Can you help me straighten some things out?

Posted on: Sat, 07/27/2002 - 10:05am
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pWe're getting ready to meet with the school one more time (at least) before school starts Sept. 3. This meeting will probably focus on different reaction scenarios and how to best treat them./p
pMy first question for you is: how would you handle swelling only (for example, child has cross-contaminated hands, doesn't know it, rubs his eye, eye swells, no other symptoms)? I know some of you are Epi first, no matter what, but I am not necessarily of that opinion. /p
pSecond: our son has started 'reacting' to his own sweat over the summer, and unfortunately, his reaction is the same as his "tip off" reaction to contact: scratching the back of his neck. How would you suggest the teachers differentiate between the two/handle them? I'm thinking just give Benadryl and watch, along with washing hands and the affected area, even if it IS only a sweat reaction./p
pFor those of you who think as I do, which is that Benadryl will not stop a major reaction in any way, do you tell the school to give Benadryl only unless there are 2 or more systems involved? I'm trying to think of a quick way for the teachers to deal with things. Here at home we weigh every minute as it goes by - I know that isn't going to be the case at school. I don't want him Epi-penned every time he clears his throat, though./p
pIs there any easy way to present this??? I've already given them a "long" list of symptoms and treatments, but I'm looking to shorten it to help them remember what to do in MOST cases. Am I making sense??? (Sometimes I really don't think so!! [img]http://uumor.pair.com/nutalle2/peanutallergy/wink.gif[/img] )/p
pBTW, the school is going to call me EVERY time there is ANY suspicion that he is reacting. I only live 1 mile away, so the plan is for me to go to the school EVERY time they call. But I don't necessarily want them to wait for me to get there before he is treated. /p
pCan anyone help me sort this out?/p

Posted on: Sat, 07/27/2002 - 10:49pm
williamsmummy's picture
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Joined: 03/26/2002 - 09:00

This is one of the many problems that are faced by parents and teachers when caring for the food allergic child.
I think your allergist should be able to give you some good advice on this, if you have been advised to always use an anti histamine first , and use epi-pens if child is not responding then tell the school staff exactly that.
However on a differant note, allergen rubbed in to the eye can cause an anaphylactic reaction. Swelling , esp facial swelling should always be regarded as a serious symptom. There is no harm in taking a child to the hospital to be monintered for a while , as a stronger reaction may sometimes occour hours later.
Its clear that you need medical advice so that you can be sure that you and your sons teachers are fully informed on the management of allegy.
I wish you good luck and point out that so far I am still encountering some problems with my sons school, and its a total pain in the whatsit!!!!
bye sarah

Posted on: Sun, 07/28/2002 - 10:14am
JSaastad's picture
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Joined: 03/29/2002 - 09:00

This is a great question, one that I am trying to figure out an answer to also.
Could the school nurse always monitor your childs blood pressure after giving benadryl until you arrive? Or is this not safe?? I will be asking my allergist for alot of guidance here. I hope others on this board can share their thoughts on this too. Thanks,
Jill

Posted on: Sun, 07/28/2002 - 11:56am
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Joined: 05/28/2009 - 16:42

williamsmummy,
I would ask my allergist, but she has already given her "list" to the school - pretty generic, IMO. I have given my "list" as well, but think it could use some focus. It's just so hard to explain to them - when you live with it 24/7 it becomes second nature. I want to refine our "list" (of symptoms and their treatments) to something more user-friendly. Don't know if that's possible.
There are some cut-and-dry scenarios, but some aren't so easy. Like the swelling I mentioned above. I've never dealt with that, so I really don't know what I would do. If it was the ONLY symptom, I would probably just Benadryl and watch, but I don't know, so I don't know what to tell the school in that situation. I'm pretty sure the allergist's "list" says to Epi if 2 or more symptoms are present. I'll have to double-check.
We have already met with the school several times and think we have things spelled out pretty well, but these kinds of questions pop into my head from time to time, and throw me into a second-guessing frenzy.
Jill,
As for the nurse... she is barely ever there, so she will be of very little help. As a matter of fact, I think the most crucial person in the equation is going to be the secretary. She is the one who will make the call home and monitor my child until I get there. Good luck to you in your endeavor, too!

Posted on: Mon, 07/29/2002 - 11:22pm
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This is such a tough thing as I wrestle with this myself. I mean you don't want to be in a situation where someone questions giving our children epipens/ER trips everyday.
Our nurse is full time so any situation in which a reaction is suspected, he will be escorted to the nurse for observation. The nurse and other VIP's will have his prior reaction history which includes hives, but these were hives like no other. I have never seen a person's body progess into hives like Ryan's did last January when he ate Kellogg's cereal. That's not to say the hives in the future won't be mild, but as I told my mother, his past reactions have been quick with physical symptoms that stand out--profuse vomiting, severe hives, mild to moderate wheezing.
This probably isn't much help at all, but perhaps there isn't really an answer. Just educate people the best we can with whatever information we can provide. I don't know...

Posted on: Tue, 08/20/2002 - 6:02am
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Here's what we came up with last night:
** SIGNS OF AN ALLERGIC REACTION**
Mouth: Minor: itching, tingling
Major: swelling of tongue, swelling of lips or mouth, difficulty speaking or swallowing, excessive salivating or drooling
Throat: Minor: light annoying cough
Major: itching or tightness in the throat, hoarseness, difficulty breathing, excessive throat clearing
Nose: Minor: sneezing, sniffling, runny nose
Eyes: Minor: itchy, watering
Major: swelling around the eyes
Skin: Minor: itchy rash, hives, eczema flare-up, generalized flushing of the skin
Major: swelling extremities
Gut: Minor: nausea, abdominal cramps
Major: nausea, diarrhea, vomiting
Lung: Major: shortness of breath, coughing, wheezing, labored or shallow breathing,
Heart: Major: weak pulse, dizziness, low blood pressure, rapid heartbeat
Behavior: Major: weakness, sleepiness, sense of impending doom,loss of consciousness
** The severity of symptoms can change quickly and can potentially progress to a life-threatening situation. Allergic reactions are very rapid. Continual observation is necessary.
**ACTION FOR UNCONFIRMED EXPOSURES**
1. Observe, checking for symptoms, for two hours.
** ACTION FOR MINOR REACTIONS**
1. Give medication: Liquid Benadryl Dose: 2 tsp Route: orally Frequency: every four hours
2. Call emergency contact.
3. Observe under supervision for 1-2 hours.
** ACTION FOR MAJOR REACTION**
1. Give medication: Liquid Benadryl Dose: 2 tsp Route: orally
Administer EpiPen Jr.
2. Call 911 (rescue squad) request advanced life support and epinephrine.
3. Call emergency contact.
*****************************************
What do you think? (This is done on a chart so it's a lot easier to read/understand.) I know everyone's plan is different, but does this generally make sense to you?
Thanks for any input. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
[This message has been edited by Lam (edited August 20, 2002).]

Posted on: Tue, 08/20/2002 - 6:14am
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Joined: 05/28/2009 - 16:42

Lam --
Just a quick thought. What about deleting "Allergic reactions are very rapid"? My thought is that leaving out that sentence might ensure that someone will watch a bit longer/more carefully in an uncertain situation (while they are getting ready to "call" it) if they are keeping the other two sentences ("Can change quickly...Continual observation is necessary) in mind, rather than thinking that, if it isn't happening fast, it may not be happening.
Just my .02. Let us know how it goes!
--Sue

Posted on: Tue, 08/20/2002 - 7:42am
anonymous's picture
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Joined: 05/28/2009 - 16:42

Sue,
Thanks for pointing that out and for responding so quickly!!
Those few sentences were taken directly from the paper our allergist provided to us for our school (the one I said was "pretty generic"). What we did was blend our "long" list with her "generic" one. [img]http://uumor.pair.com/nutalle2/peanutallergy/wink.gif[/img]
I agree, that sentence could be misleading. Thanks again! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

Posted on: Tue, 08/20/2002 - 10:15am
JSaastad's picture
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Joined: 03/29/2002 - 09:00

Under Action for Major Reaction, I would list GIVE EPI PEN first, before benadryl and put it in bold. I want people to know that despite all of the information on the chart, the most important thing to get correct and remember is the epi pen. Thanks so much for posting, I am going to use all of it!
Jill

Posted on: Tue, 08/20/2002 - 11:17am
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Joined: 05/28/2009 - 16:42

Jill,
"Eagle Eyes!!" Thanks for catching that!! I can't believe we didn't!!
Again, this was on the paper from the allergist's - IN THAT ORDER. I agree - Epi should be given first in a major reaction.
Another thing (that we DID catch) on the paper from the allergist: "swelling of lips or mouth" was under Minor. We didn't agree, so we moved it to Major on our revision.
This paper will be used as the "alert" paper for subs and the info sheet for those who need it on a day-to-day basis at school. It will also show our son's name, etc., note his allergies, and have his picture on it. And our phone numbers are listed after "call emergency contact".
Thanks so much!! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
[This message has been edited by Lam (edited August 20, 2002).]

Posted on: Tue, 08/20/2002 - 1:18pm
Anonymous's picture
Anonymous (not verified)

Our allergist recommends the benadryl-before-the-epi protocol, unless of course our daughter is unconscious. I believe the thinking is that since the reaction is being caused by a massive release of histamines, that to get something into the system to stop them is imperative. Of course the epi is followed just minutes (if not seconds) later, to help counteract the effects of all that histamine.
[This message has been edited by KWest (edited August 20, 2002).]

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