Pink eye questionable

[sophonie418]

I'm new to the whole school nurse substitute position, I am aslo a new registered nurse. I had a child with an eye that seemed irritated in a way. I called home to ask if this child has had any symtoms of pink eye. The mother states she hasn't seen any other signs, it's just irritated. I informed her to get it checked out to see if it is pink eye or not. She said he should be fine but she will check it out later. The child is kindergarden age. The child has also stated that his eye doesn't itch or bother him. Should I send him back to class? Or send him straight home?

[AdobeRN]

Do you have anything written in your policy regarding pink/red irritated eyes?

If I know of other confirmed cases of pink eye in the grade or class I usually just send them home - telling parent that we have had cases of it and recommend MD evaluation to r/o pink eye.

In our area we have alot of kids allergic/senistive to every tree/pollen/grass - so sometimes it is just due to allergies. I question the kid - how long, did you wake up this way, has this happened before, did your parent notice this morning, itchy, pain??? I always call the parent and ask them the same questions - I have some parents that will come pick up kids right away and others will want me to reassess in an hour or two. If I need to reassess l will send the kid back to class after I flush the eyes with saline, handwash & instruct them to keep hands off face/eyes. When the kid returns and symptoms have not changed or they seem worse I just go ahead and send them home.

[coughdrop.2.go, BSN, RN]

If I have a student that comes to me and I have a suspicion of pink eye the student automatically gets a call home and they must bring back a note from the Doctor stating whether or not it's pink eye in order to attend class again. However, I have a book from the American Academy of Pediatrics called Managing Infectious Diseases in Child Care and Schools and it does not recommend excluding children from school who have pink eye unless the student has a fever or the child does not have the ability to understand how to prevent spreading the pink eye to others through hand washing, hygiene, not rubbing eyes, etc.

[100kids, BSN, RN]

In this case it seems the only symptom is a red eye. If I spoke to the child and mom and there were no other signs indicating pink eye then I would instruct mom to keep an eye on it. I would rinse the eye to clear out anything that might be irritating it and I would keep checking it. After speaking to mom if the eye had been red for more than a day or if he/she wakes up and it is still red tomorrow I would advise getting it checked by a doctor to rule out pink eye or to help with whatever is irritating it.

[NurseEllie13]

I agree with 100kids. No drainage, no pain, no report of eye being extra "sticky" this morning when the student woke up---rinse it out, back to class, try not to touch it.

Our policy to return for diagnosed pink eye is a doctor's note saying the student can return and/or at least 24 hours since first antibiotic treatment.

[fetch, BSN, RN]

I use a chart similar to these to help evaluate the eye: (1) (2)

Like everyone else said: see what the parents say, if they had any symptoms at home, good hand washing, also sometimes the teacher can help you out. ("Oh, it just appeared when they came back inside from recess!" versus "Well every hour or so there's a lot of crusties that I help them clean off.")

[RainMom]

In our area we have alot of kids allergic/senistive to every tree/pollen/grass - so sometimes it is just due to allergies.

^^^THIS

I had a terrible time with my son's school when he was five. Multiple calls home for pink eye. First two times, his eye was nearly clear by the time I went to pick him up. In our rural area, there is not actually a school nurse; staff from the health dept are called as needed & do screenings.

The third time I refused to pick him up but went into eat lunch with him & see for myself. I showed up about the same time as the HD nurse who had been called because I would not pick him up. Finally had them put in his file allergies causing red eyes & stop calling every week for "pink eye"!

PS- Yes it can be a problem, but sometimes you have to listen to the parent & assess over time.

[JenTheSchoolRN, BSN, RN]

Irritated eye/eyes? I agree with those that suggest allergies. It is actually my first thought before pink eye every time.

If the student has no discharge and a there is a history of seasonal allergies, I flush the eyes, instruct about hand washing, return to student to class. If a student does have multiple symptoms/I suspect pinkeye, I do call home to have parent make doctor's appointment, have them pick student up.

Our policy is similar to others: 24 hours after treatment, student can return to school. Of course, I work with the older kids, yet sometimes I find it isn't really easier to get them to hand wash and stop touching their eye/eyes... :)

[NutmeggeRN, BSN]

Thanks Fetch

Those are great quick references!

[Nurse ABC]

Go by your school policy. Ours go home with dr note to return. My own kid's school, stay at school. Signs it really is pink eye:only one eye affected, swollen, red, hurts, sensitive to light; itchy, sticky yellow matter, eyes matted shut after sleep, feels gritty to them, etc. Also, pull down their bottom eye lid-if really deep red most likely infected. There's usually more than one of these symptoms together. Signs it's allergies you have the watering, itchiness, and a little red most likely both eyes. Once you see enough of them you can usually tell right away if it's pink eye or not. The thing with pink eye is it gets worse quick. If you just aren't sure it's more likely allergies or early pink eye-too early to know for sure so too early to treat. If not sure, rinse out with saline, have them hold wet paper towel on it a sec to cool it down, have them wash their hands, and return to class. Call mom to keep an eye on it (no pun intended!) You can check back on them later if you want. If no worse than when you saw them a few hours ago most likely allergies.

[RNlove17]

in our district, they don't even send kids home for pink eye. They say it's not that contagious so I send them back to class. I call and let the parent know though, and then it's on them. If the kid comes back then I'll call again and tell them they really need to take them to the doctor.

[aetienn6]

I know this post is old but I just had a student show up this morning with redness to both of his eyes.They did not appear watery, I noticed no drainage, and he denied any pain or feelings of itchiness. His mother works at the school so I told her I wanted to talk to her, I told her I didn't think it was pink eye but I wanted to discuss somethings with her . Well I got busy and she up and took him to the doctor who then said he had conjunctivitis and myriad of other bacterial infections related to his upper respiratory system and sinuses. Now I feel like people are going to think I don't know what I'm doing but if I had gotten to speak to her I would have probably told her to go ahead and go to the doctor anyway