Clinic

A student with the following symptoms will be sent home from school:

• temperature of 100 degrees F or more
• vomiting or diarrhea
• suspected contagious condition/illness
• too ill to function in the classroom
• severe stomachache, headache, or earache

PLEASE NOTE: A student should not be sent to school if fever-reducing medication is required to get the temperature below 100 degrees. To help keep our Mitchell family healthy, students must be 24 hours free of fever or diarrhea before returning to school following an illness.

lf your child has a diagnosed food allergy or has a history of a severe reaction to an allergen, you must bring appropriate medication to the clinic so that clinic staff is able to properly treat an adverse reaction should one occur while your child is at school. lf your child has an “intolerance” rather than a true allergy, please call the clinic to speak with the Nurse to discuss the best action plan for your child.

Medications (over the counter or prescription) to be administered at school:

• Must be delivered to the clinic by the parent/guardian and signed in with the nurse.
• Must be in the original container and labeled for age-appropriate use.
• All medications, including cough drops, must be kept in the clinic during the school day.
• Students may NOT transport medications to and from school.
• Prescription medications must include the pharmacy prescription label.
• Per CISD policy: overthe-counter medication dosage must not exceed the dose recommendation listed on the bottle. Exception: lf your physician, dentist or orthodontist has directed a certain dosage to be given that is greater than that recommended on the container, a
  written order will need to be included with the Medication Permission Form. Most common medication (ie Tylenol, Motrin, Benadryl) labels will specify consulting a doctor prior to administration and will not list a dosage for children under age 12. Thus, CISD will not
  administer that medication to a child under age 12 unless ordered by a doctor, Junior Strength medication may be required for students under age 12. Please check labels before coming to the clinic to deliver medication.

If your child has fever, vomiting, or diarrhea, please keep your child at home. Your child may return to school once they have been free of fever, vomiting, or diarrhea for 24 hours without the help of medications.

If your child has a rash of unknown origin or an eye that looks suspicious for pink-eye, your child will be sent home from school and allowed back with a doctor’s note clearing him or her for school attendance.

It’s not too late to get a flu shot! The flu vaccine is the best way to fight the flu. CDC recommends that everyone 6 months of age and older should get an injectable flu vaccine. The flu vaccine cannot give you the flu. If you have heard that the flu vaccine this year is “not effective”, know that the vaccine protects against multiple strains of the virus so even if it is not
effective against one strain, it is still offering protection against others.

Wash hands often and thoroughly. Hand hygiene is easy and effective in preventing the spread of bacteria and viruses. Soap, water and 20 seconds of scrubbing is all it takes to wash those germs away.

The Lice Frequently Asked Questions may also provide helpful information.
Head lice continues to be an ongoing nuisance. Conroe ISD follows recommendations from the Centers for Disease Control and Prevention (CDC) and the Texas Department of State Health Services (DSHS) as well as those contained in the position papers of the American Academy of Pediatrics (AAP) and the National Association of School Nurses in the treatment for lice. Health Services also considers community standards and impact in developing this protocol. The goal of the school district is to support families in their efforts to control and eliminate head lice while maintaining student privacy.

PROCEDURE FOR HEAD LICE DETECTION AND MANAGEMENT AT SCHOOL
In working with head lice and student surveillance, it is important to keep the following in mind:

• Implementation of head lice surveillance and control procedures is based on current scientific research and best practice.
• School staff is trained by the School Nurse in head lice detection and management procedures.
• Information about head lice infestation is to be shared as deemed appropriate by the School Nurse and School Principal.
• Maintaining confidentiality of student information in compliance with FERPA.
• The importance of the School Nurse and/or school staff documenting head lice
  surveillance efforts.

1. When a student is found to have live lice:
   1. The parent is notified and information related to detection and elimination of head lice can be provided at that time or sent home with the student in a sealed envelope.
   2. The parent/guardian of student and school official will decide if the student needs to be sent home.
   3. The parent is instructed that the student should be treated before returning to school.
   4. In some cases (based on the School Nurse’s professional judgment), it may be appropriate to have the student’s head checked upon return to school.
2. When a student is found to have nits present (no live lice detected):
   a. The parent is notified and encouraged to nit-pick (at least daily for the next two weeks).
   b. The student is not sent home from school.
   c. Information related to detection and elimination of head lice is sent home with the student.
3. When to check beyond the identified student with live lice:
   a. Determine if the student has siblings. If yes, check the siblings in the immediate school.
   b. If the student has other siblings (not in the immediate school building), notify the parent/guardian of the advisability of checking family members and taking precautionary measures to avoid family infestation.
   c. Full Classroom screenings for head lice are generally not done. “Current evidence does not support the efficacy and cost-effectiveness of classroom or school-wide screening for decreasing the incidence of head lice among children.”
4. Classroom environment:
   a. The classroom is only one of many environments where head lice can be transmitted.
   b. According to the CDC, most transmissions occur in the home environment (friends, sleepovers, camp, etc.).

Classroom tips:

• Play items (hats, wigs, dress up clothes etc.) cleaned after each child’s use.
• Children’s personal items (combs, brushes, hats, scarves, sweaters, coats, etc.) are not shared.
• Carpet is vacuumed frequently.
• No sharing of cloth or upholstered pillows, mats etc.
• Nap items (pillows, blankets, towels etc.) are stored separately in a cubby or plastic bag and taken home at least weekly to be washed.
• Sweaters, backpacks, and coats hung separately on hooks and not touching. Sweaters, coats, and hats can often be placed in each student’s backpack.
• Girls with long hair may want to wear their hair in “contained” hair styles (ponytails,
  buns, braids, etc.).

Notification Procedures

• The customary notification for the presence of head lice is to be done on an individual case by case basis to the parent/guardian of an infested student. Classroom notifications are not done with typical head lice cases, but may be done in certain instances.
• In the rare case a student is to be excluded (see Exclusion Procedures), a notice will be given to the parent in person or by phone contact.
• In some cases, it may be appropriate in the professional opinion of the School Nurse and in consultation with the School Principal to consider a general parent/guardian notification for a high number of identified cases of head lice.

Exclusion Procedures

Note: the presence of severe infestations of untreated head lice can be disruptive to the educational setting

• In the rare case that a student has either: 1) chronic head lice infestation or 2) severe head lice infestation that is disruptive to the learning environment, the School Nurse will be consulted.
• If in the nurse’s professional judgment it is determined that Exclusion needs to be considered, the nurse will consult with the building administrator about implementing Exclusion.
• With chronic head lice infestation cases, the nurse will secure documentation of repeated and unsuccessful head lice management measures.
• See Notification Procedures (#5)
• The return of the student after exclusion will be predicated on a head check in the school clinic with evidence of progress in head lice management and progress toward eradication of the head lice. Evidence will look like elimination of live lice and a decrease in the number of nits.
• It may be appropriate in the judgment of the School Nurse to monitor progress of lice management over a period of time; the goal is supporting the family in eradication of this pest.