Health Services & Nursing

Health Guidelines for School Attendance

Keeping a sick child home protects other children, school staff, and visiting community members from catching an illness that can be spread from person to person.

A sick child who is unable to participate at school should be kept home to rest and recover until symptoms improve. Please be aware of the following guidelines for school attendance.

A student with any of the following symptoms should not attend school:

Temperature of 100 degrees or higher
Nausea, Vomiting, or Diarrhea
Eye redness and/or drainage
Undetermined rash and/or scaly patches over any part of the body or scalp
Intense itching with signs and symptoms of secondary infection
Open, draining lesions

A child with any of these symptoms must stay home until they are symptom-free for 24 hours and without the use of medication before returning to school. For more information please see "Health Reasons to Keep Your Student Home" (English/Spanish).

If a parent suspects that his or her child has a contagious disease, the parent should contact the school nurse so that other students who might have been exposed to the disease can be alerted. Remember, hand washing can prevent the spread of diseases.

When you take your child to a healthcare provider for an evaluation of illness or injury, please be sure to request a written letter stating when your child may return to school and any accommodations required upon his/her return.

For COVID-19: please refer to the ��ϱ�� ISD COVID-19 Health and Safety Protocols for students who are experiencing symptoms, have tested positive, or have been in close contact with an individual who tested positive.

��ϱ�� ISD is required to report certain contagious (communicable) diseases and illnesses to the Texas Department of State Health Services (TDSHS) or our local/regional health authority. For a complete list of Communicable Diseases, please see the

Please click on Common Illnesses for additional information.

Common Illnesses

Common Illnesses	When can my child return to school?
	When on antibiotics and fever-free for 24 hours without the use of fever-suppressing medication and approval by a healthcare provider.
	When all lesions have crusted over and it has been at least 24 hours since the last new lesion appeared.
	When fever-free for 24 hours without the use of fever-suppressing medication.
	A doctor's note is required unless symptoms have resolved.
	See the ��ϱ�� ISD COVID-19 Health and Safety Protocols
	When diarrhea-free for 24 hours without the use of diarrhea-suppressing medication.
Fever	When fever-free (< 100.0 F) for 24 hours without the use of fever-suppressing medication.
	When fever-free for 24 hours without the use of fever-suppressing medication.
	When fever-free for 24 hours without the use of fever-suppressing medication.
	When diarrhea-free and fever-free for 24 hours without the use of fever-suppressing or anti-diarrheal medication.
	After completion of five days of antibiotic therapy.
	Unless directed by a physician, students with MRSA infections should not be excluded from attending school. Exclusion from school/sports activities should be reserved for these with wound drainage that cannot be completely covered and contained by a clean, dry bandage and those who cannot maintain good personal hygiene.
	When diarrhea-free and fever-free for 24 hours without the use of fever-suppressing or anti-diarrheal medication.
	When on antibiotics and fever-free for 24 hours without the use of fever-suppressing medication.
Vomiting	When able to tolerate food and liquids without any recurrence of vomiting, typically 24 hours after the last episode.

For a full list visit the CDC website:

For more information:

Temperature Weather Guidelines

The extreme heat and cold in our region are a concern to the health and safety of our students and staff members. Outdoor time has many health benefits for children. According to ��ϱ�� policy, all children in elementary schools must engage in at least 30 minutes of recess per day and a minimum of 135 minutes of physical education per week. The following temperature guidelines have been established in order to provide a safe and healthy environment for students participating in outdoor activities at ��ϱ�� ISD. The listed temperatures and wind-chill factors are designated figures for terminating and/or modifying outdoor activities including: Athletics, Fine Arts, PE, and Recess. Exposure duration and frequency of breaks should be modified as the temperatures approach the listed thresholds. Athletics and Fine Arts staff will use the designated weather tool, Wet Bulb Globe Temperature (WBGT) to monitor current weather conditions and determine if indoor practices are required. For all other activities, the campus principal or designee is responsible for monitoring their respective campus weather conditions and determining what activities will be permitted.

Definitions:

Acclimatization – The process of gradually increasing the intensity of activity in a progressive manner that improves the body’s ability to adapt to and tolerate exercise in the heat.
��ٰ��𳾾��پ��&�Բ��;– Includes the arms, hands, legs, and feet.
Rest Breaks – This period of time is a non-activity time that is in a ‘cool zone’ out of direct sunlight and during which students are encouraged to hydrate.
Wet Bulb Globe Temperature – The WBGT is a measurement tool that uses ambient temperature, relative humidity, wind, and solar radiation from the sun to get a comprehensive measure that can be used to monitor environmental conditions during exercise. WBGT is different from heat index, as it is a more comprehensive measurement of environmental heat stress on the body.
Wind Chill – What the air temperature feels like to the human skin.
Weather Sentry/DTN – weather program utilized by Athletics & Fine Arts to monitor weather conditions and make decisions regarding the safe usage of outdoor facilities.
Cooling Mechanism – large tub or tarp that can be filled with ice and water to rapidly cool the internal body temperature of an individual experiencing exertional heat stroke.
Summer Band Uniform – Includes the wearing of shorts and short sleeve shirt/polo

Schools should honor reasonable parent requests that a student be allowed to stay indoors. Requests based on health reasons must be honored. The parent and school must work to determine when the child should be excluded from outdoor activities due to health concerns.

Cold -

When properly clothed, elementary school-aged children can participate in safe, vigorous play in an outdoor environment in most weather conditions.
When the temperature falls below 60 degrees, it is recommended to wear a jacket or coat, long sleeves, and long pants.
Increased caution should be practiced when the wind chill factor reaches below 40. Wind chill is the temperature a body feels because of wind.
When the wind chill falls below 30 degrees, it is recommended that students be kept indoors.
Asthmatic children may need special accommodation of their need during cold weather.
The parent and school must work to determine when the child should not participate in outdoor activities due to health.

Cold Weather Guidelines

If precipitation occurs in cold weather, reduce exposure time by 20 minutes**

Weather	Athletics (Practices)	Fine Arts	PE/Recess
Wind Chill 35° to 38° without precipitation	90 minutes of total exposure. Extremities must be covered.	90 minutes of total exposure. Extremities must be covered.	45 minutes of exposure with a 15 min indoor break at the 25 min mark. Extremities must be covered.
Wind Chill 31° to 34° without precipitation	70 minutes of total exposure. Extremities must be covered.	70 minutes of total exposure. Extremities must be covered.	30 minutes of exposure. Extremities must be covered and jackets/coats are required
Wind Chill 25° to 30° without precipitation	60 minutes of total exposure. Extremities must be covered.	60 minutes of total exposure. Extremities must be covered.	No Outside Activity
Wind Chill under 25°	No Outdoor Activity/Practices

Heat -

Reduce the intensity and duration of strenuous physical activity initially and gradually increase to accomplish proper acclimatization.
Fully hydrate students prior to strenuous physical activity.
Provide access to cool water and schedule frequent rest periods. Teachers should ensure that water is available to all students (water bottles, water fountain, etc.)
Plan strenuous outdoor activities for early morning when possible.
Be aware of chronic health issues and medications of students so that heightened surveillance of students with special needs occurs.
Students with certain conditions are at a greater risk of heat stress. Included (but not limited to): cystic fibrosis, asthma, vomiting, diarrhea, fever, obesity, diabetes, chronic heart failure, caloric malnutrition, anorexia nervosa, sweating insufficiency syndrome.
Check to see if a student's medication has specific precautions regarding heat, sunlight, etc.
Students should be educated on signs of dehydration and heat related conditions. Use a "buddy system" to help students monitor each other.
Implement extra precautions when practicing on concrete or asphalt.
Cooling mechanisms must be available for all outdoor athletic and marching band activities where the WBGT is 80 degrees or higher.
Personnel trained to recognize heat illness and administer appropriate cold water immersion techniques are highly recommended at all outdoor activities.
WBGT readings should be taken 15 minutes before outdoor activities and every 30 minutes during the session. Designated staff should use the provided onsite measuring tool to determine WBGT readings. If onsite tool is not available, district provided weather application can be used as an alternative.
Rest breaks must involve unlimited hydration intake and rest without any activity involved.
Watch out for signs of heat related illness.

Hot Weather Guidelines for Participation

Weather	Athletics	Fine Arts	PE/Recess
WBGT <82.0	Normal Activity Provide at least three separate rest breaks each hour with a minimum duration of 3 minutes each time.	Normal Activity Provide at least three separate rest breaks each hour with a minimum duration of 3 minutes each time.	Normal Activity Provide at least three separate rest breaks each hour with a minimum duration of 3 minutes each time.
WBGT 82.0-86.9	Provide at least three separate rest breaks each hour with a minimum duration of 4 minutes each time.	Provide at least three separate rest breaks each hour with a minimum duration of 4 minutes each time.	Provide at least three separate rest breaks each hour with a minimum duration of 4 minutes each time.
WBGT 87.0-90.0	Maximum 2 hour practice with a 4 min water break every 15 min Football: Players are restricted to helmet, shoulder pads, and shorts during practice. If the WBGT rises to this level during practice, players may continue to work out wearing football pants without changing to shorts	Maximum 2 hour practice with a 4 min water break every 20 min Summer Uniform utilized for non-competitive performance or extended exposure such as FB games. Competitive performance process should allow for immediate removal of uniform following performance	45 minutes of exposure with a 4 min water break every 15 min
WBGT 90.1-92.0	Maximum 1 hour practice with a 5 min water break every 15 min Football: No protective equipment may be worn during practice, and there may be no conditioning activities Cross Country: Runners must be in sight of the coach at all times. Middle School: 45 minutes of exposure with a 5 min water break every 15 minutes.	Maximum 1 hour practice with a 5 min water break every 15 min Summer Uniform utilized for all performance events, including contests	No Outside Activity
WBGT >92.1	No Outdoor Workouts. Delay practice until a cooler WBGT is reached.

The values listed in the chart above are WBGT measurements-not air temperature or heat index measurements

Heat-Related Illnesses

WHAT TO LOOK FOR	WHAT TO DO
HEAT STROKE
High body temperature (103 or higher) Hot, red, dry or damp skin Fast, strong pulse Headache Dizziness Nausea Confusion Losing consciousness (passing out)	Call 911 right away-heat stroke is a medical emergency Move the person to a cooler place Help lower the person’s temperature with cool cloths or a cool bath Do not give the person anything to drink
HEAT EXHAUSTION
Heavy sweating Cold, pale, and clammy skin Fast, weak pulse Nausea or vomiting Muscle cramps Tiredness or weakness Dizziness Headache Fainting (passing out)	Move to a cool place Loosen your clothes Put cool, wet cloths on your body or take a cool bath Sip water Get medical help right away if: You are throwing up Your symptoms get worse Your symptoms last longer than 1 hour
HEAT CRAMPS
Heavy sweating during intense exercise Muscle pain or spasms	Stop Physical activity and move to a cool place Drink water or a sports drink Wait for cramps to go away before you do any more physical activity Get medical help right away if: Cramps last longer than 1 hour You’re on a low-sodium diet You have heart problems
SUNBURN
Painful, red and warm skin Blisters on the skin	Stay out of the sun until your sunburn heals Put cool cloths on sunburned areas or take a cool bath Put moisturizing lotion on sunburned areas Do not break blisters
HEAT RASH
Red clustered of small blisters that look like pimples on the skin (usually on the neck, chest, groin or in the elbow creases)	Stay in a cool, dry place Keep the rash dry Use powder (like baby powder) to soothe the rash

Staff

Alana Bejarano, RN, MSN, NCSN
Executive Director

Jose Serrano, MPH
Assistant Director

Mary "Maddie" Grant, RN
Nurse Coordinator

Richard Soto, RN
Nurse Coordinator

Donna Piket, MPH
Public Health Coordinator

Ginger Voss
Contracts Manager

Ellie Gamble, LCSW-S
Health Logistics Coordinator

Contact

Student Medical Record Requests

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