Recurrent Syncope in Classroom Setting

Specialties School

Published

Specializes in Community Health Nurse.

I need advice. I have a student that has had 5 syncopal episodes thus far this school year. She has seen Neuro, Cardio, General Practitioner for this condition. Neuro has placed her on nortriptyline q HS for cluster migraines. Cardio has placed on Florinef q AM for dysautonomia. It is ineffective in preventing these episodes. They happen anytime and anywhere. It is very disruptive to class.

Her mom says that she will get home and is perfectly fine.

Admin wants her home schooled- reasoning- safety of all students, disruption to other students.

What is your take?

I don't know where to stand on this. Is this something a 504 can cover? Does she need someone with her at all times? I have suggested that she just lay in the nurses office and once she has recovered then she should go back to class. The school is scared to make that judgment and for me to make that judgment. They worry about the 1 time- that she falls and really hurts herself. I see there point. It is not my job to diagnose.

We have no paperwork from the doctor. I have given mom IHP's that she has never filled out and returned.

Specializes in Critical Care, Dialysis, School Nursing.

WOW! Sounds like there needs to be a meeting with you, principal, and parent. She has 2 diagnoses and two meds and still has the same symptoms. An MD should be guiding you as to in school treatment. Has she had a Holter monitor done? You have no paperwork?! Sorry for disjoined sentences. How old is student? Female? Never happens at home?? Any other medical or behavior issues??Yikes...

Specializes in School Nursing, Public Health, Home Care.

I had a student once with similar symptoms and it was caused by the fluorescent lights. But in any case the school district is obligated to provide her with an education--I can't believe they would be willing to incur the expense of a homebound tutor, besides, she isn't homebound. I agree with skoolrn about a meeting. I'd also ask for a release of info to speak directly with her primary MD. Tough situation when you don't even know what it is you're dealing with.

Keep us informed!

Specializes in Maternal - Child Health.

Home schooling seems extreme.

There are other conditions which can cause a student to suddenly loose bodily control, including seizures. I daresay there must be at least one student with seizures attending your school district.

I agree that a meeting would be a good place to start. Perhaps identify activities that would place the child at risk of injury should a fainting spell occur and devise a plan to protect her from injury during these activities (buddy system, adult escort, etc.) But for the parts of her day spent sitting at a desk, I don't see the risk.

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