Just curious... children who vomit!!

Kittery · Jan 25, 2018

Our school policy is vomit goes home and stays home until 24 hours without vomiting. That said, it's understood that I can use my discretion. But if I don't have a clearly not-illness-related reason for the student vomiting, I will send home.

I would see if getting the doctor's permission to remain in school after one episode and no other s/s in writing would suffice. I have taken notes like that before, but it'll probably depend on your school's administrators or even school board.

NutmeggeRN, BSN · Jan 25, 2018

Hmmm...always very suspicious of unwitnessed vomitus...ESPECIALLY when they decline an offer of mouthwash...

bsyrn, ASN, RN · Jan 25, 2018

If they vomit once, have no fever and feel better.....off to class they go. If I get them back again they are sent home.

scuba nurse, BSN, MSN, RN · Jan 25, 2018

Sometimes it doesn't matter what I think, the teacher will be like "he threw up, send him home" even if I think they are fine, the teachers are the ones who dont want the kid in class. So i send them home, to keep the peace.

WineRN · Jan 25, 2018

Yep to all of the above. Just an additional thought: Your "school nurse" may not be a nurse, not all schools have an RN, so perhaps it's an aide or office staff. I'd get a note from his doctor saying that, in the case of a single episode of vomiting, do -whatever intervention-, observe, and return to class.

^This. We have a strict 24 hour vomit free policy and I have told parents that I COMPLETELY understand that little bobby is making himself throw up to miss math, but my hands are tied until I get a doctor's note saying this is his normal.

I usually only send home if I actually see the vomit. So many times teachers send them down without seeing it, or send them with a trash can that has a little spit/phlegm in it. Those kiddos go back to class.

MrNurse(x2), ADN · Jan 25, 2018

I usually only send home if I actually see the vomit. So many times teachers send them down without seeing it, or send them with a trash can that has a little spit/phlegm in it. Those kiddos go back to class.

There is so much you can tell from actually seeing it. Gross, but true. To OP, you may want to make sure your son has a good plastic bag, or even better, an emesis bag, to help the nurse.

JenTheSchoolRN, BSN, RN · Jan 25, 2018

There is so much you can tell from actually seeing it. Gross, but true. To OP, you may want to make sure your son has a good plastic bag, or even better, an emesis bag, to help the nurse.

True! I have had students describe their vomit to me, which they are think it is weird. But I push as I tell them nothing to too gross in my office :). It can really help me determine their "re-vomit status" so to speak when it is not witnessed. Separates out the phlegm vs puke and also helps me determine the puke-fibber as well.

allnurses Guide · Jan 25, 2018

What is your all's policy regarding children who vomit?
I'm talking, a child who has vomited, whom after vomiting seems just
fine, no fever, no other symptoms.
What about a child who vomits, who has vomited like this before,
and history shows that once the child vomits one time, he's fine
after that?
I ask because I've been called to school several times now over
the past year or two, to come and take my son home and make him
miss the entire day of school, because of one episode of
vomiting. Usually he vomits on the bus on the way to school,
sometimes he vomits as soon as he gets to school. He is
always FINE after that and I have told the school nurse this.
Doesn't seem to matter, I have to take him home for the
rest of the day.
1. I KNOW there is always the possibility of a virus that could be
spread around.
2. No I don't know why he does this. Possibly he is getting motion
sickness on the bus from the constant stopping and starting. Possibly
it has something to do with his medicine. Possibly he needs something
to eat. I am really not sure. Whatever causes it, he usually does it
just once and then he is fine the rest of the day.
3. No I don't mind having him at home, but I do mind him missing
more school than necessary.
I guess I just maybe need to get him to the doctor and explore
why this happens, and maybe get a note from the doctor saying that
it is unneccesary to excuse him every time it happens.
It doesn't happen more than once a month or so.
Anyway, I'm just curious, what are your policies on this sort of
thing? Totally curious as to your thoughts.

I am a person who vomits. It's been going on since I was in 1st grade and I am about to be 55. During my school years in 1st through 3rd grade I vomited nearly every day right after lunch. My mom was a stay at home but it still became an attendance issue. Our Dr thought is might be some sort of food sensitivity and we removed all dairy products from my diet. My mom met with the principal - we didn't have a school nurse, and they came up with a plan that if I threw up I would be allowed to lay down in her office for 30 minutes and if I still felt sick I would be sent home. Mostly I felt fine and didn't even go to the principal's office.

This issue has carried into adulthood and I have numerous gastro consults with no clear answers. I have an anti-emetic on hand for days it happens and I just keep plugging on.

Hppy

cooties_are_real · Jan 25, 2018

We don't send every vomiting student home here. Learned this after about 4 years at the HS level. We had one young man that would "vomit" phlegm at least once a week. No fever and felt kind of yucky afterwards. Refused to send him one day and he asked if he could sign himself out since he was 18. I said yes thinking he would be gone the rest of the day. 3 weeks later I realized I had not seen him at all, look him up and sure enough, he had checked himself out of school. He enrolled in an near by school district. I also have some that will make themselves vomit and not necessarily by gagging themselves.

bitter_betsy, BSN · Jan 26, 2018

My vote is motion sickness. I can't ride in a car without puking if I am not driving. I couldn't ride on a bus if I tried. Maybe try one of those motion sick bracelets from the drug store. The ones you wear behind your ear work too but I'd hate to introduce drugs into a childs system every day just to get them to school. I'd think there would be a long term solution. As a side note - as I've gotten older it has gotten worse (and so have my migraines). I used to be able to read and I can't now. I used to be ok if I could look out a window and I can't now. I really just feel this is motion sickness - he gets to school, pukes (luckily he makes it to school) and then all the herky jerky stops and he's good to go. I wish you well. Him too - motion sickness sucks.

allnurses Guide · Jan 26, 2018

thanks for all of the feedback. Again, was just totally curious as to, if

your school districts had a policy. Mine might, I don't even know as I

haven't asked. :laugh: Guess we may just have to try to get down to

the root of what causes him to do this. I've actually been driving him

to school most days now when I can, in case it IS motion sickness.

I remember vomiting all over the big round rainbow rug during story

time when I was in kindergarten. My teacher was SOOOO mad!!!

:laugh: she was a big ol' meanie, I never liked her.

RobotechTD · Jan 26, 2018

Based on the Maryland Communicable Diseases: Guide for Schools, the students have to vomit more than once before we send them home. See the website below and check page 4. I first learned about this rule when a parent did not want to send her "special" student home after only vomiting once.

As school nurses, we have the discretion of keeping some students in school if they vomit multiple times because some of them practiced vomiting on command so that they could go home.

https://phpa.health.maryland.gov/IDEHASharedDocuments/guidelines/CDSummary_FINAL_2011_Nov.pdf