|Laura Wade, Nurse Coordinator
School Nurse, Mile Creek School
School Nurse, Lyme Consolidated School
School Nurse, Center School
- School Health Requirements
- Regulations for Control of Communicable Diseases
- Immunization Requirements for Students Enrolled in Connecticut Schools 2022-2023 (page 1)
- Immunization Requirements for Students Enrolled in Connecticut Schools 2022-2023 (page 2)
- General Information from the Health Office
- Medication Administration
- A student should remain at home...
- Use of Cough Drops in Elementary Schools
- Medical Exclusion for Physical Education Class
- Medication Regulation Regarding the Administration of Epinephrine to Students Who Have No Prior History of Anaphylaxis
In compliance with the State of Connecticut State Department of Education regulations, current health assessments are required of all students entering preschool and kindergarten, and again during Grade 6 and Grade 9. New students transferring into CT schools must meet CT regulations and school district policy. Health Assessment Record forms are available online under the parent forms portal, in the health offices in each school, and are included in the registration packet. Please contact your child’s school nurse with any questions regarding this mandate. All students are required to have a mandated physical assessment before starting school classes.
Preschool and Kindergarten Health Assessments must be completed within one year prior to entry into school.
Physical assessments are required during Grades 6 and Grade 9. Mandated physicals for grade 6 students must be completed between June 1st of Grade 5 and before starting Grade 7. Mandated physicals for grade 9 students must be completed between June 1st of Grade 8 and before starting Grade 10.
***Please note that all asterisked areas on the physical assessment form must be completed for all students including Hemoglobin/Hematocrit Screening and must include Lead Screening for students in Pre K.
Sports Physicals are required every 13 months for all students participating in interscholastic schools at the middle school and high school levels. Students will not be able to practice or participate in competitions without medical compliance.
Appropriate immunization requirements are expected of all students enrolled in CT schools. Proof of immunization compliance or an approved Medical Exemption Certificate is required of all students in order to attend school classes.
Annual vision, hearing, and postural screenings will be done in schools as mandated by the regulations of the CT State Department of Education and our local Board of Education. Vision and hearing screenings are required for students in Grades K,1.3.4.and 5. Although not required, nurses also do vision and hearing screenings on students in PreK and often in Grade 2.
Postural screenings are done for females in Grades 5 and 7, and males in Grade 9. Parents will be notified in advance of the screenings and notified if their child’s screening is out of normal range and in need of a referral to a physician or a specialist.
Administration of Medication in School
Medication (both prescription and over-the-counter) may be administered in school with a written authorization from the medical provider and signed by a parent/guardian. Medication must be brought to the nurse by the parent or guardian in a properly labeled prescription bottle including the name of the student, the name of the medication, dosage, and time of administration. Over-the-counter medications must be brought to the nurse in the original bottle. High school and middle school students are able to carry and self-administer epinephrine injectors and inhalers with proper authorization from the physician and parent. Medication remaining at the end of the end of the school year must be picked up by the parent.
Student Absences from School
Please keep your child home from school when illness or a communicable disease is suspected. Students who have had a fever (100 degrees or higher), vomiting, or diarrhea should not return until symptom-free for 24 hours without use of a fever-reducing medication. Students should be able to tolerate solid food and liquids before returning to school. Parents are required to notify the school if their child is absent for any reason. A school nurse is available in each school who may be reached by phone or email if there are any questions.
Medical Exclusion from Physical Education Classes and Recess (Elementary School Students)
If a student is ill or injured and unable to participate in Physical Education class, a parent may submit a written excuse that will be accepted for a maximum of two PE classes per semester. Students who require a longer exclusion from PE class must have a physician’s note excluding them from PE class that includes date parameters of a maximum of six weeks. Students needing additional exclusion time will be required to obtain a written extension from their physician.
Use of any type of splint, ace or Velcro wrap, crutches, wheelchair, or elevator requires a written note by the medical provider.
Absences from School Due to Illness
Communication between families and the school nurse is critical when it comes to identifying potential outbreaks of contagious illness in our schools. It is imperative that we all work as partners in promoting the health and wellness of our entire school community, which includes not only our students, but our staff members as well.
Please notify your child’s school nurse and keep them home from school with the following:
• Fever of 100.0 or above. Students should be fever-free without use of a fever-reducing medication for 24 hours before returning to school.
• Any skin rash suggestive of a communicable disease.
• Eye discomfort suggestive of a possible bacterial or viral infection that includes but is not limited to drainage, itching, and redness.
• Vomiting and/or diarrhea. Students should stay at home for 24 hours without repeated episodes of vomiting/diarrhea and should be able to tolerate fluids and solid food.
• Cough that is persistent and disruptive.
• Other nonspecific symptoms that have been associated with possible Covid-19 infection such as sore throat, muscle or body aches, nausea, headache, congestion, runny nose.
The following illnesses may require an assessment by a physician and possible exclusion from school.
Allergic Conjunctivitis. This condition more often involves both eyes simultaneously; itching is prevalent and the discharge is clear. There is usually some swelling of the eyelids and other allergy symptoms are present, such as sneezing, itchy and runny nose. Students do not need to be excluded from school.
Bacterial/Viral Conjunctivitis. Both conditions are very contagious and spread easily. The student can return to school 24 hours after an antibiotic has been started if symptoms have improved. It is difficult to differentiate viral vs. bacterial conjunctivitis. Therefore, treatment with prescription antibiotic eye drops is recommended for both conditions.
Chicken Pox (Varicella). Students are to be excluded for not less than five to seven days from onset of the disease and until all pox are crusted over and healing. There is no exclusion for contacts unless they are unvaccinated for varicella.
COVID-19. This novel virus made a pandemic presence in early 2020 and has caused significant illness and in some cases, death. The full control of this viral infection may not be realized until widespread immunity and immunization occur. Until that time, we must be vigilant and aware of any febrile or flu-like illness and subsequently test for Covid-19 infection. Nurses will follow public health guidelines in excluding student with possible Covid-19 infection from school for evaluation and possible quarantine and isolation.
Fever. Students with a temperature of 100 degrees or higher will be sent home from school. They must remain at home for at least 24 hours fever-free without use of a fever-reducing medication.
Fifth Disease (erythema infectiosum). This is a common and highly contagious childhood ailment that causes a distinctive “slapped-cheek” appearing rash of the face and a lacy red trash on the trunk and limbs. By the time the rash or joint pain appear students are no longer contagious and do not need to be excluded from school.
Hand, Foot, and Mouth. This is a viral infection caused by a strain of Coxsackie virus. Symptoms of this virus often include fever and flu-like symptoms. One or two days after the fever starts, students may get painful mouth sores (herpangina). These sores usually start as small red spots, often in the back of the mouth, that blister and can become painful. They can be on the soles of the feet, palms of hands or sores in the mouth. There is no specific medical treatment for Hand, Foot, and Mouth Disease. This disease spreads easily through person to person contact, airborne when an infected person coughs or sneezes, and when in contact with contaminated surfaces and objects. Students may return to school when they have been afebrile without fever reducing medication for 24 hours.
Impetigo. Impetigo is a highly contagious bacterial skin infection. Students should be excluded until treated for at least 24 hours.
Influenza A or B/Influenza-like illnesses. Students with influenza-like illness must remain at home for at least 24 hours after they are fever-free without the use of fever-reducing medications and other symptoms have improved. Symptoms of influenza include fever, cough, runny or stuffy nose, body aches, diarrhea, vomiting, and fatigue.
Measles/Mumps/Rubella. Students with these illnesses must stay at home from school for at least five days after onset of symptoms. There is no exclusion for contacts unless they are unvaccinated.
Molluscum Contagiosum. This condition is noted by the presence of a skin rash that has clear or flesh colored bumps and is caused by a virus. It can spread from one part of the body to another or from person to person. It is most often found on the trunk, arms, and face. Students may attend school and participate in sports; however, it is recommended to keep the exposed bumps covered to prevent the spread of molluscum.
Mononucleosis. The clinical diagnosis of infectious mononucleosis is suggested on the basis of the symptoms of fever, sore throat, swollen lymph glands, and the age of the patient. Laboratory tests are needed for confirmation. Serologic results for persons with infectious mononucleosis include an elevated white blood cell count, an increased percentage of certain atypical white blood cells, and a positive reaction to a “mono spot” test. Attendance at school and full activities is contingent on MD approval.
Pediculosis (Head Lice). While pediculosis is not considered an infectious disease, transmission from one individual to another can occur primarily through direct head to head contact or secondarily through the sharing of personal items such as hats, scarves, helmets, brushes, combs, or pillows. Students with live head lice should be treated at home and may return to class after appropriate treatment has begun. Students should be inspected by the school nurse upon return to school. Following treatment, students may remain in school if there are nits, but the family should continue with proper nit removal procedures. The school nurse should reinspect the student for presence of head lice 7-10 days following the initial treatment. Retreatment may be necessary. Parents should contact their child’s physician for recommendation of treatment and should keep in mind that other household members should be inspected for head lice and treated as needed. The school nurse provide instructions on dealing with treatment for students and family members with head lice.
Pertussis. This is a highly communicable, vaccine-preventable disease that lasts for many weeks and is typically manifested in children with paroxysmal spasms of severe coughing, whooping, and posttussive vomiting. Students are to be excluded from school until treatment with appropriate antibiotics for a minimum of 5 days.
Ringworm. Ringworm is a common infection of the skin/scalp and nails that is caused by several different kinds of fungus. It is characterized by a red ring of scaly skin that grows outward as the infection spreads. If there is ringworm on the scalp, the student needs to be treated with prescription, antifungal medication. If a suspected ringworm is found anywhere other than the scalp, cover the area with a band aid (student may stay in school if area is covered) and send to MD for diagnosis. MD note or proof of treatment is sufficient to return to school.
RSV. Respiratory syncytial virus is a common and contagious virus that causes infections of the respiratory tract. Students must remain at home for 7 days from onset of symptoms, as this is how long the virus can be “shed” and may be contagious. Students may return to school after seven days AND symptoms (coughing) have significantly improved and fever-free for 24 hours without fever-reducing medication.
Scabies. Students are to be excluded until control measures are instituted. Scabicides used to treat human scabies are available only with a prescription from a physician. No “over-thecounter” products have been tested and approved to treat human scabies. Proof of treatment is sufficient for return to school.
Strep Throat. Students diagnosed with strep throat are to be excluded from school until treated with one full day (24 hrs) of antibiotics.
Tuberculosis. Students are to be excluded while there is evidence that the condition is active. Exposures need not be excluded.
Varicella (chicken pox). Students are to be excluded for at least five to seven days from onset of the disease and until all pox are crusted over and healing. No exclusion for contacts unless they are unvaccinated.
Each school has a registered nurse on duty during school hours to attend to student health needs. First aid measures for illness and injury occurring in school will be performed according to first aid guidelines and the written standing orders approved and signed by our medical advisor. Treatment for injuries occurring at home and off school premises are the responsibility of the parent/guardian and family physician.
At the beginning of each school year or upon school entry, each student will require a parent/guardian to enter current demographic, emergency contact, and health information into Power School, our District 18 Student Information System. Families will receive a communication during the summer prior to school entry with instructions for entry of information. This mandatory annual update is critical for school personnel to be able to contact families and for the school nurse to be able to meet the medical needs of students. It is imperative that emergency contacts be people who have agreed to be contacted if a parent/guardian is unavailable. It is the responsibility of the parent to arrange for pick-up of the student if deemed appropriate by the school nurse or administration. Our school technology teams are available for any questions or assistance needed with completion of the Power School Student Information System entries.
State regulations require each child to be immunized according to the current CT Department of Public Health requirements. Proof of immunizations is to be provided to the student’s school nurse prior to admission to school. The State and local Boards of Education also require a physical examination for students in Pre-K, K, Grade 6, and Grade 9. Kindergarten, Grade 6, and Grade 9 physicals are to be recorded on the blue State of Connecticut Health Assessment Record, and Pre-K physicals are to be recorded on the yellow Early Childhood Health Assessment Record. All mandatory (*) screening items are to be completed by the physician’s office. The front page is to be completed by the parent/guardian, and the completed form is to be given to the health office to remain on record in the student’s cumulative health record. New entrants from within the United States are to submit a school entry physical form from their previous school that addresses the screening items that are required in District 18. New entrants from outside the United States must present a recent physical examination conducted by a U.S licensed physician dated within 12 months of entry.
Annual vision, hearing, and postural screenings are conducted on selected grades according to state regulations, and parents will be notified prior to the screening process. Vision and hearing screening is conducted annually for students in K, Grades 1, 3, 4, and 5. Postural screening is conducted for females in grade 5 and 7, and for males in grade 9. Parents/guardians will receive a written physician referral if their child is noted to have a possible deficit in one or more of the screenings.
State regulations and Board of Education policy mandate that medication shall be administered to students during school hours only when it is not possible to achieve the desired effects by administering the medication at home. If medication administration of prescribed and over-the-counter medication is necessary during school hours and school activities, the following criteria must be met:
· A medication authorization form for each medication is to be completed by the physician, dentist, APRN, or PA with written authorization by the parent/guardian and is to be kept on file in the health office. Medication forms are available on the district website under the parent portal, in each school health office, or from your child’s physician. The forms are to be renewed annually as needed.
· The medication must be in its original container, properly labeled with the student’s name, name of the medication, dosage, time of administration, and not more than a 90-day supply. Any remaining medication must be picked up by a parent/guardian or responsible adult at the end of the school year.
· Self-administration of medication for treatment of asthma and life-threatening allergies are appropriate when approved by a physician and a parent/guardian.
· All medication, except those approved for transport by students for self-administration, shall be delivered to the school by a parent/guardian, or other responsible adult and shall be received by the school nurse or, in her absence, a principal or designee.
· All medication, except for those that are approved for self-administration, will be administered by the nurse or trained school staff
· Students may not carry or maintain any unauthorized or unidentified medication in school or on the school bus.
A STUDENT SHOULD REMAIN AT HOME FROM SCHOOL WITH THE FOLLOWING SYMPTOMS OF COMMUNICABLE ILLNESS OR DISEASE
· A temperature of 100 degrees or greater. Students should be fever-free without use of a fever-reducing medication for a minimum of 24 hours before returning to school.
· Vomiting and/or diarrhea. Students should remain at home for at least 24 hours without repeated episodes of vomiting and/or diarrhea. They should be able to tolerate fluids and solid food before returning to school.
· A cough that is persistent and disruptive.
· Any skin rash suggestive of a communicable disease.
· Eye discomfort suggestive of a possible bacterial or viral infection that may include symptoms such as drainage, itching, redness, and pain.
· Other non-specific symptoms that have been associated with possible Covid-19 infection such as sore throat, headache, muscle or body aches, congestion, runny nose, or sudden loss of taste/smell.
Non-medicated cough drops/throat lozenges may be administered by the school nurse with written permission from the parent/guardian. Medicated cough drops/throat lozenges (includes those with menthol) require a physician and parental authorization.
Use of cough drops/throat lozenges may be restricted per advisement of our medical advisor based on current pandemic considerations.
If a student is ill or injured and unable to participate in a PE class, a parent may submit a written excuse that will be accepted for a maximum of two PE classes. Students who require an exclusion from PE class must have a physician’s note excluding them from PE class that includes date parameters of a maximum of six weeks. Students requiring additional exclusion time will be required to obtain a written extension time from their physician for an additional maximum of six weeks.
Medication regulations require that Connecticut schools designate and train nonmedical qualified staff who have volunteered to administer emergency epinephrine in a cartridge injector to a student who is exhibiting signs of having a severe allergic reaction who has not been previously identified by a physician as having a severe allergy. It authorizes the emergency use of Epipens (or equivalent cartridge injector) by nonmedical staff if the nurse is absent or unavailable during the school day hours on school grounds. The qualified staff must meet annual training requirements.
Any parent/guardian of a student who does NOT want epinephrine given to their child who has NO PREVIOUS HISTORY OF SEVERE ALLERGY OR DIAGNOSIS in the event of a severe allergic reaction must submit a letter in writing to the school nurse.
Medical Requirements for all Students (2022-2023)
State of CT Early Childhood Health Assessment Record (for Pre-K physicals)
State of CT Health Assessment Record (for new registrants, Kindergarten, Grades 6 and 9 physicals)
Sports Physical Examination Form
Authorization for the Administration of Medication by School Personnel (must be signed by the prescribing doctor)
Authorization for School Nurse to Administer Acetaminophen/Ibuprofen in the Middle and High Schools
Sunscreen Authorization Form
Medical Exemption Certification Form
Field Trip Medication Authorization Form
International Field Trip / Acknowledgement of Physician Consultation
Authorization for Emergency Epinephrine Administration to Students Who May Be Exhibiting Signs of Severe Allergic Reaction