vomiting students?

[KATT RN]

I'm wondering what ya'll do with your student's who vomit. A lot of the time I ask if their stomachs are still hurting and if they feel nauseated. Did they eat? Temp check, etc. If everything is okay I send them back to class but this gets A LOT of push back from teachers wondering "if they threw up then they have to go home". A lot of the times I tell them some kids just have to throw up, it doesn't usually mean they are sick, but it doesn't seem to get through to them. Anyways, I'm just wondering what your general rule of thumb is and any thoughtful advice is welcomed ❤️  

[arlingtonnurse]

We used to be 24 hours vomit free but now it's more nuanced.  If a kid just vomits once and it seems pretty clearly to be 'something else' (gagging from coughing or food, exposure to nauseating sights/smells, motion sickness) I will let parents know but usually keep them in school if they tolerate crackers and water easily.  Similarly, if a kid pukes once but seems fine before pick up, they can return if they have eaten two meals without issue.  

[NutmeggeRN, BSN]

I'm in HS and it depends...

How do they look? Do they have a fever? What did they eat or drink prior? DId they take a med on an empty stomach? Is it a new med? Is anyone else sick at  home? Do they feel better?  What is the stress/drama factor? I don't always send them home.

[SchoolNurseM]

In my district, if they throw up they are sent home. 

 

[Cattz, ADN]

We generally go by the 24 hour - no vomit - rule. I would prefer - if a student vomits 2 times in 24 hours- they go home. This allows for those kids who have a really active gag reflex, or the bus sick, etc. I work 3 days a week- each in a different building. If I was in a building everyday and could use my assessment and nursing judgement- I would definitely change it to go this route. But, since the secretaries are me when I'm not there- we pretty much have to go with the 24 hour rule. 

The guidelines put out by Missouri Department of Health in the "Prevention and Control of Communicable Diseases Manual" says this about school exclusion- Vomiting 2 or more times in the previous 24 hours, unless determined to be caused by a noncommunicable condition and the child is not in danger of dehydration."

It is a great resource and can be found at - https://health.mo.gov/living/families/schoolhealth/pdf/Communicable_Disease.pdf

Happy FriYAAY Friends.  GO CHIEFS!!

[NRSKarenRN, BSN, RN]

Cattz said:

It is a great resource and can be found at - https://health.mo.gov/living/families/schoolhealth/pdf/Communicable_Disease.pdf

Happy FriYAAY Friends.  GO CHIEFS!!

You got your wish -- KC CHIEFS won the 2024 Super Bowl.

Thanks for Missouri School Prevention and Control of Communicable Diseases guidelines.

[Cattz, ADN]

NRSKarenRN said:

You got your wish -- KC CHIEFS won the 2024 Super Bowl.

Thanks for Missouri School Prevention and Control of Communicable Diseases guidelines.

Thanks! That game was a heart stopper. Kids and adults are tired but still excited this morning!

I hope the resource is helpful. I use it often. It takes the guesswork out of whether to exclude or not- consistency is my middle name. 

[drvncrazy, BSN]

It does depend on how sick they appear and what they were doing when they vomited.  We do NOT automatically exclude for vomiting 1x.  As we all know- kids vomit for many reasons and not always due to illness.

[Cattz, ADN]

drvncrazy said:

It does depend on how sick they appear and what they were doing when they vomited.  We do NOT automatically exclude for vomiting 1x.  As we all know- kids vomit for many reasons and not always due to illness.

I feel so passionate about this particular subject and this is one strong reason why a nurse in the building is so important. We have assessment skills that Untrained Assistants, Secretaries, etc do not have. No fault of theirs' I appreciate them.