Health Services

May attend school unless the student has one of the following:

• Pain is severe enough that the child cannot effectively participate in class
• Pain starts after an injury Bloody or black stools Diarrhea (see “Diarrhea” for return guidance)
• Vomiting (see “vomiting” for return guidance)
• Fever (see “Fever” for return guidance)

• Cough is severe enough that the child has difficuly participating in class
• A cough suspected to be associated with asthma where coughing cannot be controlled by medications for which the school has physician’s orders or the student requires monitoring
• Fever (see “Fever” for return guidance)
• Difficulty breathing or rapid rate of breathing (see “Difficult or noisy breathing” for return guidance)

• Wheezing that cannot be relieved with medications for which the school has physician’s orders and the student has a health care plan and requires no additional monitoring
• Skin or lips seem purple, blue, or grey
• Fever
• Rapid breathing or increased effort to breathe, such as chest retractions (space between ribs sinks with each breath), belly breathing (belly goes up and down with breathing)
• Breathing problem that causes the child to have pursed lips, difficulty speaking, or difficulty eating

• Behavior changes
• Pain starts after an injury
• Pain prevents participation in school activities
• Fever (see “Fever” for return guidance)

• Stool not contained in a diaper or the student cannot reach the toilet in a timely manner
• Stool looks like it contains blood or mucus, or appears like sticky black tar Yellow skin/eyes (jaundice)
• Diarrhea that occurs during an outbreak, and exclusion is recommended by the local health department

Note: If the child has been diagnosed with a specific infection (such as Shigella, Salmonella/typhoid, Shiga toxin-producing E. Coli, norovirus, etc.), follow the advice of the local health department, or the guidance of the child’s health care professional.

• Problems seeing (vision changes)
• An injury to the eye involving forceful impact or penetration
• Pain or discomfort which prevents meaningful participation in school
• Drainage or build up from one or both eyes

Note: Pink eye (i.e., conjunctivitis) is inflammation of a layer that covers much of the eyeball. It is most often caused by a virus, and children with viral pink eye typically get better after 5-6 days without antibiotics. Staying home from school or child care is not necessary. Frequent hand washing should be encouraged.

• Fever went away in the night – without using fever reducing medications at any time, e.g., Tylenol, Advil, Motrin (acetaminophen or ibuprofen) – and is still gone in the morning; AND
• Other symptoms are improving and the child can participate comfortably in routine activities
• Student should be fever free for 12 hours since any fever reducing medication

• Vomiting has occurred 2 or more times in 24 hours
• Concern for a serious allergic reaction, such as hives appearing with vomiting
• Vomit appears green or bloody
• Recent head injury
• Signs or symptoms of illness
• Fever (see “Fever” for return guidance)

Return when:

• Vomiting ended during the night and child is able to hold down food or liquids in the morning
• Vomiting ended during the night and the student’s illness symptoms are improving

Note: If there is concern for an outbreak after RCSD has consulted with the local public health department and norovirus is suspected
children should not return until 48 hours after symptoms have resolved.

• Inability to swallow without significant discomfort
• Fever (see “Fever” for return guidance)
• Breathing difficulties
• Excessive drooling or muffled voice

Note: Most children with sore throat have viral infections. If a child is diagnosed with strep throat, they should receive antibiotics for at least 24 hours before returning.

• Oozing, open wound or infection that cannot be covered and is in an area that might come in contact with others
• Skin that looks bruised without a known injury or in an unusual location
• Rapidly spreading dark red or purple rash (may indicate a rare but severe bacterial infection; usually accompanied by fever).
• Tender, red area of skin, rapidly increasing in size or tenderness
• Associated symptoms of a serious allergic reaction (rash with throat closing, abdominal pain, vomiting, or wheezing)
• Fever (see “Fever” for return guidance)
• There is concern for a disease like chickenpox or measles. If this is the case, the child should see a healthcare provider.

Note: For diagnosed conditions, RCSD communicable disease guidelines will be followed for conditions such as lice, impetigo, ringworm, scabies, and pinworms and the child may return after the appropriate treatment is started

• Pain or discomfort which prevents meaningful participation in school.
• Concussion symptoms: Pain occurs after a fall or other injury to the head and is severe or associated with vomiting, vision changes, behavior change, or confusion.
• Possible infection: Stiff neck, headache and fever can be symptoms of meningitis a potentially serious infection. Meningitis can also cause sensitivity to light, vomiting, and/or confusion. A stiff neck is most concerning if the child can’t look at their belly button (putting chin to chest) due to pain or the back of the neck is painful (not soreness in the sides) along with the other symptoms above.

Get immediate medical attention for either of the above conditions.