What’s Your Rule About Epi-Pens?

[Childminder]

I was told that unless the parent has paid to have me trained in the use of an EPI pen then do not use them. I guess that they have to be administered at just the right time and they expire quickly so you have to watch that too. We were told to call 911.

[MrsSteinel'sHouse]

I haven't read all of the other posts but here is my 2 cents.

I have had various allergies and a kidlet with no peanut butter and epi pens.

You need to know how far you are from the hospital. In my case, I am at best 20 minutes and an ambulance maybe at least 10 (small village, volunteer) and maybe no pediatric emt available. So I have to have at least 2 epi pens because you may have to readminister in 15 minutes.

Something else to consider.

[saved4always]

I never had a dck with an allergy that required an epi-pen but my daughter has one for a peanut allergy. We have known she was allergic to peanuts since she was about 2 years old and she is 10 yo now. We have had epi-pens for years for her but have never used one. She did take a bite of a peanut butter cookie a few years ago at church and we ended up taking her to the ER because we were not positve whether we should do the epi-pen or not. Honestly, our pediatrician prescribed it without ever really discussing with us how and when to use it. We gave her benedril which, of cours, did not work. At the ER, they administered the epinephrine and she was fine after a very short time. Befoire the epinephrine, she had hives, vomiting, swollen lips, runny nose, trouble breathing, etc. The ER doctor told us that we should give her the epi-pen even if we just suspected that she consumed peanuts...that it would not hurt her if we were mistaken. We do give 2 epi-pens to the school and 2 to summer camp (daycare) as well as having 2 at our home now. We have 2 just in case the first does not stop the symptoms. Our pediatrician said we should take her to the ER (or school should call EMS) even if we use the epi-pen. Just to be sure she is okay.

Administering an epi-pen is not really very difficult. The epi-pen should include a practice syringe and the parents should show you how to use it. You basically just jab it into the child's thigh. If this child has consumed peanuts and not had a reaction, I would suspect that he is not (and never has been) allergic to peanuts. My understanding (and experience with my daughter has been like this) that a peanut allergy gets worse with each comsumption, not better. My daughters first reaction was mild hives that disappeared on thier own. I did not know til the next day that my neighbor had given her a peanut butter cracker when she watched her for me...she had never had peanuts before. The next time was that time at church and it was definitely MUCH worse than that first. It is definitely not something that I would "forget" to mention to a caregiver. I always note it in all caps and written big on any form asking for allergies or medical info. It is not something I take a chance with.

[saved4always]

also it is my understanding if an epi pen is used the next step is call the amblance. so you need permission to do so and a statement saying the parents will pay for it The epi pen only gets you until you can get medical care.

This is what my pediatrician said...that my daughter is to go to the ER when the epi-pen is administered. Her daycare this summer required that we bring 2 epi-pens in case the first does not work and in case the ambulance is not there quickly enough.

[jojosmommy]

I think lots of people are being far too harsh on the mother.

I think you need to consider that this allergy is like any other medical issue and varies depending on the individual child, and their health.

I also think you consider the fact that no parent in the world would intentionally forget to tell you something they thought would help their child, especially in a life or death situation. They took the time to interview you and didn't just open your door and shove the kid in so they obviously took concern in who would be watching their child and how your program is run.

Allergies are something that some children grow out of. Some children also get worse after repeated exposures. The reactions are vastly different for every kid and can be mild to severe. I also disagree with the idea that simply because a doctor gave an epipen that means it is a severe allergy. I have met many un/under qualified doctors who have simply writen a RX to cover their bases. Without any background on how to use it, when to use it, etc. Just being given one by a doctor doesnt mean the kid even needed it.

My child has tons of allergies (soy, rice, dairy, chicken, beef, corn, peaches, sweet potato, peas, carrots, pumpkin, kiwi,.... I could continue but I'll save you the trouble). Her reactions are different depending on the number of exposures, the amount ingested, and vary from food to food. She has also already aged out of some of the allergies she has and she is only 10 months old. The point of sharing this is that the mom probably doesnt think about the peanut allergy at every moment since the child has not had a reaction for over a year and even then you said they werent severe.

If you think you are getting enough support from the mom to care for the child safely then do so. Require she leave an epipen there at all times so nobody accidentally forgets at drop off to leave you with one. Ask about safe foods and this childs indicators of an allergy. Take a class on how to use an epipen safely. Call 911 if you have any concerns with the child at any time.

[saved4always]

I think lots of people are being far too harsh on the mother.

I think you need to consider that this allergy is like any other medical issue and varies depending on the individual child, and their health.

I also think you consider the fact that no parent in the world would intentionally forget to tell you something they thought would help their child, especially in a life or death situation. They took the time to interview you and didn't just open your door and shove the kid in so they obviously took concern in who would be watching their child and how your program is run.

Allergies are something that some children grow out of. Some children also get worse after repeated exposures. The reactions are vastly different for every kid and can be mild to severe. I also disagree with the idea that simply because a doctor gave an epipen that means it is a severe allergy. I have met many un/under qualified doctors who have simply writen a RX to cover their bases. Without any background on how to use it, when to use it, etc. Just being given one by a doctor doesnt mean the kid even needed it.

My child has tons of allergies (soy, rice, dairy, chicken, beef, corn, peaches, sweet potato, peas, carrots, pumpkin, kiwi,.... I could continue but I'll save you the trouble). Her reactions are different depending on the number of exposures, the amount ingested, and vary from food to food. She has also already aged out of some of the allergies she has and she is only 10 months old. The point of sharing this is that the mom probably doesnt think about the peanut allergy at every moment since the child has not had a reaction for over a year and even then you said they werent severe.

If you think you are getting enough support from the mom to care for the child safely then do so. Require she leave an epipen there at all times so nobody accidentally forgets at drop off to leave you with one. Ask about safe foods and this childs indicators of an allergy. Take a class on how to use an epipen safely. Call 911 if you have any concerns with the child at any time.

It is so true that each child reacts differently to their allergy to a food. In my daughter's case, she can be around people eating peanuts. She can eat things made in facilities that also process food that has peanuts in it. She only reacts to actually ingesting something with the ingredients peanuts or peanut butter. She has never been tested for the allergy but we know from the one bad reaction she had that she is definitely allergic. That is why I am wondering if the child in the original post even has a peanut allergy. If he really ate a peanut ingredient and did not react, I would not think he was allergic. That is probably why the mom is not worried. I would still want the epi-pen at my house for a child like that...just in case. I would take this child and not worry too much about the allergy. I already never served peanuts or peanut butter to any of my dck's just because I did not want to be the one to "discover" an allergy the hard way.

[e.j.]

I think lots of people are being far too harsh on the mother........I think you need to consider that this allergy is like any other medical issue and varies depending on the individual child, and their health.

Not having met the mother, I was thinking the same thing. I was at my kids' allergist during one of their appointments and he asked if either my husband or I had allergies. I said no initially but then realized, my husband is allergic to bee stings and I have mold and pollen allergies. I felt a little ridiculous because who forgets they have allergies? I did, though because in my case, they're usually mild and only bother me at certain times during the year. My husband rarely gets stung so that didn't cross my mind either. Both of my kids have allergies to certain foods and they have EpiPens "just in case" but because we stay away from the foods they are allergic to, I could see myself forgetting to let a day care provider know during an initial interview.

Personally, I'd give her the benefit of the doubt. If she were willing to work with me and get me the paperwork I needed from the dr. detailing the allergy, reaction to look for and action to take if exposed, I would keep her as a client. If she blew off my concerns and refused to provide the information I needed, I would drop her.

[Blue sky]

Are you required to be med. certified to administer the epi?
My state requires this. I got certified once and never renewed because I didn't want the liability.

which state are you in? I have heard that CA is now require to choose if you provide the "incidental medical services" or not. if you choose to do so, then you have to submit "a PLAN to provide the incidental medical service"
here is the quote from CA site
"when the parent/authorized representative has provided written
authorization and obtained written instructions from the child’s physician. The licensee must
submit a Plan to Provide Incidental Medical Services. " there for you may tell the parent that you do not serve that type of service I think.

[lblanke]

Neither Benadryl nor inhalers will stop anaphylaxis, and some doctors have taken Benadryl off the plan for treatment of a known exposure. You cannot make the family pay for training. It has to be spread out to all children in your care. It is a big responsibility, and if you are unwilling or unable to provide a safe environment, do not keep the child. Kids with food allergies can safely attend preschool, daycare and school with accommodations and do not require a nanny or to be home schooled. Fortunately allergic reactions are rare if everyone is careful, but they can be serious, so it is important to know what to do if one should occur. FARE.org has great factual information on life threatening allergies.

[Blackcat31]

which state are you in? I have heard that CA is now require to choose if you provide the "incidental medical services" or not. if you choose to do so, then you have to submit "a PLAN to provide the incidental medical service"
here is the quote from CA site
"when the parent/authorized representative has provided written
authorization and obtained written instructions from the child’s physician. The licensee must
submit a Plan to Provide Incidental Medical Services. " there for you may tell the parent that you do not serve that type of service I think.

The post you quoted is from 2012.

I don't think the poster is still an active member here.

[Kimskiddos]

I accepted a child into care and mom did not tell me until their first day that they have a peanut allergy and also an epi pen! Not happy about this.

We discussed the issue and kid is seeing an allergist and has had peanuts recently without an allergy issue. Mom says they have never used the pen and have not had any allergy issues/hives/etc for over a year (kid is 3) but that the doctor insists that they have an epi pen just in case. I have told mom that I do not guarantee a peanut free home and that I do not have any experience with epi pens.

Kid is not scheduled to come on a permanent basis for another week and half (finishing out the time in the current childcare arrangement).

What would you do?

I had this same kiddo, she is now in school. Honestly it wasn't a big deal at all for us! Her mom replaced the epi pen about every 6 months.

She was receiving peanut therapy (Dr. would give her small doses and check for reactions.) Her allergy wasn't severe and all I had to do was omit the peanut butter and nuts (not that I ever really served nuts), cut out the cranola bars, read labels a little more carefully and let other parents know that I had a child with nut allergies when they brought holiday/birthday treats (they were very accommodating). With the added bonus of getting a lot more fruit treats because that was easier for them to supply. If I wasn't sure about something she just didn't get it.

[Blue sky]

Oh, Sorry about that. I will check next time.
thanks

[Unregistered]

That's bologna.

I don't think any mother with half a brain would merely "forget" a detail like that.


It reads intentional, and that wouldn't fly with me. I'd have sent them on their way the moment she finally chose to disclose it.



My son has had kids in his class with peanut allergies. My son couldn't even have peanut butter toast in the morning for breakfast because even arriving an hour later if they caught wind of his breath they'd have a reaction that would send them to the hospital. Trying to find just snacks for him to bring was nearly impossible, even things manufactured in a plant that may have been exposed to the dust were out, which is about everything shy of just plain old raw fruits and vegetables. Even those we had to be sure weren't stored next to anything that could have been a trigger food. Just forget trying to ever send him cold lunch from home....oy. The last two school years we've pretty much had to become peanut free in our own home just to keep them safe there.

I was sympathetic to the child but it was incredibly frustrating for our family.

If I were a parent of such a child I'd likely acquire a nanny for them to be sure the environment was kept safe and controlled as opposed to leaving such a potentially fatal affliction in the hands of someone who has far too many children to be worrying about if a speck of peanut or tree nut dust is floating through the air.

It's just too much to ask imho, and surely not one of those things one would or should ever just drop in a providers lap on the day care is to begin.

This is probably a hugely unpopular opinion, but if the kid is this bad then he or she needs to be home-schooled. A peanut free school or daycare environment is one thing, but dictating what another family eats in their own home is way out of line. And as a daycare provider there's no way I could enforce this or protect the kid from this.

[Blackcat31]

Oh, Sorry about that. I will check next time.
thanks

That's okay... old threads are always full of good info but I just wanted to point it out to you that it was old just because I didnt want you to wait for a reply from that poster.

[DaveA]

If I have a child with an epi pen I require a contract addendum detailing allergy, reactions, when to use, and post-use parental notification and medical treatment. I have parents provide 2 epi pens- 1 each for house and car first aid kits.