Flowchart for Assessing Illness in the Absence of the School Nurse

Individual feels ill HCP = Health Care Provider

RTS = Return to School

Check
≤ 99.9°F (No Fever) ≥ 100.0°F (Fever)
temperature

Observation History Observation History

Signs and symptoms? Symptoms?

Observe individual’s AND Duration of signs Observe individual’s AND Duration?
demeanor and and symptoms? appearance and Ill family members
activity level. Has individual taken activity level. or friends?
any medicine? Other conditions?

Distressed, flat
(no emotion), Does not
Cheerful, active Insignificant1 Significant2 Appears ill* Insignificant3 Significant4
lethargic, or appear ill
ill appearing

isolate; isolate; Call parent to isolate; Call parent to isolate;

call parent to call parent to pick up student call parent to pick up student; call parent to
Return pick up student; Return pick up student; and monitor for pick up student; advise parent to pick up student;
to class refer to HCP; to class refer to HCP; fever/symptoms; refer to HCP; monitor student refer to HCP;
provide RTS provide RTS if yes, refer to provide RTS to decide if MD provide RTS
Plan Form Plan Form HCP Plan Form visit is warranted Plan Form

* If individual is experiencing difficulty breathing or shortness of breath, call 911.

1 Note: Students referred to HCP
Insignificant: symptoms just started; history of allergies; mild symptoms; no medicine taken or only allergy medicine taken may not return to school until:
2
Significant: symptoms began at home in the a.m. or last night; appears ill; doesn’t typically complain; teacher insists (1) HCP provides alternative
student is ill; reports taking medicine at home such as ibuprofen (Advil/Motrin) or acetaminophen (Tylenol) diagnosis; (2) parent can provide
3
Insignificant: temperature in the 100’s, does not appear ill, cheerful and talkative neg test result; or (3) after 10 days,
4
Significant: high fever; appears ill; family member is sick; has asthma, diabetes, other chronic condition if neither of the above sought.

Last updated June 24, 2021