Notes from the Health Office



Welcome back to school! Following is information from the TCS Health Office. Our Health Office goals are to guide each child to an understanding of their own unique and important role in promoting and maintaining self health. We welcome questions! We try to help every child help him or herself through accessible health care and education.

Our registered nurse, Helen Grimm, is available to implement the health program, give individual advice on health concerns, and to provide emergency first aid Monday through Friday 8:05 AM to 3:15 PM. She may also be reached by calling 487-1558, ext. 205. The health curriculum is being updated to bridge the gap between the current and revised MA state requirements, due in place in school year 2012- 2013. Periodically, the school nurse assists teaching classes on health related issues such as personal hygiene, healthy living habits, menstruation (grade 4), puberty (grade 5), and reproduction (grade 6). Further information will be forthcoming.

Please notify the school before 9:30 AM if your child will be absent. It is helpful if you specify the reason for absence as well, especially if it is health related.

Please complete your child’s emergency form and return it to school. Update this information as needed throughout the school year. Remember, in the event of an emergency, medical or otherwise, the school must be able to reach you or another responsible person.

The nurse maintains a medical history on all students. To best meet your child’s health needs and to keep his/her school records up to date, please notify the school nurse of any change in health status as well as any updated immunization information.

Children who are ill or have a contagious disease are not allowed to attend school. Please do not send your child to school when symptoms of illness occur: fever over 100.4 F, vomiting, diarrhea, severe sore throat, severe coughing. If your child has experienced any of these symptoms within the last 24 hours, please keep them at home. Illnesses spread very rapidly in a school setting. Children who come to school and exhibit any of the above symptoms are isolated until a parent/ guardian can be notified. Please let the school nurse know should your child contact any contagious disease (i.e. Measles, Chicken Pox, Whooping Cough, Scarlet fever, Strep Throat, Fifth’s Disease, Conjunctivitis, Scabies, Impetigo).

Medications (both prescription and non prescription) should not be taken during school hours if it is possible to achieve the medication regimen at home. Medications to be taken three times daily may be administered in the morning before school, after school and at bedtime. In situations where medication must be taken during school hours, please refer to the attached MEDICATION POLICY. In order to ensure student safety, no child is allowed to carry medication on his/ her person at school or on the school bus unless authorized by the school nurse.

Please inspect your child’s hair frequently and call the school nurse if you have any questions. Prevention is the key to controlling this pesty problem and we need your support. Attached is the pediculosis notice for your information.

Physicals are required in grade 4 and in the coming months you will be notified more about them. You may choose to have your child’s health care provider do a physical examination or use the services of the school physician which are available free of charge. If the fourth grade physical has not been completed and returned to the school nurse by the end of March arrangements will be made for the health appraisal to be scheduled at school.

Your child’s posture will be screened for scoliosis starting in the 5th grade annually through grade 9. Referrals will be made if appropriate.

Each child’s vision and hearing is screened annually and you will be notified of any problems that necessitate medical follow-up.

Criteria for Excluding an Ill or Infected Child from School

Children do not need to be excluded for minor illnesses unless:
They are too sick to participate comfortably in school activities.
They need more care than the staffing level allows
They are unusually lethargic, irritable, cry persistently, have difficulty breathing, or show other signs of possible severe illness.

Children may return to school:

Chicken Pox- five (5) days after the onset of rash or when all lesions have dried and crusted, whichever is later.

Conjunctivitis- (Pink or red conjunctiva with white or yellow eye discharge, often with matted eyelids after sleep, and eye pain or redness of the eyelids or skin surrounding the eye)- 24 hours after treatment was begun.

Diarrhea, Intestinal Tract Diseases, Infectious Diarrheal Diseases (Giardia, Shigella, Salmonella, Campylobacter)- Children who have uncontrolled diarrhea may not stay in school. Children with uncontrolled diarrhea with fever or vomiting should be kept home until fever and other gastro intestinal symptoms have been gone for 24 hours. For the specific infectious diseases noted above, documentation of three (3) negative stool samples is required before return. Children who have mild diarrhea without vomiting or fever may come to school if the diarrhea is controlled or contained by toilet or diaper use with proper handwashing.

Head Lice- After treatment was begun. Child must be cleared by the school nurse before attending school or riding the bus.

Hepatitis A Virus Infection- One (1) week after onset of illness and jaundice (if any) has disappeared or until immune serum globulin has been administered to appropriate children and staff in the program within two (2) weeks of exposure, as directed by the health department.

Impetigo- 24 hours after treatment was begun.

Measles- Seven (7) days after the rash appears.

Mouth Sores- Unless the child cannot control his or her saliva, unless the child’s physician or local health department states that the child is noninfectious.

Mumps- Nine (9) days after onset of gland swelling.

Pertussis- After five (5) days of appropriate antibiotic therapy has been completed.

Pinworm Infection- 24 hours after treatment was begun.

Rash- Unless there is a fever or behavioral change, or when a physician has determined that the illness is not a communicable disease.

Ringworm Infection- After treatment has begun.

Rubella (German Measles)- Four (4) days after rash appears.

Scabies- After treatment has been completed.

Strep Throat- 24 hours after treatment was begun, and when the child has had a normal temperature for 24 hours.

Tuberculosis (Tb)- Until the child’s physician or local health authority states the child is noninfectious.

Vomiting- Unless the child has vomited twice or more in the previous 24 hours, or unless the vomiting is determined to be due to a noncommunicable condition, the child is afebrile, and the child is not in danger of dehydration.



Now that the school year has begun, it is time to be alert to the problem of pediculosis (head lice) and their nits (eggs). Head lice are acquired innocently by the cleanest of heads and easily spread because of the proximity of children in the classroom. In an effort to control and eliminate the problem, we need the cooperation of parents.

Explanation of condition: The adult female head louse is the one that lays eggs. The eggs are stuck to individual hairs by a glue like substance. The egg hatches in five to ten days and reaches maturity in up to two weeks.

Living Pediculi (Lice): The louse is grey brown in color, approximately 1/10th to 1/8th of an inch long, and actively moves about the head causing an itchy sensation. The louse itself is not hard to kill. The many medications which may be obtained at the drug store are equally effective in killing lice.

Nits (Eggs): The nit is very hard to kill. The only sure way is to remove it from the hair to which it is attached. The nits are grey/ white in color and on first glance may look like dandruff. It the nit adhers to the hair so strongly that it must be removed with a fingernail then it is certainly a live nit.

Treatment: The pharmacist can be of assistance in selecting one of the many topical medications for killing lice. These commercial products are considered to be the swiftest and most efficient treatment, but not the only means of tackling this problem. When using the medicated shampoos, be sure to carefully follow the instructions, repeating the application as suggested on the box. Additional applications are not usually necessary. None of the medicated shampoos will kill the nits. That is why diligent fine combing is crucial to an effective treatment regimen. Part the hair into small sections and fine comb each strand from the root down. Be careful not to comb the nits onto yourself.

Disinfection: Scald combs and brushes with a little bleach added to the water. Boil the fine tooth comb after use. All clothing, including hats, scarves, coats, sweaters, etc should be washed. An alternative is to put everything in the dryer on ‘hi’ for 20 minutes to kill the lice. Don’t forget all towels, sheets, blankets, bedspreads and couch throws. Stuffed animals or smaller pillows also need to be thrown in the dryer or they may be isolated in plastic garbage bags for two weeks, during which time the lice will die. And then there is the car.... Vacuum the seats and head rests. When you are all finished, try and look on the bright side at how clean you house is! ( I know, it’s a stretch).

Contacts: All members of the family and family contacts should be checked and promptly treated if infected. Continue to check all members of the family routinely for at least a month.

Exclusion from school: If head lice is detected, please do not send your child to school. Also, please notify the nurse. Children seeking re-entry to school after home treatment must first report to the school nurse. If head lice is detected in school, the child may be sent home. The child may not ride on the school bus until cleared for readmittance by the school nurse.

Control: Please teach your child that a simple exchange of hats, scarves, brushes, combs, pillows and other personal items can result in the transmission of head lice from one child to another. As an added precaution, PARENTS SHOULD CHECK CHILDREN'S HEADS FREQUENTLY!

Thank you for your cooperation. Please feel free to contact the school nurse at 487-0943 if you have any questions or need further information.



The purpose of these regulations is to provide a safe, consistent and reasonable approach to the taking of medication by children during school hours. Whenever possible, medicinal preparations should be given at home. Under certain conditions when medication must be taken during school hours, the following procedure is to be carried out:

1. All prescription or non-prescription (over-the-counter) medications must be accompanied by a physician's written authorization. For short-term prescription medications, i.e. those requiring administration for ten school days or fewer, a pharmacy labeled container may be used in lieu of a physician's order.

2. All medications must be accompanied by a written parental authorization for school personnel to supervise taking of the medication. School personal are not to assume the responsibility for the administering of medication by injection.

3. All medications should be in the original pharmacy container and be clearly labeled with the child's name, medication's name and dosage.

4. All medication must be brought to the school office by the child's parent or guardian.

5. It is the responsibility of the child to come to the office and ask for his or her medication at the prescribed time.

6. During school hours and on the school bus, no child shall have any medication on his or her person unless authorized by the school nurse.


Health Office


Each December /January the height and weight of all TCS 1st and 4th graders are calculated to determine students' Body Mass Index or BMI. The Commonwealth of Massachusetts requires that these results be sent home to parents and guardians. Please remember that all results should be considered in the context of overall growth and development. Also, all results are strictly confidential and will be kept in your child's health record. For more information about body mass index and healthy living choices please visit and Also, please feel free to contact the health office with any questions or concerns.

There will be a postural screening annually for all 5th and 6th grade students each May.