General Instructional Guidelines
Health / Physical
Non-Instructional
Table of Contents
Health / Physical is comprised of two major areas; Non-instructional
and Instructional areas. The “non-instructional” components are
included as samples of what a district / program need to meet state
and/or local safety guidelines and best practices in creating a safe
learning environment for students and staff.
The “Instructional” area includes materials and curriculum for teaching
students about family life, sex education and personal safety.
Beliefs and Assumptions
Non-Instructional Content
A. Delegated Functions
B. Common Procedures
1. Medication Considerations at SchoolC. Common Diagnosis
a. Medication Overview
b. Common Medications
1. Albuterol
2. Aminoglycosides
3. Benzodiazpines
4. Celexa
5. Congentin
6. Depakote
7. Ditropan
8. Epi-pen (Epinephrine)
9. Haldol
10. Lorazepam
11. Neurontin
12. Oral Contraceptive
13. Prevacid
14. Prozac
15. Risperdal
16. Tegretol
17. Zantac
18. Zonegran
19. Zyrtec
c. Medication Administration
d. Medication Related Forms
2. Shunt Placement Plan1. Medication Treatment Summary Form
2. Medication Management Form
3. Medication Management Behavior Monitoring Form
4. PRN Medication Record Form
3. Gastrostomy Tube Plan
4. Gastrostomy Tube Feeding Competence
5. Gastrostomy Tube Site Care
6. General Guidelines for Seizures
7. Seizure Plan
8. Seizure Activity Log
9. Seizure Report Form
10. DNR/DNI Determinations for Educators
11. Neuroleptic Malignant Syndrome Information Sheet
12. Respiratory Assessment
13. Reaction to Insect Stings
14. Anthrax Procedures
15. Other Sample Forms
a. Student Medical Profile
b. Students with High Pain Tolerance
c. Individual Student Health Data Form
D. Crisis Intervention Plan
1. PurposeE. Safety Considerations
2. Crisis Response Team
3. In Case of Fire
4. Severe Weather
5. Accounting for all Staff and Students
6. Securing the Facility
7. Physical Aggressions
8. Hazardous Materials
9. Bomb Threat
10. Demonstrations and Disturbances
11. Suicide Prevention Guidelines
12. Suicide Prevention Flowchart
13. Data Gathering Worksheet
14. Post Crisis Evaluation Form
15. Evacuation Status Summary Form
16. Sample Letter
17. Sample Staff Emergency Information Form
1. Responders Guide to Injury and IllnessF. The Medically Fragile Student
2. Guidelines for Transporting Students in Wheelchairs
3. Bloodborne Pathogens
G. Seven Sample Individual Health Plans
H. Resources