely provided during the school day
• In some cases, additional planning may be required prior to the student’s start date to ensure appropriate staffing, training, and resources are in place

Ongoing communication between families, the healthcare team, and school staff is essential to support the student’s health needs while maintaining access to their education.