Los Angeles Unified School District

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All protocols with the exception of the clinic-specific diabetic protocols, need the following authorization forms completed:
   Additional forms related to protocols:  
   E. Review for Support Services Due to Health Needs -Complete for Student with Protocol Before the IEP
       Meeting 
   F. Protocol and Medication Checklist Form- Medication/Protocol Checklist for Licensed and Unlicensed
        Assistive Personnel 
 
 
Anaphylaxis
   Protocol:  Emergency Treatment of Anaphylaxis (Rev. 05/2016)
                    Anaphylaxis - Emergency Care Plan 
Catheterization
   1. Clean Catheterization (Rev. 6/15)
   3. Clean Self-Catheterization (Rev. 1/16)
   4. Sterile Catheterization  (Rev. 05/2016)
 
 
Diabetic Protocols
   1. Blood Glucose Testing (Rev. 11/06)
   2. Glucagon Injection (Rev. 11/06)
   3. Hypoglycemic Reaction (11/06)
 
   Other Related Information and Forms: Student with Diabetes
 
   For LAUSD Food Services Web Page for Menu click here; for carbohydrate count click here
        Refer to LAUSD Menu for specific food item name
   Note: The interactive menu is no longer in use.
 
 
Gastrostomy
 
Jejunostomy
 
 
 
 
Mechanical Ventilator (Rev. 5/2016)
 
Ostomy Care (Rev. 11/06)
 
 
Oxygen Therapy (Rev. 12/15)
 
 
Seizure
Protocols:
      The following forms MUST be completed with the above protocol:
      a.  Seizure Action Plan
 
 
      Related Forms and Information
      c. Seizure Action Plan 
      d. Seizure Record
   
 
Suctioning
Protocols 
   1. Oral Nasal Suctioning (Rev. 6/15)
   3. Tracheostomy Suctioning (Rev. 6/15)
   4. Tracheostomy Tube Replacement (Rev. 6/15)
 
Related Form:
 
 
   
   
 
 
 
 
 
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