Cough - send home?

[manjaNurse]

Hi all,

I've been having this problem a few times already. Some teachers are so concerned that the child was coughing in class. These few times, they have send the children to me to send them home. I find this ridiculous.

I will asked the child to stay in my room for a while and listen to the so-called severe cough.

Yes, the children did have deep cough but they do not present with - fever, phlegm, runny nose, shortness of breaths or continuous coughing. Why should I send them home?

I usually put them on a face mask, give them lozenges and send them back to class, with a note to the teacher to observe for signs of lethargy or fever.

What else should I do?

Regards,

Siti

[Flare, ASN, BSN]

i don't do the face mask or lozenges (need a dr's order for cough drops...) but i do advise that student to increase fluid intake, wash hands frequently and cough into their elbow. They're sent back to class just the same however.

[bunsterj]

If they were afebrile, not coughing up something ugly, and not coughing to the point of emesis I gave them some water and the coughing into elbow and hand washing lecture and sent them back to class. This usually didn't sit well with the sending teachers, who commonly felt that the child should go home, take some cough syrup so they will "get better", or go to the doctor for "some antibiotics." I repeatedly reinforced that antibiotics do not help colds or other viruses, cough syrup and other cold products do not cure colds..and likely don't help a cough any better than water, and that students cannot stay home for as long as they are coughing as it could last for a few weeks. I reinforce that everyone should wash/sanitize their hands frequently and keep their hands away from their mouth/nose/eyes. Every year the same teachers send students to the office with a note of "John needs to go home, he is coughing," or "John is coughing, he needs a cough drop"--we did not stock any over the counter meds, and John would need a note from his physician for any cough drops he might bring in, and would have to stay in the office while it dissolved. Never utilized a face mask.

[Purple_Scrubs, BSN, RN]

I have occasionally sent a child home with a cough and no fever or other signs of illness, but very rarely. If the student is coughing incessantly to the point that they cannot participate fully, then there is no point in keeping them in class. In 3+ years on the job, this has only happened a handful of times, so I try every alternative to keep the kiddo in class whenever possible.

Also keep in mind that recurring cough can be a sign of asthma. I had a kid whose mom kept coming to school to give him cough syrup at the teacher's request (bypassing sending the kid to me). I had no idea this was happening and when the PE teacher finally sent the kid to me for assessment, he was wheezing terribly. I called mom and believe me, she was not too happy that she had been trying to treat asthma with cough syrup because the teacher would not refer the child to the nurse!

[bunsterj]

I guess I was incorrect in assuming that the cough was as a result or a cold or the flu. If that didn't seem to be the case, I would let the parents know.

[CalNevaMimi, LPN, LVN]

As a teacher, I've had students coughing as if one of their lungs was going to fly out. I'd direct them to "go get some water" outside of the classroom so they could get in a little walk and fresh air as well. Now, as a school nurse, I'd be concerned with fever and phlegm, as well as asthma. Not all asthmatic attacks are wheezy. When in doubt, call the parent and explain the situation. They might very well have more information to offer.