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  • Protocols

    Each Specialized Physical Healthcare Service (SPHCS) or protocol has specific authorization form posted under the protocol guidelines.
 
A. Specialized Health Care Services:
   (1)  Form
   (2)  Guidelines
 
 
 
D. For a protocol or SPHCS that is not listed on the standardized specialized physical health care services, please download the Generic Authorization Form (English/Spanish)
 
        Assistive Personnel
I. Review for Support Services Due to Health Needs -Complete for Student with Protocol Before the        IEP Meeting
 
  
  

 

Guidelines

Solu-Cortef Protocol Guidelines

 

Authorization Forms:

English/Spanish - Other languages are not available

Emergency Medication Authorization

 

Related Forms and Information:

Emergency Care Plan for School

Adrenal Insufficiency - Power Point

 

 

 
Protocols Guidelines: 
 
 
Authorization Forms: (5/2017):
 
 
 
 
 
Authorization Forms: (5/2017)
 
 
 
a. Clean Catheterization Guidelines (3/2019)
   Authorization Forms for Clean Catheterization (5/2017)
 
 
    Authorization Forms for Clean Self-Catheterization with Assistance (5/2017)
 
 
c. Clean Self-Catheterization Guidelines (3/2019)
   Authorization Forms for Clean Self-Catherization (5/2017)
 
 
d. Sterile Catheterization Guidelines (3/2019)
   Authorization Forms for Sterile Catheterization (5/2017)
 
 
e. Training Videos Link
 
Guidelines:
 
1. Blood Glucose Testing (3/2019)
2. Hypoglycemic Reaction (3/2019)
3. Glucagon Injection (Severe Hypoglycemia) (3/2019)
 
 
 
Authorization Forms:
 
3. Glucagon Injection (1/2020)
 
 
 
Other Related Forms and Information:

For LAUSD Food Services Web Page for Menu click here; for carbohydrate count click here.

 

 

 Epinephrine for Schools Resource Page

Gastrostomy
 
    Authorization Forms for Gastrostomy Feeding: Bolus Method (5/2017) 
 
    Authorization Forms for Gastrostomy Feeding: Slow Drip Method or Pump (5/2017) 
 
    Authorization Forms for Gastrostomy Tube Replacement (5/2017) 
 
d. Training Videos Link
 
 
 
  
Jejunostomy
 
 Authorization Forms for Jejunostomy Tube Feeding: Slow Drip Method or Pump (5/2017) 
 
 
 
Protocol Related Form:  Special Diet Form
 
 
 
 
 
Mechanical Nebulizer Treatment - Guidelines (3/2019)
 
Authorization Forms with the Parent Section in Different Languages (5/2017) 
 
 
 
Mechanical Ventilation Guidelines (3/2019)
 Authorization Forms for Mechanical Ventilation (5/2017) 
 
Other Related Forms/Information 
 
 

 

Ostomy Care (3/2019)

Authorization Forms with the Parent Section in Different Languages (5/2017) 
 
 
 
Oxygen Therapy - Guidelines (3/2019)
 
Authorization Forms for Oxygen Therapy (5/2017)
 
 
 
Protocols:
1.  Diastat - Diastat Guidelines  (3/2019)
Authorization Forms for Diastat (5/2017)
 
2.   Vagus Nerve Stimulation (VNS) - VNS Guidelines (3/2019)
Authorization Forms for VNS (5/2017)
Related Forms and Information
      c. Seizure Action Plan: English/Spanish
      d. Seizure Record
      e. Parent Questionnaire for Students with Seizures
          (1) English/Spanish (2) English/Armenian (3) English/Chinese (4) English/Korean
Protocols 
   1. Oral Nasal Suctioning (3/2019)
       Authorization Forms for Oral/Nasal Suctioning (5/2017)
 
      Authorization Forms for Oropharyngeal and Nasopharyngeal Suctioning (5/2017)
 
   3. Tracheostomy Suctioning(3/2019)
      Authorization Forms for Tracheostomy Suctioning (5/2017)
      Authorization Forms for Tracheostomy Tube Replacement (5/2017)
 
Training Videos Link and Related Forms:
 
 

What's New

Forms

Protocols

References

District Policies Regarding Critical Issues

 

 

Forms and Information

 

Immunizations Guidelines and School Based Clinics

Immunization Toolkit for Schools

Measles

Pertussis

Health Brochures

 

 

 

Types of Services and Supervisor Contact Information

 

 

Infant and Preschool Special Education

Special Education Resource Nurse

Pre-school Transition School Nurse

Visually Impaired Program

Carlson Home Hospital

Specialized Physical Healthcare Services

 

Audiometric Testing Program

CPR/Automated External Defibrillators

Communicable Disease

Condom Availability

Nurse Family Partnership

Oral Health Programs

Queens Care

  • Announcements

    Immunization Program and SMS School-based Clinics Schedule

     CPR Class Schedule    LAUSD American Heart Association