SCOLIOSIS SCREENING FOR ARKANSAS SCHOOL...
Transcript of SCOLIOSIS SCREENING FOR ARKANSAS SCHOOL...
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SCOLIOSIS SCREENINGSCOLIOSIS SCREENING
FOR FOR
ARKANSAS SCHOOLARKANSAS SCHOOLARKANSAS SCHOOLARKANSAS SCHOOL
CHILDRENCHILDREN
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ObjectivesObjectives
Participants will be able to:Participants will be able to:
•• Explain why scoliosis screening is necessary.Explain why scoliosis screening is necessary.
•• Identify the 9 steps of Scoliosis Screening. Identify the 9 steps of Scoliosis Screening.
•• Demonstrate how to perform the first two stages of Demonstrate how to perform the first two stages of
scoliosis screening. scoliosis screening.
•• Differentiate between a normal spine and scoliosis and Differentiate between a normal spine and scoliosis and
the recommendation for referral. the recommendation for referral.
•• Describe the documentation standards for the Describe the documentation standards for the
Scoliosis Program.Scoliosis Program.
•• Explore diagnostic and treatment options available. Explore diagnostic and treatment options available.
•• Identify financial and medical resources for referrals. Identify financial and medical resources for referrals.
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ADH Rules and ADH Rules and
Regulations For Regulations For
Scoliosis ScreeningScoliosis ScreeningEffective as of November 1, 2007Effective as of November 1, 2007
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I. Purpose I. Purpose
• Scoliosis is lateral curvature of the spine,
resembling an S-curve or a C-curve.
• Idiopathic Scoliosis accounts for 85% of all
scoliosis cases.
• Condition detected in children between ages of
10 and 15 years.
• Girls affected more often than boys.
• About 2 in 100 people have a mild form of
scoliosis.
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I. Purpose Cont.I. Purpose Cont.
• Scoliosis can be relatively easily detected by
performing a 30 second scoliosis screen.
• Early detection and treatment can help prevent
physical and emotional disability.physical and emotional disability.
• Rules and Regulations provide a method to
assure all school age children are screened for
scoliosis and necessary referrals for medical
follow-up are made.
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II. Authority: II. Authority:
It’s the Law!It’s the Law!
Arkansas Act 95 of 1989 and Act 41 of Arkansas Act 95 of 1989 and Act 41 of 1987 requires that Arkansas Children be 1987 requires that Arkansas Children be 1987 requires that Arkansas Children be 1987 requires that Arkansas Children be screened for scoliosis in selected grades. screened for scoliosis in selected grades. Rules and regulations implementing the Rules and regulations implementing the act were adopted by the Arkansas act were adopted by the Arkansas Department of Health and filed in 1998 Department of Health and filed in 1998 and and revised in November of 2007revised in November of 2007..
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III. DefinitionsIII. Definitions
•• Certified Instructors:Certified Instructors: Individuals who Individuals who
train the screeners. These shall be train the screeners. These shall be
licensed health practitioners who have licensed health practitioners who have licensed health practitioners who have licensed health practitioners who have
successfully completed the Arkansas successfully completed the Arkansas
Department of Health Instructor Training Department of Health Instructor Training
Course in Scoliosis Screening.Course in Scoliosis Screening.
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III. Continued DefinitionsIII. Continued Definitions
•• Screeners: Screeners: Individuals who perform the actual Individuals who perform the actual
scoliosis screening. These shall be licensed scoliosis screening. These shall be licensed
physicians, individuals who have been trained physicians, individuals who have been trained
to perform scoliosis screening by a Certified to perform scoliosis screening by a Certified to perform scoliosis screening by a Certified to perform scoliosis screening by a Certified
Scoliosis Screening Instructor, or individuals Scoliosis Screening Instructor, or individuals
who can document completion of a scoliosis who can document completion of a scoliosis
screening workshop within the past five years screening workshop within the past five years
and demonstrate competence to a Certified and demonstrate competence to a Certified
Scoliosis Screening Instructor.Scoliosis Screening Instructor.
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III. Continued DefinitionsIII. Continued Definitions
• Scoliometer: An instrument that
measures the degree of rotation of a
deformity of the back found on a routine deformity of the back found on a routine
scoliosis screening.
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III. Continued DefinitionsIII. Continued Definitions
• Scoliosis Screening Procedure: The
procedure used to examine a child for
scoliosis. It consists of evaluating the scoliosis. It consists of evaluating the
child in six positions. The forward bend
technique is included in three of these
positions.
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III. Continued DefinitionsIII. Continued Definitions
• Forward Bend Technique: A technique
used to determine the presence or
absence of an abnormality of the spine. It
involves observing the person being
screened from the rear, front, and side
while the person is bending forward.
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• Scoliosis
from Greek:
skoliōsis
III. Continued DefinitionsIII. Continued Definitions
skoliōsis
meaning from
skolios,
"crooked"
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IV. Responsibility:IV. Responsibility:
•• Who must institute and maintain a Who must institute and maintain a
continuing scoliosis screening program:continuing scoliosis screening program:
•• Public elementary and secondary schoolsPublic elementary and secondary schools
•• Institutions supported by state funds Institutions supported by state funds
providing education to minor childrenproviding education to minor children
•• Private institutions providing education to Private institutions providing education to
minor childrenminor children
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IV. Responsibility:IV. Responsibility:
•• Rules and RegulationsRules and Regulations
•• Arkansas State Board of Health Arkansas State Board of Health
•• Training ProgramTraining Program•• Training ProgramTraining Program
•• Arkansas Department of Health provides Arkansas Department of Health provides
an Instructor Training Course in Scoliosis an Instructor Training Course in Scoliosis
Screening.Screening.
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V. Screening ProgramV. Screening Program
•• QualificationsQualifications
•• Licensed physiciansLicensed physicians
•• Individuals trained by a Certified Scoliosis Individuals trained by a Certified Scoliosis
Screening InstructorScreening InstructorScreening InstructorScreening Instructor
•• Individuals providing documentation of Individuals providing documentation of
successful completion of a Scoliosis successful completion of a Scoliosis
Screening Workshop within the past five Screening Workshop within the past five
years and can demonstrate competence to years and can demonstrate competence to
a Certified Scoliosis Instructor.a Certified Scoliosis Instructor.
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V. Screening Program Cont.V. Screening Program Cont.
•• Guidelines for Screening:Guidelines for Screening:
•• GirlsGirls-- 66thth and 8and 8thth gradesgrades
•• BoysBoys-- 88thth gradesgrades•• BoysBoys-- 88thth gradesgrades
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V. Screening Program Cont.V. Screening Program Cont.
•• Screening Procedure Screening Procedure (five stages)(five stages)
11stst StageStage--Scoliosis Screening Scoliosis Screening
ProcedureProcedureProcedureProcedure
22ndnd StageStage--Scoliometer Scoliometer
33rdrd StageStage--Recommendation for ReferralRecommendation for Referral
44thth StageStage--Referral SystemReferral System
55thth StageStage--FollowFollow--UpUp
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V. Screening Program Cont.V. Screening Program Cont.
•• Recommendation for ReferralRecommendation for Referral
•• Referrals are made on students with an Referrals are made on students with an
abnormal screening and/or scoliometer abnormal screening and/or scoliometer
reading of reading of >> 77°°..reading of reading of >> 77°°..
•• It is recommended that scoliometer It is recommended that scoliometer
readings of readings of >>88°° be referred to an be referred to an
orthopedist.orthopedist.
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V. Screening Program Cont.V. Screening Program Cont.
•• Referral SystemReferral System
•• Certified Scoliosis Screening Instructor or School Certified Scoliosis Screening Instructor or School
Health Nurse shall contact the parents of a child who Health Nurse shall contact the parents of a child who
fails the screening by letter, telephone call, or in fails the screening by letter, telephone call, or in
person to:person to:person to:person to:
11. explain the findings. explain the findings
2. define and discuss scoliosis2. define and discuss scoliosis
3. discuss the need for referral to a licensed physician3. discuss the need for referral to a licensed physician
•• The School shall provide a Scoliosis Screening Report The School shall provide a Scoliosis Screening Report
to the parent to take to the licensed physician.to the parent to take to the licensed physician.
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V. Screening Program Cont.V. Screening Program Cont.
•• FollowFollow--UpUp
•• Reschedule absent students for screening within Reschedule absent students for screening within
90 days of missed screening.90 days of missed screening.
•• Reasons for all exclusions must be documented.Reasons for all exclusions must be documented.•• Reasons for all exclusions must be documented.Reasons for all exclusions must be documented.
•• Students referred to a physician for scoliosis Students referred to a physician for scoliosis
screening failure, and then fail to see physician screening failure, and then fail to see physician
require a second contact by mail, telephone or require a second contact by mail, telephone or
in person at least one additional time to discuss in person at least one additional time to discuss
importance of followimportance of follow--upup
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VI. Training ProgramVI. Training Program
•• Certified Scoliosis Screening Instructors Certified Scoliosis Screening Instructors
must be recertified every five years.must be recertified every five years.
VII. Confidentiality of InformationVII. Confidentiality of Information
VIII. Notification of ScreeningVIII. Notification of Screening
•• At least seven days prior to scoliosis At least seven days prior to scoliosis
screenings parents must be notified.screenings parents must be notified.
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IX.IX. Exclusions to ScreeningExclusions to Screening
• Act 41 of 1987 states that "no child
shall be screened if its parent or
guardian objects to the screening
in writing stating as the basis of in writing stating as the basis of
the objection that it is contrary to
the parent's or guardian's religious
beliefs.“
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X. Quality AssuranceX. Quality Assurance
The Arkansas Department of Education shall The Arkansas Department of Education shall
collect statistics on Scoliosis Screening activities collect statistics on Scoliosis Screening activities
in the state. The following information shall be in the state. The following information shall be
reported annually:reported annually:
1. the target population eligible for screening1. the target population eligible for screening1. the target population eligible for screening1. the target population eligible for screening
2. the number of children screened2. the number of children screened
3. the number of children referred3. the number of children referred
4. the number of children seen by a physician4. the number of children seen by a physician
5. the number of children diagnosed with scoliosis 5. the number of children diagnosed with scoliosis
by a physicianby a physician
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THE NINE “P’s”THE NINE “P’s”
Purpose Planning Population
Personnel Preparation Place
Permission Procedure Paperwork
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PURPOSEPURPOSE(First “P”)(First “P”)
•• Early detection to prevent further damageEarly detection to prevent further damage
•• Detection of other abnormalitiesDetection of other abnormalities•• Detection of other abnormalitiesDetection of other abnormalities
oo Child AbuseChild Abuse
oo Acanthosis NigricansAcanthosis Nigricans
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Suspected Child AbuseSuspected Child Abuse
•• Child Abuse as defined by Child Abuse as defined by Arkansas code 12-12-503
•• Do School Nurses report child abuse? Do School Nurses report child abuse?
•• Reporting the suspected child abuse.Reporting the suspected child abuse.•• Reporting the suspected child abuse.Reporting the suspected child abuse.
•• Failure to report suspected abuseFailure to report suspected abuse
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AbuseAbuse can be physical or sexual. It includes
non-accidental physical injury, shaking a baby,
tying a child up, and giving or exposing a child
to alcohol or other drugs.
Reasonable and moderate discipline (such as
spanking) is generally not considered abuse as
long as it does not cause injury more serious
than transient pain or minor temporary marks
and is administered by a parent or guardian.
Arkansas code 12-12-503
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Reporting Suspected Child AbuseReporting Suspected Child Abuse
School Nurses are Mandated ReportersSchool Nurses are Mandated Reporters
Child Abuse HotlineChild Abuse Hotline1.800.482.59641.800.482.5964
http://www.arkansas.gov/reportARchildabuse/pdf/suspected_child_abuse_report.pdf
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Failure to Report Suspected AbuseFailure to Report Suspected Abuse
Class C misdemeanor; willful failure Class C misdemeanor; willful failure
to report: civilly liable for all to report: civilly liable for all to report: civilly liable for all to report: civilly liable for all
damages proximately caused by that damages proximately caused by that
failure.failure.
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Acanthosis Nigricans/NeckAcanthosis Nigricans/Neck
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Acanthosis Nigricans/Under ArmAcanthosis Nigricans/Under Arm
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Acanthosis Nigricans/HandAcanthosis Nigricans/Hand
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PLANNINGPLANNING(Second “P”)(Second “P”)
•• This is the most important “P”This is the most important “P”
•• Get organizedGet organized
•• Determine date and site then scheduleDetermine date and site then schedule•• Determine date and site then scheduleDetermine date and site then schedule
•• Recruit helpRecruit help
•• Notify parents at least 7 days priorNotify parents at least 7 days prior
•• Remind students one day prior to screeningRemind students one day prior to screening
•• Set up roomSet up room
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POPULATIONPOPULATION(Third “P”)(Third “P”)
This changed in November 2007This changed in November 2007
•• Girls are to be screened in the 6Girls are to be screened in the 6 and 8and 8•• Girls are to be screened in the 6Girls are to be screened in the 6thth and 8and 8thth
grades only.grades only.
•• Boys are to be screened in the 8Boys are to be screened in the 8thth gradegrade
•• This includes public and private schools.This includes public and private schools.
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PERSONNELPERSONNEL(Fourth “P”)(Fourth “P”)
•• Certified Scoliosis ScreenerCertified Scoliosis Screener
•• PhysiciansPhysicians
•• VolunteersVolunteers
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PREPARATIONPREPARATION(Fifth “P”)(Fifth “P”)
•• Inform School StaffInform School Staff
•• Dates, times and locationsDates, times and locations
•• Ensure Screeners are either Certified or a Ensure Screeners are either Certified or a
PhysicianPhysician
•• Train volunteersTrain volunteers
•• Inform StudentsInform Students
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PLACEPLACE(Sixth “P”)(Sixth “P”)
•• Ensure PrivacyEnsure Privacy
•• Screen boys and girls separatelyScreen boys and girls separately•• Screen boys and girls separatelyScreen boys and girls separately
•• Good lighting essentialGood lighting essential
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PERMISSIONPERMISSION(Seventh “P”)(Seventh “P”)
•• Parental notification at least 7 days Parental notification at least 7 days
prior to screeningprior to screening
Act 41 of 1987Act 41 of 1987 states that "no child shall be states that "no child shall be
screened if its parent or guardian objects to screened if its parent or guardian objects to
the screening the screening in in writingwriting stating as the basis stating as the basis
of the objection that it is contrary to the of the objection that it is contrary to the
parent's or guardian's religious beliefs."parent's or guardian's religious beliefs."
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PROCEDUREPROCEDURE(Eighth “P”)(Eighth “P”)
•• Screener seated or standingScreener seated or standing
•• Student should be 4Student should be 4--6 feet away6 feet away
•• Student’s feet two to three inches apart, Student’s feet two to three inches apart,
knees straight and arms hanging loose knees straight and arms hanging loose
at sideat side
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PROCEDURE PROCEDURE -- Stage 1Stage 1
�� Position 1Position 1--Student facing front to screenerStudent facing front to screener
�� Position 2Position 2--Student bends forward slowlyStudent bends forward slowly
�� Position 3Position 3--Student facing to sideStudent facing to side�� Position 3Position 3--Student facing to sideStudent facing to side
�� Position 4Position 4--Student bends forward slowlyStudent bends forward slowly
�� Position 5Position 5--Student’s back to screenerStudent’s back to screener
�� Position 6Position 6--Student bends forward slowlyStudent bends forward slowly
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PROCEDURE PROCEDURE -- Stage 2Stage 2
•• The second phase of screening requires use The second phase of screening requires use
of the scoliometer.of the scoliometer.
•• Student is in position 6 with back to screener Student is in position 6 with back to screener
bending forward slowly with hands together bending forward slowly with hands together
as if diving.as if diving.
•• When using a scoliometer, referralWhen using a scoliometer, referral is made on is made on
students exhibiting unequal lumbar or students exhibiting unequal lumbar or
thoracic areas of thoracic areas of ≥ 7≥ 7 degrees or greater.degrees or greater.
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NORMAL SPINENORMAL SPINE
Four main areas:Four main areas:
�� Cervical (neck)Cervical (neck)
�� Thoracic (chest)Thoracic (chest)
�� Lumbar (small of back)Lumbar (small of back)
�� Sacral (lower spine)Sacral (lower spine)
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Three Types of Spinal Curves:
•• KyphosisKyphosis--slight slight
curvature is curvature is
normal.normal.
•• LordoisLordois--slight slight •• LordoisLordois--slight slight
curvature is curvature is
normal.normal.
•• ScoliosisScoliosis--lateral lateral
curvature is never curvature is never
normal.normal.
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ScoliosisScoliosis::
•• Abnormal lateral Abnormal lateral
curvature of the spine curvature of the spine
of 10of 10°° or more. or more.
•• Rotation in the spinal Rotation in the spinal •• Rotation in the spinal Rotation in the spinal
column creates a side column creates a side
to side, to side, ““SS”” shaped shaped
curve when viewed curve when viewed
from behind. from behind.
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STRUCTURAL SCOLIOSISSTRUCTURAL SCOLIOSIS
•• Idiopathic Idiopathic –– 85%85%
•• CongenitalCongenital•• CongenitalCongenital
•• NeuromuscularNeuromuscular--CP, MDCP, MD
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FUNCTIONAL SCOLIOSISFUNCTIONAL SCOLIOSIS
A structurally normal A structurally normal
spine that appears to spine that appears to
have a lateral curve have a lateral curve have a lateral curve have a lateral curve
(scoliosis).(scoliosis).
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Kyphosis:Kyphosis:
An abnormal increase An abnormal increase
in normal kyphotic in normal kyphotic
(posterior) curvature of (posterior) curvature of
the thoracic spine which the thoracic spine which the thoracic spine which the thoracic spine which
can result in a can result in a
noticeable round back noticeable round back
deformity. deformity.
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Lordosis:Lordosis:
An abnormal An abnormal increase in normal increase in normal lordotic (anterior) lordotic (anterior) curvature of the curvature of the curvature of the curvature of the lumbar spine. lumbar spine.
This can lead to a This can lead to a noticeable "swaynoticeable "sway--back“ appearance. back“ appearance.
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EQUIPMENTEQUIPMENT
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TREATMENT OPTIONSTREATMENT OPTIONS
•• ObservationObservation
Periodic medical examinations and xPeriodic medical examinations and x--raysraysPeriodic medical examinations and xPeriodic medical examinations and x--raysrays
•• BracingBracing
•• SurgerySurgery
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PERIODIC EXAMINATIONSPERIODIC EXAMINATIONS
•• XX--RAYSRAYS
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PERIODIC EXAMINATIONSPERIODIC EXAMINATIONS
•• Risser SignRisser Sign
Skeletal maturity can be assessed by the Skeletal maturity can be assessed by the
Risser signRisser signRisser signRisser sign
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BRACING……thenBRACING……then
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BRACINGBRACINGMilwaukee BraceMilwaukee Brace
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BRACINGBRACING
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BRACING…..nowBRACING…..now
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BRACING…..nowBRACING…..now
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SURGERYSURGERY
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Vertebral Body Stapling (VBS)Vertebral Body Stapling (VBS)
Application of metal
staples to the front of the
spine.
Staples are insertedStaples are inserted
between two vertebral
bodies, which squeezes
the growth plates and
slows the growth of
that side of the spine.
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PAPERWORKPAPERWORK(Ninth “P”)(Ninth “P”)
�� Make written referrals and followMake written referrals and follow--up up
as indicatedas indicated
�� Complete School Scoliosis Screening Complete School Scoliosis Screening �� Complete School Scoliosis Screening Complete School Scoliosis Screening
Annual Summary in APSCN.Annual Summary in APSCN.
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Parent Notification of Scoliosis Screening
Dear Parent, During the next few weeks a scoliosis screening program will be conducted to screen children for
scoliosis in school.
Scoliosis is a sideways curving of the spine, resembling an S – curve or C – curve. Eighty-five
percent of the time scoliosis has no known cause and tends to run in families. This type of
scoliosis first develops between the ages of 10 –15 years and occurs more often in girls than
boys. If scoliosis is detected early, treatment can be started and almost all of the curving can be
prevented.
The procedure for screening is a simple one in which the child’s back is observed as he/she
19
stands upright and as he/she bends forward. To observe this condition, each child will be asked
to remove their shirt or blouse (girls may wear bra or bathing suit top with an open back). The
screening will be conducted in privacy with only student and examiner present.
Any curvature or “back hump” that is noticed during the screening may indicate the need for
further studies. If a problem is found, you will be notified. We will recommend that you take your
child to a physician of your choice for an evaluation.
We encourage all students to participate in this program. If you do not want your child screened
please let us know in writing by three days before the screening date. Phone calls will not be
accepted. If your child is currently under treatment for a back problem, please let us know in
writing.
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A. Head
A. Head B. Shoulder
B. Shoulder C. Scapula
Address: C. Waist D. Waist
D. Hips E. Hips
Screener: 1 3 5
Grade:
Class:
Student Name M/F DOB 2 4 6
SPINAL SCREENING
WORKSHEET
Re
scre
en
ing
D
ate
:
Scre
en
er:
Un
de
r C
urr
en
t M
ed
ica
l T
rea
tme
nt
Confirm
Findings
Y/N
School:
Da
te F
am
ily C
on
tacte
d
Da
te R
efe
rre
d f
or
Exa
m:
Dia
gn
osis
& t
rea
tme
nt
Re
po
rt D
ate
R
ece
ive
d:
Follow-
up
Ne
ed
s S
ch
oo
l F
ollo
w-u
p:
Ye
s/N
o
FILLING OUT THE SPINAL SCREENING WORKSHEET
It is important that the screener include as much information as possible about His/Her findings for easy reference in the rescreening.
Adapted from the Texas department of Health, Bureau of Matenal & Child Health , Child Health division, December 1985
The pictures on the spinal screening worksheet represent the positions in which the student is viewed by the Screener. The front, back, and side views each have
several areas of focus. Each area has a letter designation. Use these letters on the worksh
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Parent Notification - Scoliosis Screening Follow-up Needed
Dear Parent, This letter is in regards to the scoliosis screening your child received
on at .
A trained screener checked your child’s back and has recommended further evaluation by a physician of
your choice.
We would like to emphasize that this is just a screening. A complete examination by a physician is
recommended to determine if there is a problem. We urge you to contact a physician within the next two
22
weeks.
The Division of Children’s Medical Services (CMS), Department of Human Services may offer financial
assistance for this evaluation when needed. Parents must apply for CMS prior to obtaining the medical
evaluation. Contact your School Nurse for more information about this program.
Sincerely,
School Nurse
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Dear Doctor: In accordance with Act 41 of 1987 and Act 95 of 1989 our school has conducted an annual scoliosis-screening program for detection of postural deformities such as scoliosis and kyphosis. The purpose of the screening program is to recognize deformities in their earliest stages so that progression can be prevented. Through scoliosis screening, this student has been observed to have variations consistent with either R/L thoracic scoliosis, lumbar scoliosis, or kyphosis. Please review the findings and, if your examination concurs with the screener’s, an appropriate X-ray of the spine should be obtained to establish the diagnosis. It is important that a standard technique be used in getting the X-ray. It is recommended that a single STANDING AP X-ray of the spine be obtained. A 14 x 17-inch film is acceptable if the top of the film is at the level of the shoulders and the tube is centered on the center of the cassette. The child must be standing straight and not be in a slouch position. If a kyphosis has been suspected, than a STANDING lateral film, using the same technique, should be obtained. In order that our school make required reports it is necessary to receive follow-up information from you. Please complete the following information and return this form to the school. Thank you, School Nurse, Scoliosis Screening Program Student Name: X-Ray Shows: DISPOSITION: Signed by M.D. Date: Please return to Nurse:
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Scoliosis Tracking and Annual Scoliosis Tracking and Annual
Scoliosis Summary ReportingScoliosis Summary Reporting
is completed on APSCNis completed on APSCN
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REFERRALSREFERRALS
Children’s Medical ServicesChildren’s Medical ServicesDonaghey Plaza SouthDonaghey Plaza SouthP.O. Box 1437 Slot 526P.O. Box 1437 Slot 526Little Rock, AR 72203Little Rock, AR 72203--14371437Little Rock, AR 72203Little Rock, AR 72203--14371437(Nancy Holder, Director)(Nancy Holder, Director)
Toll Free (800) 482Toll Free (800) 482--58505850--ext.ext.--22277 22277 or (501) 682or (501) 682--22772277
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REFERRALSREFERRALS
Shriners Hospitals for ChildrenShriners Hospitals for Children
(Shreveport or St. Louis)(Shreveport or St. Louis)
�� Contact local club/representative for Contact local club/representative for applicationapplicationapplicationapplication
�� Scimitar Shrine Temple Scimitar Shrine Temple –– Little Rock Little Rock 501501--565565--59925992
�� Shrine 1Shrine 1--800800--237237--50555055
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REFERRALSREFERRALS
Shriners Hospitals for ChildrenShriners Hospitals for Children
�� Less than 18 year oldLess than 18 year old
�� Copy of Immunizations and Birth Copy of Immunizations and Birth CertificateCertificateCertificateCertificate
�� Letter of referral from PCPLetter of referral from PCP
�� 3 pictures of child’s problem 3 pictures of child’s problem –– ex. Xrays, ex. Xrays, CT,MRICT,MRI
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RESOURCESRESOURCES
�� http://medstat.med.utah.edu/scoliosishttp://medstat.med.utah.edu/scoliosis
�� http://srs.orghttp://srs.org
�� http://www.tdh.state.tx.ushttp://www.tdh.state.tx.us
�� www.orthopaedicswww.orthopaedics--scoliosis.comscoliosis.com
www.consultingorthopedists.comwww.consultingorthopedists.com�� www.consultingorthopedists.comwww.consultingorthopedists.com
�� http://www.rad.washington.edu/mskbook/scoliosihttp://www.rad.washington.edu/mskbook/scoliosi
s.htmls.html
�� Individual Healthcare Plans for School Nurses Individual Healthcare Plans for School Nurses (2005)(2005)
�� The New School Nurse Handbook The New School Nurse Handbook (3rd Edition)(3rd Edition)
�� School Nursing: A Comprehensive TextSchool Nursing: A Comprehensive Text (5(5thth Edition)Edition)
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FAQ’sFAQ’s
1. A lack of calcium will not cause scoliosis.
2. Poor posture does not cause scoliosis.
3. Carrying a heavy book bag does not cause
scoliosis. scoliosis.
4. Scoliosis is not usually painful in adolescence,
but can become so in adulthood.
5. Braces do not make the spine straight.
6. Smoking does interfere with bone healing.
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More FAQsMore FAQs
7. The metal implant (spinal instrumentation)
does not activate the metal detectors at
airports, does not rust, and is not subject to
rejection by the body.
8. Surgery does not interfere with normal 8. Surgery does not interfere with normal
childbearing.
9. Spinal deformities are not contagious.
10. At present, there is no known prevention for
spinal deformities.
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•• Spinal DeformitiesSpinal Deformities--Scoliosis Scoliosis
Scoliosis Screening for Early DetectionGillette Children’s Specialty Healthcare &
The Minnesota Spine Center
•• Spinal DeformitiesSpinal Deformities--Scoliosis Scoliosis Screening VideoScreening Video
•• 15 Minutes15 Minutes
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PRACTICUMPRACTICUM
•• Pair up and practice the procedurePair up and practice the procedure
•• Document findings on the proper formsDocument findings on the proper forms•• Document findings on the proper formsDocument findings on the proper forms
•• Skills CheckSkills Check--offoff
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THE ENDTHE END