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Head Lice Policy and Protocol


1.  Prevention at School:

     * Assign individual coat hooks or lockers to students.
     * Assign permanent mats, soft toys, towels, pillows, or blankets to each student.
     * Discourage sharing of combs, brushes, barrettes, hats at school.
     * Keep students' hats and scarves in coat sleeves or pockets.
     * Discourage use of dress-up centers at school, especially during outbreaks.
     * Educate teachers and staff about prevention, control, and signs and symptoms of
        head lice.
     * Inform staff to refer any child with the following observable signs for a pediculosis screening:
       scratching of head, possible nits, any suspicious bug or insect in hair, red scratch marks on scalp
       or nape of neck.
     * Inform parents about general information and referral procedures through school handbook.
        notifying school when they discover head lice at home.
     * Parents should not rely on school staff to check for head lice as this will delay treatment.
     * Parent inquiries about head lice should be forwarded to the health secretary or school nurse.

2.  Initial Referral:

     * Live lice and/or untreated nits idientified by school personnel.
     * Exclusion from school until first treatment completed and no live lice are seen.
     * Child excluded and parent called.
     * Siblings identified and checked.
     * Education of parent and letter with checklist by health secretary or school nurse.
     * Cases documented on confidential pediculosis flow sheet for follow up.
     * Custodial staff notified to vacuum classroom on the day a case identified-
        includes carpets, upholstered furniture, pillows, stuffed animals, etc.
        INSECTICIDE SPRAYS ARE NOT RECOMMENDED due to allergic reactions and toxicity. 
        Fumigation or "bombing" by pest control agent are ineffective and possibly harmful.

3.  Readmission to School:

     * Health secretary or nurse verifies with parent that child has been treated.
     * Health staff checks child's head for evidence of live lice.  (Some shampoos do not immediately kill live  
        lice. Although child needs to stay home until lice are dead, parent should not treat child again until
        recommended by package directions or physician).
     * Recheck of child in 7 to 10 days.  If live lice found refer the child again, following protocol in Section 2

4.  Control at School:

     * If three non-related cases are reported in a classroom within 2 weeks, consideration will be given to 
       screening the entire classroom. The school nurse together with the building principal will make this
       decision.  The school nurse is responsible for this screening.
     * A "no nit" policy will be considered if a student is excluded for head lice three or more consecutive 
       times. This decision will be made by the school nurse together with the building principal.  The parents   
       will be asked to accompany the child to school so that the nurse can discuss and demonstrate treatment if
     * The school nurse will offer a public health nurse and/or physician referral after three consecutive  
     * Repeated school exclusions for head lice can become educationally significant. The nurse will make a  
        referral to the child study team and/or building administration to determine plan.