Vomiting

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Question for you guys. What do you do for kids complaining of vomiting (and you actually see them throwing up) whose parents cannot come pick them up? I'm talking no fever or other symptoms other than a tummy ache and vomit. Exclusion guidelines here say kids are to go home until "determined that they are no infectious or in danger of dehydration." However, many parents at this school do not have transportation (or honestly I think just don't want to pick them up). It is difficult for me to keep them in my office as it is very small and I have so many other kids coming for meds, diabetes, and a multitude of other things. So do you guys just make them lay there? Send them back to class if they are feeling better?

Honestly I think some of them just make themselves throw up to go home.

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Specializes in Pediatrics Retired.

I don't accept that. So they're saying if their child was taken to the emergency room from school, they would not be able to go to the ER, the child would be left alone at the ER.

Picking up a sick child from school is not a parental "choice" and could easily fall into the neglect category according to CPS.

That's my story and I'm sticking to it.

Oh yea, vomiting at school isn't an automatic dismissal home. My assessment has to lead me to believe the child is contagious.

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Specializes in Med-surg, school nursing..

I usually want them to throw up more than once before sending home. Like you said, some kids make themselves vomit, others have sinus drainage, or the all-time fave...nasty food contest.

So if a parent couldn't come, kid has no fever, and they've only vomited once, I'd send them back. Of course if they continue to have witnessed vomits I would keep trying the parents.

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Specializes in Med-surg, school nursing..

And I agree with Dude, if they truly need to be picked up, not coming is NOT an option. I get the principal involved if I have to.

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We have battled parents on no transportation. I have kept kids in my clinic until time to leave to ride the bus because parents weren't able to be reached. (One student I kept in my clinic honestly didn't have anyone to come get her due to her family situation). More often than not I have found parents just don't answer the phone. I pretty well know which parents will pick their kids up and which ones won't. What I hate is the parents that say I will be there in a little while and never show up. Especially when it deals with out special education kids who ride buses that leave right after lunch.

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Specializes in ED, School Nurse.

I get administration involved if I really think the student needs to be dismissed and parent/other emergency contacts are unreachable or unable to come get the student.

The school resource officer has given rides home for students before under special circumstances.

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Specializes in School Nurse. Having conversations with littles..

We changed the wording on this for this year. I don't have the exact thing in front of me. But, it goes something like this. "A child who vomits 2 times or more in 24 hours may be sent home. This has been a nice change. For instance, the kid who throws up 1 time in the night, for whatever reason- can come to school, if they feel like it. Now, that being said, if they throw up again within the next 24 hours. They are excluded. If, they throw up at school 1 time, and they feel ok after that. They can stay."

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Our district's guidelines state that if a child vomits at school (and I consider this vomiting that has been seen by an adult), they must go home and can not return until free of vomiting episodes for 24 hours.

Unfortunately there are cases where I know the child has only vomited because of menstruation, sinus drainage, test anxiety, etc. However, the staff and other students know this is a policy, so I can't get away with making exceptions.

Sometimes I will keep the student in the clinic until dismissal if I know that their family situation warrants it. I'd rather them be with me and monitored than have an 11 year old alone and vomiting at home.

If the parent is playing the "I can't pick them up" game, I play the 911 card. If they don't answer, I will leave a voicemail letting them know that I will have to call 911 if nobody calls me back with arrangements. I also call all emergency contacts and let them know the same thing.

I have a very no-nonsense district. It's a double edge sword.

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Never thought about the resource officer giving rides home.. Will keep that in mind!

I get administration involved if I really think the student needs to be dismissed and parent/other emergency contacts are unreachable or unable to come get the student.

The school resource officer has given rides home for students before under special circumstances.

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Specializes in kids.
Our district's guidelines state that if a child vomits at school (and I consider this vomiting that has been seen by an adult), they must go home and can not return until free of vomiting episodes for 24 hours.

Unfortunately there are cases where I know the child has only vomited because of menstruation, sinus drainage, test anxiety, etc. However, the staff and other students know this is a policy, so I can't get away with making exceptions.

Sometimes I will keep the student in the clinic until dismissal if I know that their family situation warrants it. I'd rather them be with me and monitored than have an 11 year old alone and vomiting at home.

If the parent is playing the "I can't pick them up" game, I play the 911 card. If they don't answer, I will leave a voicemail letting them know that I will have to call 911 if nobody calls me back with arrangements. I also call all emergency contacts and let them know the same thing.

I have a very no-nonsense district. It's a double edge sword.

Can you not amend your policy? Seems to me that if you know or are reasonably sure their vomiting is a non contagious issue, then dismissal home is not the in the best interest of the child. Maybe one sentence, "Or as determined by the school nurse after a nursing assessment". If every kid that puked left school, I would on the unemployment line!

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If I think they are truly sick, I keep them in the clinic. If I suspect a different reason, I will let them go back to the classroom. I have been in hot water with some teachers because of it, but oh well. Most times it's a matter of parents who don't answer the phone or don't have a working phone and thankfully, it doesn't happen often.

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Specializes in School nurse.
I don't accept that. So they're saying if their child was taken to the emergency room from school, they would not be able to go to the ER, the child would be left alone at the ER.

Picking up a sick child from school is not a parental "choice" and could easily fall into the neglect category according to CPS.

That's my story and I'm sticking to it.

Oh yea, vomiting at school isn't an automatic dismissal home. My assessment has to lead me to believe the child is contagious.

i agree with OldDude but will add that if a non frequent flyer comes in and has puked I'll give a call home. Sometimes they stay, sometimes they go home. As for the parent who won't pick up, we have admin support to call the police. To avoid that, many times a parent answers when you call from the kids phone.

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