Free CPR Training Resource Helps Students and Community to Save Lives

Is Your Campus Prepared for a Cardiac Emergency?

Each year, more than 350,000 out-of-hospital cardiac arrests occur in the United States. Cardiac arrest is an electrical malfunction in the heart that causes an irregular heartbeat (arrhythmia) and disrupts the flow of blood to the brain, lungs and other organs.

Survival stats are grim. Over 70 percent of cardiac arrests happen outside of the hospital, which means this can happen anywhere - at home, at work, or even in an educational setting. About 90 percent of people who suffer out-of-hospital cardiac arrests die. And while CPR, especially if performed in the first few minutes of cardiac arrest, can double or triple a person’s chance of survival, only about 46% of people who experience an out-of-hospital cardiac arrest get the immediate help that they need before professional help arrives.

Students play in integral part in increasing survival from cardiac arrest. Currently, 31 states require CPR training, including hands on practice on a manikin, as a high school graduation requirement. As of result of this legislation, approximately 1.8 million students (nearly 60 percent of the U.S. student population) are trained each year in the lifesaving skill of CPR.

Being prepared and confident to respond requires keeping skills as fresh as possible. That’s why the American Heart Association recommends receiving CPR training every two years and why it is currently exploring ways to bridge the gap between mandatory high school training and university-level courses.

Since the needs of university level students differ greatly from the needs of middle or high school students, the American Heart Association has introduced the brand new CPR in Schools University Toolkit. The toolkit consists of free resources for event activation, promotion, and social media resources for student athletes, members of a Greek organizations, resident assistants, student government officers, club members, among others. These resources provide everything needed to plan, organize and execute a CPR training event for students on campus.

Bring CPR Training to Your Campus with AHA's CPR in Schools Training Kit

55583fl_w_3_1The AHA’s CPR in Schools Training Kit is an all-in-one educational program that provides an opportunity for college students to bring Hands-Only CPR training to their campuses. Hands-Only CPR is CPR without mouth-to-mouth breaths. It is the recommended approach for anyone who has not been trained by a credentialed instructor who sees a teen or adult suddenly collapse in an out-of-hospital setting.

This kit allows college students to facilitate Hands-Only CPR trainings with their fellow students and spread the message of Hands-Only CPR. In this leadership role, students teach other students how to save lives.

The training kit comes complete with support from the American Heart Association, the trusted leader in heart health. These kits are easy to use, durable, and are designed to train 10 -20 people at once. The kit is also reusable, so one kit can train hundreds of people. Plus, you do not need to be an AHA instructor which is why thousands of high schools and middle schools throughout the country are currently using these kits. The kit can also be used to train campus faculty, staff and community members to extend the lifesaving skills into the community.

Students learn so much in college, but it’s also important to continue the skills they learned in high school. Please share this with friends and family to make students aware that they can become a part of the generation of lifesavers and help save a life with CPR.

Ask the Expert: Vision Screening with Dr. P. Kay Nottingham Chaplin, (EdD)

Ask The Expert

School Health is pleased to bring you this “Ask the Expert” blog with Dr. P. Kay Nottingham Chaplin, (EdD), director of Vision and Eye Health Initiatives for School Health and Good-Lite, member of the Advisory Committee to the National Center for Children’s Vision and Eye Health (NCCVEH) at Prevent Blindness, and co-chair of the NCCVEH Education/Data Subcommittee.

In this blog, Dr. Nottingham Chaplin will address a few commonly asked questions about vision screening, guidelines, and best practices.  


Q: What is the difference between optotype- and instrument-based vision screening?

A:  Optotype-based screening is the name for screening with tests of visual acuity, commonly known as eye charts. Software tests of visual acuity, such as EyeSpy 20/20™, are also available for optotype-based screening. “Optotype” is the name for pictures, letters, or numbers on tests of visual acuity.

Recognition visual acuity is the quantifiable, subjective measurement of the clarity, or clearness, of vision at the brain level when identifying black optotypes on a white background using specific sizes at a prescribed and standardized distance.

Instrument-based screeners neither measures visual acuity nor provide reports with visual acuity values (i.e., 20/XX). Instead, these devices analyze light reflecting from the retina at the back of the eye. This analysis provides information about the presence of risk factors in the eyes that may lead to decreased vision or amblyopia.

Instrument-based screening devices, such as the Welch Allyn® Spot™ Vision Screener, measure both eyes simultaneously and provide objective information about:

  • Significant refractive errors (i.e., hyperopia, myopia, and astigmatism);

  • Asymmetry of the refractive error from one eye to the other, known as anisometropia (for example, one eye may be myopic and the other hyperopic);

  • Misalignment of the eyes;

  • Presence of media opacities (i.e., cataract); and

  • Anisocoria (unequal pupil size).

Q: Do national guidelines or recommendations exist for instrument-based screening?

A: Two national guidelines or recommendations currently exist.

In 2015, the National Expert Panel (NEP) to the National Center for Children’s Vision and Eye Health at Prevent Blindness published recommendations for lay screeners, nurses, and others who screen children in educational, public health, or primary health care settings.

The NEP paper states that when screening children ages 3, 4, and 5 years, instrument-based screening is useful for shy, non-communicative, or preverbal children who cannot participate in optotype-based screening.

A guidance document from the American Academy of Pediatrics (AAP), American Association of Certified Orthoptists, American Association for Pediatric Ophthalmology and Strabismus, and the American Academy of Ophthalmology was published in 2016 for screening the vision of infants, children, and young adults. The AAP guidelines are for pediatricians and primary care physicians.

The AAP guidance document states:

  • Instrument-based screening can begin with children as young as age 12 months, although screeners will likely be more successful engaging a child at age 18 months.

  • At age 3 years, distance optotype-based screening may be attempted or the child can be screened with an instrument.

  • At ages 4 and 5 years, either distance optotype-based or instrument-based screening may be used.

  • At ages 6 years and older, optotype-based screening remains the preferred method, but instrument-based screening may be used when children and young adults cannot participate in optotype-based screening.

  • Instrument-based screening may be a helpful alternative when screening children of any age who have development delays.

Q: If I use an instrument, such as the Welch Allyn® Spot™ Vision Screener, do I need eye charts?

A: Screeners cannot successfully screen 100% of children with tests of visual acuity. Similarly, screeners cannot successfully screen all children with an instrument. Reasons may be related to pupil size, environmental lighting, and a child’s ability to fixate on the device’s target.

If you primarily conduct instrument-based screening, you want a test of visual acuity, such as an eye chart or Eye Spy 20/20, as a back-up jto be used if you cannot capture an reading with an instrument. For example, if an instrument has a 90 percent capture rate, a test of visual acuity will enable you to screen the other 10 percent of children the same day.

Whether you prefer optotype- or instrument-based screening, or a combination of the two approaches, a key to successful vision screening is using evidence-based tools and procedures as one of 12 components of a strong vision and eye health system of care. You can also use this checklist to evaluate your annual vision health program.

The right screening tools give us an important leg-up for identifying potential visual impairments. Screening with evidence-based tools helps ensure that we find and treat children with vision challenges so that all can learn and perform to the best of their abilities.
School Health offers a wide variety of optotype- and instrument-based screening tools to meet your needs. Click here to see our full line of vision screening products.

If you have a question that was not answered above, please let us know in the comment section below and we will research the answer.

Keep in touch with Dr. Kay!

For more information and references:
Vision and Eye Health at NASN:

Committee on Practice and Ambulatory Medicine, Section on Ophthalmology, American Association of Certified Orthoptists, American Association for Pediatric Ophthalmology and Strabismus, American Academy of Ophthalmology (2016). Visual system assessment in infants, children, and young adults by pediatricians. Pediatrics, 137(1), 1-3. Retrieved from

Cotter, S. A., Cyert, L. A., Miller, J. M., & Quinn, G. E. for the National Expert Panel to the National Center for Children’s Vision and Eye Health. (2015). Vision screening for children 36 to <72 months: Recommended Practices. Optometry and Vision Science, 92(1), 6-16. Retrieved from

Donahue, S. P., Baker, C. N., Committee on Practice and Ambulatory Medicine, Section on Ophthalmology, American Association of Certified Orthoptists, American Association for Pediatric Ophthalmology and Strabismus, American Academy of Ophthalmology (2016). Procedures for the evaluation of the visual system by pediatricians. Pediatrics, 137(1), 1-9. Retrieved from

National Center for Children’s Vision and Eye Health, Vision Systems, at

Nottingham Chaplin, P. K., Baldonado, K., Hutchinson, A., & Moore, B. (2015). Vision and eye health: Moving into the digital age with instrument-based vision screening. NASN School Nurse, 30(3), 154-60. Abstract available at

Nottingham Chaplin, P. K., & Bradford, G. E. (2011). A historical review of distance vision screening eye charts: What to toss, what to keep, and what to replace. NASN School Nurse, 26(4), 221-227. Abstract available at

Nottingham Chaplin, P. K., Marsh-Tootle, W, & Bradford, G. E. (2015). Navigating the path of children’s vision screening: Visual acuity, instruments, & occluders. Retrieved from

Year of Children’s Vision at

Much of the information for this document came from:

Nottingham Chaplin, P. K., Baldonado, K., Hutchinson, A., & Moore, B. (2015). Vision and eye health: Moving into the digital age with instrument-based vision screening. NASN School Nurse, 30(3), 154-60. Abstract available at



Develop a Lifesaving Cardiac Emergency Response Plan for Your School


Sudden Cardiac Arrest (SCA) affects roughly 326,000 people each year, including over 6,000 youth. During cardiac events, time becomes a critical factor. With each passing minute, an SCA victim’s chance for survival decreases by 7 to 10 percent.

Recently, a study that appeared in the AED Rescue ImageCanadian Medical Association Journal showed that people who suffer cardiac arrest on the upper floors of high-rise buildings are less likely to survive than those on the lowest floors. The study found that less than 1 percent of people above the 16th floor survived a cardiac arrest, while over 4 percent of people on the first or second floor survived. The higher floors are associated with longer response times for EMS personnel to reach victims, and they directly correlate to lower survival rates.

But these first minutes are critical whether a victim of SCA is in a tall building or a small community school. That’s why it’s important for both rural and urban communities to develop a planned response to a cardiac emergency, before the emergency occurs. Having a planned response that is known and rehearsed can help save precious minutes between an SCA event and when a victim begins to receive care.

To help prepare your school for a cardiac emergency, the Sudden Cardiac Arrest Foundation recommends having a Cardiac Emergency Response Plan in place. A Cardiac Emergency Response Plan is a written plan that establishes what steps to take if an SCA event happens in your school.

According to the SCA Foundation, the Cardiac Emergency Response Plan will help make sure that you can respond efficiently and effectively when a cardiac emergency occurs. Quick action in the first few minutes of a cardiac emergency, even by lay bystanders, can double or even triple a victim’s chance of survival.

With a Cardiac Emergency Response Plan, you can:

  • Identify a Cardiac Emergency Response Team – The Cardiac Emergency Response Team should include staff members with CPR/AED training, the school nurse, school administrators, health and physical education teachers, athletic directors, athletic trainers, coaches, and event advisors. Each member of the team should be familiar with the plan, and provide evaluations and updates as necessary.

  • Properly Place AEDs – The number of AEDs placed at a school should be sufficient to enable the response team to retrieve an AED and respond to a victim within two minutes of notification, both inside the school and on the school grounds. AEDs should have clear signage and should always be in locations that are accessible at all times. School Health offers a full line of AEDs and accessories to make sure that your school has the equipment you need.

  • Ensure AED Readiness & Maintenance – AEDs should be regularly checked and maintained according to manufacturer’s recommendations. Schools should designate a specific contact to verify AED readiness and maintenance. In addition, resuscitation kits - including latex free gloves, a razor, a pair of scissors, antiseptic wipes, and a CPR barrier mask – should accompany all AED devices

  • Establish Emergency Response Protocol – The Cardiac Emergency Response Team should establish a protocol to follow in case of a cardiac event. The protocol should include properly recognizing the signs of cardiac arrest, calling 911 and assigning someone to meet the emergency responders, starting CPR, and using an AED.

  • Train Staff for Cardiac Events - The sooner an SCA victim receives care, including bystander CPR, the more likely they are to survive. An effective Cardiac Emergency Response Plan calls for at least 10 percent of school staff – including the school nurse – to be trained in CPR and AED use. This training should include both cognitive and hands-on practice, with continuous training that helps to ensure readiness in the event of a cardiac emergency. Products like the AHA’s CPR in School Training Kit can help ensure that your staff has the training that they need.

  • Notify Parents – The Cardiac Emergency Response Team should notify parents that the school has adopted a Cardiac Emergency Response Plan, and encourage parents to be trained in CPR/AED use.

These carefully orchestrated responses to cardiac emergencies will help reduce deaths in school settings and can help ensure that chaos does not lead to an improper or inadequate response.

For more information about Cardiac Emergency Response Plans and insightful SCA information, please visit the Sudden Cardiac Arrest Foundation.

Worried about lice outbreaks? Don’t lose your head.

As students with their winter hats and caps return to school from break, we’ll see another visitor come with them: head lice.


Winter is a more active time for lice outbreaks as children have more close contact and often share coats, scarves, and hats with one another. And as lice outbreaks increase, so does the news around them. Lately parents and health professionals have been bombarded by over-hyped information campaigns about “super lice.” When we hear “super lice” we immediately conjure mental images disgusting bugs that are bigger and stronger than any kind of lice or nit that we’ve seen before. We picture them crawling around the scalps of children and jumping menacingly as they spread among the children of the school.

We naturally become concerned for the welfare of children when they hear these fear-inducing names. We look for ways to respond quickly, and with brutal force – hoping to prevent the spread of infestation.  However, this response can sometimes create problems where none existed before.

Know the facts - “Super lice” are actually treatment-resistant lice with a media-hyped name. As an example, think of infections that are resistant to antibiotics. Treatment resistant lice are created in much the same way – through improper use of chemical applications or prescription treatments.

Interestingly, treatment resistant lice are not a new phenomenon. These kinds of lice have been present in schools for over 40 years.

Campaigns and media stories about super lice contain pieces of information that, while factual, are dangerous when taken without context. This can breed fear and cause further problems. For example, improper treatment with harsh chemicals and pesticides is one of the ways that treatment-resistant lice have become stronger. And sometimes parents resort to home remedies such as mayonnaise or olive oil that are not scientifically proven to be effective in treating lice. That's why manual removal through combing is a critical part of treating any lice infestation.

Combing is the only safe and effective method to end infestations especially for lice that are resistant to chemical treatments. School Health is pleased to offer the LiceMeister® Comb, which has the US Food and Drug Administration clearance as a medical device for the purpose of screening, detecting, and removing lice and their eggs (nits). Lice combs are also useful for removing dead nits from the hair in order to reduce diagnostic confusion and the chance of unnecessary re-treatments in the future.

How you can be prepared - Parents should become proactive in the examination and treatment (when necessary) of their children when they are exposed to lice. With proactive examinations, parents are able to identify lice concerns early which makes treatment easier, and helps prevent the spread of lice among students.

Sometimes, identifying head lice can be quite difficult. Using the LiceMeister Comb along with a magnifying lens is recommended to accurately identify lice. It can be easy to confuse nits with dandruff, hair spray droplets, and dirt particles.

  • The best diagnosis is made by finding a live nymph or adult louse on the scalp or hair of a person.

  • Nits attached firmly within 1/4" of the base of hair shafts may indicate an infestation if no moving nits are found. This is not accurate 100% of the time.

Watch for signs of lice - that "Tickly" Feeling Can Be a Sign of Head Lice

Head lice symptoms include:

  • A tickling feeling or a sensation of something moving in the hair

  • Frequent itching

  • Sores from scratching

Oh no, head lice! The National Pediculosis Association (NPA) has identified tips to help parents and schools control head lice without the danger of exposing children and their environment to pesticides and other harsh chemicals.

NPA’s Tips for Parents:

  1. Know how to identify lice and nits in advance of outbreaks. (See NPA’s Critter Card)

  2. Know how to check heads at home so kids can arrive to the group setting lice and nit free. (See NPA’s LiceMeister comb teaching video)

  3. Know your child's school policy on head lice. Policies vary greatly from school to school.

Of course, the best way to treat lice is not to get them in the first place.

What You Need to Know About the Latest AHA Guidelines

New information from the American Heart Association about providing lifesaving care during a cardiac emergency.


Resuscitating unconscious boyOn October 15th 2015, the American Heart Association (AHA) released the newly revised guidelines for cardiopulmonary resuscitation (CPR), and emergency cardiovascular care. The AHA continues to emphasize the importance of HIGH QUALITY CPR in an emergency cardiac situation. Effective CPR provided immediately after a cardiac event can double or even triple a victim’s chances for survival.

Studies have shown that people who feel comfortable performing CPR are significantly more likely to attempt life-saving resuscitation. Routine practice is needed in order to get the rhythm down for to perform the proper depth and rate of CPR.

Here are the AHA’s newest guidelines for providing high quality CPR:


Single rescuer:

  • The recommended sequence for a single rescuer has been confirmed: the single rescuer is to initiate chest compressions before giving rescue breaths to reduce delay to first compression. The single rescuer should begin CPR with 30 chest compressions followed by 2 breaths.

Single or multiple rescuer:

  • There is continued emphasis on the characteristics of high-quality CPR: compressing the chest at an adequate rate and depth, allowing complete chest recoil after each compression, minimizing interruptions in compressions, and avoiding excessive ventilation.

  • The recommended chest compression rate is 100 to 120 compressions per minute (updated from at least 100/min).

  • The clarified recommendation for chest compression depth for adults is at least 2 inches but not greater than 2.4 inches.

How do you know if you are performing high quality CPR during a rescue? With CPR, practice makes perfect. From manikins to AEDs to CPR masks, School Health offers the products that you need in order to practice proper CPR. We can help you make sure that everyone is properly trained to respond in an emergency cardiac situation.

Watch a video to see how Pasadena ISD is training the next generation of lifesavers!



Consider the following products for quality CPR and CPR practice:


CiSTrainingKitAHAFullProduct_LS_med The American Heart Association CPR in Schools Training Kit gives you the tools you need to teach the core skills of CPR and AED use in under 30 minutes.
59105_w The CPR RsQ Assist helps the lay responder perform high quality CPR by combining voice commands with a metronome that indicates proper compression frequency.
loopscreengrabgamify-2 When training students or community groups to perform life-saving CPR, School Health recommends the LOOP CPR Training Game. The LOOP uses game-related concepts to create a compelling training experience by showing what’s right and what needs to improve.
prestan_three-adult_v21_1 The Prestan Adult Manikin with CPR Monitor is a way to practice on a life-size manikin, offering a realistic experience to provide better CPR outcomes in emergency situations.
55410 The Prestan CPR/AED Training Kit is available exclusively through School Heath and is the complete CPR/AED training solution. By combining Prestan Manikins, the Prestan AED Trainer, and the LOOP CPR training game, training groups can practice the skills they need to achieve proper rhythm and depth, as well as best practices for proper AED use.
g5_expirationupdate Todays advanced AEDs also provide real-time feedback that offer helpful instructions to guide responders in emergency situations. School Health recommends the Cardiac Science Powerheart G5, the ZOLL AED Plus, and the Heartsine 650P. These advanced AEDs combine ease of use and reliability to help everyone when responding in an emergency situation.

For incredible save stories and insightful SCA information please visit the Sudden Cardiac Arrest Foundation.

4 Tools to Help Children Exercise Their "Speech Muscles"

Enhance speech therapy exercises with these four activities that can accelerate learning and increase performance.



Use a mirror to heighten the child's awareness of how muscles of the mouth are used to produce speech. The mirror provides the child with a visual image of the sounds they are being taught. By using a mirror, the child sees how the lips and tongue work to produce sounds. Children can build speech muscles by looking at a mirror and making funny faces!


Give your child a straw and ask her to blow through it. This activity strengthens the lips and cheeks. Some children allow air to escape through the sides of the mouth, and the result is "slushy speech." By blowing through a straw, the child stabilizes the jaw and practices appropriate lip closure.


This simple, break-resistant device magnifies voices so students hear themselves clearly while speaking softly. The auditory feedback helps students to focus and hear the sounds that make up words (phonemes) more clearly as they learn to read, spell, or process language aloud. Speech students can use the Toobaloo to help improve their articulation and phonology.


Hands-free, acoustical voice-feedback headsets help learners hear phonemes and their own voices more clearly. Whisper Phones strengthen the learning process by intensifying the sound of one's voice and minimizing auditory distractions. Users are able to focus much better on what they are learning and classrooms are actually quieter because children only need to use a soft voice to hear themselves clearly.
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Grant for Teaching CPR in Schools


John Meiners Photo 2015_editedThis blog has been written by John Meiners. John Meiners is Executive Vice President of Emergency Cardiovascular Care (ECC) Programs and International Strategies for the American Heart Association (AHA). In this key role, John leads AHA’s global effort to increase survival from cardiac arrest by working toward AHA’s global goal of reducing mortality from cardiovascular diseases and stroke by 25% by 2025.

Creating the Next Generation of Lifesavers

In the United States, 38 people every hour will have a cardiac arrest outside of the hospital. However, only 10 percent of these victims will survive. Seventy percent of the time, cardiac arrests will occur in the home. Lifesaving CPR performed by a bystander can double or even triple a person’s chance of surviving a cardiac arrest. The life you save by performing CPR is most likely to be your own family or friend!

Students play an integral part of increasing survival from cardiac arrest. Twenty-four states now require all students to be trained in CPR, with hands-on practice on a manikin, before graduating from high school. That means approximately 1.2 million students (nearly 40 percent of the U.S. student population) will be trained in CPR each year! The American Heart Association (AHA) is actively involved in helping to create the next generations of lifesavers who will help increase the chance that a cardiac arrest victim has the help he or she needs until paramedics arrive.

0807 CPR in Schools Map-01

Apply for a Grant to Train Your Students

renditionDownloadIn the first year of the AHA-Ross Dress for Less Stores CPR in Schools Program, we have trained more than 330,000 middle school students in life-saving CPR. Over three years, more than 1,000,000 students in 33 states will learn CPR. For more information about this successful CPR in Schools Program, please visit here.

We are excited to announce our newest grant program for high schools! Because of the generous donation from the Ross Stores Foundation, 250 high schools across the country will receive 2 FREE CPR in Schools Training Kits™ in the 2015-2016 school year. This all-in-one kit contains 10 manikins and materials for school teachers or administrators to train hundreds of students, as well as online resources to make implementation easy. Students learn the core skills of CPR in under 30 minutes, and it contains everything needed to learn CPR, AED skills and choking relief in school classroom settings. The easy-to-use kit utilizes the AHA’s latest science guidelines and it is portable, allowing for easy storage. It was developed for educators, school nurses or even student leaders to train groups of 10-20 students at once in a school setting.

If you’d like to learn more about getting your school involved, visit

Hurry! The deadline for grant applications is September 30th, 2015.

Remember, cardiac arrests can happen to anyone, anywhere, and when you least expect it.

Abby Snodgrass is one of those students that was able to learn CPR in high school and become a lifesaver. This is her story:

Abby was out shopping when she heard commotion on the next aisle. She ran to see what was going on and saw an 11-month-old baby who suddenly stopped breathing. Abby had recently learned CPR at her Hillsboro High school in Missouri and immediately starting performing the lifesaving technique. The baby eventually started breathing again, and emergency responders said if Abby had not acted so fast, the baby might have died.

This is just one of the many great stories of students saving lives through CPR they learned in school, thanks in part to partners like Ross Stores who donate funds to provide grants for hundreds of high schools across the country. While we’ve made some great progress over the years, we also need your help to expand this program across the country! If CPR training is not currently required in your state, join us in supporting legislation at

We thank you for being such an integral part of creating safer communities. Together, we can increase survival from cardiac arrest.

For incredible save stories and insightful SCA information please visit the Sudden Cardiac Arrest Foundation.

School Nurse from New Orleans Wins $10,000 to Upgrade Her Health Room

Angela_Damico_social_revised2Nurse Angie from Dwight D. Eisenhower Academy is Selected as the 2015 Ultimate Upgrade: Health Room Edition Contest Winner

Her students know Angela Damico fondly as “Nurse Angie.” Every day Nurse Angie cheerfully shows up to her New Orleans office to face another day of bumps, bruises, coughs, splinters, stomachaches, and bee stings. And that’s on a quiet day. Nurse Angie regularly administers prescription medications, and handles the more serious medical issues that come up in her population of nearly 800 young students.

But Nurse Angie works in a small room that also serves as the office for 3 other teachers. The furniture in her office is old and worn, and some of it broken. During examinations, a wiggly fabric screen provides privacy as students come and go from the crowded room.

Yet Nurse Angie works tirelessly without complaining about her equipment or conditions. It is because of this that School Health is pleased to be able to award the Ultimate Health Room Upgrade grand prize to Angela Damico at Dwight D. Eisenhower Academy in New Orleans!

We will work closely with Nurse Angie to provide her a more functional health room that serves her and her students. And, we will keep you updated on the progress along the way.

Here is an excerpt from the entry for Nurse Angie, submitted on her behalf by a colleague:

"Each morning Nurse Angie walks with her cooler to the cafeteria to carry ice back to her office, where she hands out ice packs for bumped heads and “magic” peppermints to settle upset stomachs. She has a continuous stream of customers with complaints ranging from coughs to splinters to bee stings. She administers ADHD, asthma, allergy and other every day prescription medications, and often can be heard calling parents and doctors to remind them to keep things up to date. She handles the many serious medical issues that crop up with our student population of nearly 800…juvenile diabetes, Sickle Cell Anemia, HIV, seizure disorders, psychiatric disorders. She races out of here when necessary to treat fight victims, evaluate sprains and falls and stabilize broken bones on the playground. In between all of these medical emergencies Nurse Angie calls parents to give them a “heads up” on what accident or illness has occurred at school today, or to tell them what to look out for if there has been a head injury.

She conducts hearing, vision and height/weight screenings, scoliosis screenings, brings in doctors and dentists to provide physicals or examinations for our high poverty student population. She prepares first aid kits for field trips and sporting events. She keeps track of immunizations and sports physicals, and each year must organize and file the most enormous mound of paperwork I have ever seen. She educates parents about the children’s medical conditions. She feeds hungry students and counsels those with eating disorders. She hosts children at lunchtime who are allergic to fish and sends out reminder emails to the staff about those allergies.

Nurse Angie does all of this cheerfully, never complaining about the shortage of outlets as she unplugs and re-plugs all of her necessary equipment into the overloaded extension cords. She has no privacy to give injections or examinations. She soothes the children with a pleasant “Oh, my Angel” so that they never complain about the large dents in the collapsing leather beds. Sometimes as I glance into her side of the room I am reminded of that scene in “Gone With the Wind” where all the soldiers are lined up laying on the ground…sometimes there are so many kids in the beds, chairs and in line to see her that I wonder how she keeps her patience.

Dwight D. Eisenhower Academy is located in the Algiers neighborhood of New Orleans, LA. It was originally built in 1970 and operated as a public elementary school run by the Orleans Parish School Board. In August 2005 Hurricane Katrina devastated the city of New Orleans, damaging or destroying nearly all the 128 school buildings. The Eisenhower school building was wind-damaged, but not flooded, and closed for a time following Hurricane Katrina. It reopened as an open enrollment public charter school, and since that time the enrollment has doubled, tripled, and quadrupled. Conditions here at the school are extremely overcrowded and there is no money for building maintenance. The building has never been remodeled.

Nurse Angie needs privacy screens, lockable storage cabinets, file cabinets and a desk that lock, a hot water heater, an ice machine, more outlets, and new exam beds at the very least. Nurse Angie needs to know that someone cares about her as she is so busy caring for others."

Stay tuned for the “after” picture and update from Nurse Angie’s Ultimate Upgrade!

Just Ask Questions: One Strategy Toward Meaningful Outcomes

Our featured blog writer Gabe Ryan was invited to speak about his experiences throughout his educational and professional career. Gabe has used a wheelchair since he was three years old and is an experienced user of assistive technology tools. Some of these tools have been life-changing for him and he looks forward to sharing his experiences and perspectives with our blog readers. 

blog6_1I was recently invited to speak as the Keynote for the Sacramento County Office of Education’s Infant Development Program. This is the ‘early start’ program for our area. Because I was a graduate of this program, the staff was particularly interested in how my life had been and what I had been doing since I transitioned out of their care as a little guy.

As a person who has moved through general education receiving support and services from educational programs, it is exciting to me that the professionals in this field were interested in hearing my perspective. I shared my experience from preschool to high school, my employment, and my activities outside of education. I reflected on different milestones and what I thought were points of interest to those working with our youngest children and their families.

A few months after this presentation another exciting opportunity was offered to me, this time at a state level! I was asked to present to the California Department of Education’s Advisory Commission on Special Education (ACSE) as the student voice of the month. The commission was interested in hearing a student’s perspective on their experience.

Being asked to share at these two events was encouraging. I appreciated the opportunity to share my knowledge, and being a part of their professional development was meaningful to me.

In my presentations I used an analogy that went something like this: each person, be they teacher, parent, service provider, or student is like a cog in a giant machine. I feel this is an important key point to continue to share. Some have small parts, some have larger and more complex parts. Some people only know their piece of work, while others know everything about the giant machine. But regardless of their position everybody involved is crucial to the outcome.

Service providers may not always see an outcome immediately or directly. But their work in combination with other providers, systems, and parents can be a huge part of advancing to a positive outcome for a student. These outcomes could be months or years down the road, sometimes figuring things out or reaching goals takes time.

I am fortunate to have continued opportunities to share my perspective and ideas. I challenge you to reach out to those you serve and ask how your services have impacted their outcomes, ask for ideas and input on the services you provide. You may find a wealth of resources and knowledge right at your fingertips.

No matter what agency you are from you make a difference and impact those you serve. Working together we create a system that is supportive and encourages learning, independence, and a better quality of life.

Are Your Eye Charts Up to Date? The Evolution of Eye Charts Over the Past 150 Years

StandardizeEyeChartsEye charts are an important part of vision screening, but how did these vision screening tools look in 1915? What about 1862? The answer may surprise you.


When you think of the word “Snellen,” you probably think of Snellen’s legacy – the Snellen Eye Chart with the big "E" at the top. This chart continues to hold a place of prominence on many walls in school nurse's offices and in the hallways of medical practices today.

Snellen, a Dutch ophthalmologist, introduced the first version of his eye chart in 1862, as a way to determine visual acuity (Bennett, 1965). Recently featured on CBS Sunday Morning, Snellen's work set a new standard for vision screening. His Snellen Eye Chart and the  Snellen Ratio are still in wide use today.

Before 1862, oculists used varied and sometimes interesting methods to assess visual acuity.

When the first school setting vision screening program began in 1899, a Snellen chart was used. (Appleboom, 1985) Many versions of eye charts have come and gone over the years, and even today's version of Snellen's chart differs from the 1862 version.

But did you know that the time-honored Snellen chart is not the preferred letter chart for testing visual acuity in 2015?

Why is a Snellen chart not the preferred chart of 2015?


While Snellen charts revolutionized vision screening programs they do not adhere to national and international guidelines for standardized eye chart design (Nottingham Chaplin & Bradford, 2011). Six guidelines for standardized eye chart design are (Nottingham Chaplin & Bradford, 2011):

  1. Optotypes should be of approximate equal legibility.

  2. Each line on an eye chart should have the same number of optotypes (typically 5).

  3. Horizontal spacing between optotypes should be equal to the width of the optotypes on a line.

  4. Vertical spacing between lines should be the height of the optotypes in the next line down.

  5. The size of optotypes should progress geometrically up or down the chart by 0.1 log units (i.e., 20/32 vs. 20/30).

  6. Optotypes should be black on a white background under good lighting conditions (luminance between 80 cd/m2 and 160 cd/m2).

If you were to draw a line around the outside of the ototypes on an eye chart adhering to the national and international guidelines, you would see a chart with an inverted triangle. Conversely, if you outlined the optotypes on a chart that does not adhere to national and international guidelines, you would see a chart with a rectangle.


So, look at the eye chart yesyou use. Do you see the inverted pyramid or a rectangle?

What should we use instead of Snellen charts for Vision Screening?


Despite many state, public health, & district vision screening guidelines listing Snellen as the preferred chart for school aged children it has been recommended to use Sloan charts for vision screening.

Developed by Louise Littig Sloan, phD, and Dr. Palmer Good, of The Good-Lite Company, the preferred tests of visual acuity for school-aged children and adults use Sloan Letters as optotypes.

Sloan published information about those letters in 1959 (Sloan, 1959). which was later used by vision professionals to design a new, standardized chart in the inverted pyramid format.

It is recommended to switch from Snellen to Sloan charts to ensure an evidence-based test of visual acuity for school-aged children that meets national and international design guidelines for standardized eye charts.

School Health offers a variety of Sloan charts and cards that meet the national and international guidelines. Call us today for a consultation on the Sloan-related screening products that are available to you.

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Appelboom, T. M. (1985). A history of vision screening. The Journal of School Health, 55(4), 138-141.

Bennett, A. G. (1965). Ophthalmic test types. A review of previous work and discussions on some controversial questions. The British Journal of Physiological Optics, 22(4), 238-271.

Nottingham Chaplin, P. K., & Bradford, G. E. (2011). A historical review of distance vision screening eye charts: What to toss, what to keep, and what to replace. NASN School Nurse, 26(4), 221-227.