Return to school after vomiting

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Specializes in Occupational Health.

I'm curious what everyone's policy is on when a student can return to school after vomiting or diarrhea?

Last year was my first year, the other nurses told me it was 24hrs for fever, vomiting, and/or diarrhea. Apparently, that is what the prior nurse had done as well.

But, that isn't what our district policy states. It's 24hrs fever free without medication, but 12hrs for nausea, vomiting, and diarrhea. So, I'm going with that... but I'm not sure it's the best policy. I can't find a rational for 12hrs, but a quick Google search shows recommendations ranging from 24hrs to 2 days. Isn't 12hrs too short to prevent the spread of gastro viruses?

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Diarrhea - must be free of diarrhea x24 hours without use of medication.

vomiting - must be able to eat 1-2 meals without vomiting.

Fever - temp below 100 x24 hours without the use of medication.

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Specializes in Community and Public Health, Addictions Nursing.

If two or more episodes of vomiting in 24 hours, stay home. Remain home until vomit-free for 24 hours (or as close to 24 hours as possible- I don't really care if it's only been 23). The main reason why I have the 24 hour rule in place is because some parents don't seem to know how long they should wait and observe their child before determining they are vomit-free. ("She hasn't thrown up for one hour! Looks like she's fine again." *vomits entire breakfast* Um, no).

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Specializes in Peds, School Nurse, clinical instructor.

I use the 24 hr rule

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Specializes in Pediatrics Retired.

I'm pretty sure your state health department has published guidelines about this...go with that, and if your school policy differs from the state you can compel a change with the state rules.

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Specializes in Occupational Health.

24hrs seems like the norm... no clue why we say 12hr.

I'm pretty sure your state health department has published guidelines about this...go with that, and if your school policy differs from the state you can compel a change with the state rules.

Sadly, VA says to exclude until vomiting/diarrhea/fever are gone, then it's fine to return. No time limit specified.

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Specializes in Pediatrics Retired.
24hrs seems like the norm... no clue why we say 12hr.

Sadly, VA says to exclude until vomiting/diarrhea/fever are gone, then it's fine to return. No time limit specified.

Wow, quite the guideline! Just go with the 12 hr thing and don't stress over it. I'm surprised some nurse there hasn't been "challenged" over the discrepancy.

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Our policy is 24 hours vomit free. I do make exceptions from time to time especially with the little ones who vomit from crying too hard/eating "gross" tasting food/seeing ranch dressing IF they only vomited once with no other symptoms.

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Specializes in School nursing.

I have so many anxiety pukers that if I always held to a 24 hour rule these kids would never be in school.

Suspected stomach bug of some kind, 24 hours or 1-2 meals without nausea/vomiting is a good rule.

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Our policy is 24 hours vomit free. I do make exceptions from time to time especially with the little ones who vomit from crying too hard/eating "gross" tasting food/seeing ranch dressing IF they only vomited once with no other symptoms.

there are always exceptions. I had a jr high kid who puked and when I asked what he had for lunch he described their "table party" which included cupcakes, cookies, doritos, skittles, and mountain dew. Sorry kid. Back to class, next time you'll know better.

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Specializes in Occupational Health.
Our policy is 24 hours vomit free. I do make exceptions from time to time especially with the little ones who vomit from crying too hard/eating "gross" tasting food/seeing ranch dressing IF they only vomited once with no other symptoms.

there are always exceptions. I had a jr high kid who puked and when I asked what he had for lunch he described their "table party" which included cupcakes, cookies, doritos, skittles, and mountain dew. Sorry kid. Back to class, next time you'll know better.

Yes! I have some littles who eat the weirdest things... then puke and are completely fine. Some teachers want to be fast and hard on sending home, others get it happens and want them back.

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Specializes in ICU/community health/school nursing.

So...why did they vomit? Did you see the vomit? Did anyone see the vomit? Projectile, a la food poisoning or norovirus? Full of phlegm like they coughed to the point of emesis? So many questions, and the policy doesn't fit all of them.

I will say that vomiting once and feeling better probably shouldn't be a 24 hour quarantine. But since my policy says so, that's what I do...

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