Medication Opinion

[Baby Beluga]

We live in an area where allergies are REALLY bad right now. Many children are being perscrbed daily doses of multi allergy meds, breathing treatments and/or steriords.

I have a child who was absent today. Mom said she has a cough and it was keeping her up at night so she kept her home and took her to the doc. Mom said doc said "chest congestion" and he gave DCG an oral dose of alburterol that she is to take via mouth 3 times a day. I have two policies:

1) a child is not allowed to be on symptom reducing medication while in care.

2) With the exception of life saving medication (inhaler, insultin, epi pen, etc) I do not give prescription medication.

Mom sent me a text asking if I would be willing to give DCG the afternoon dose. I am torn. On one hand allergies are REALLY bad so this is somewhat common. On the other hand, if she is coughing that bad, I don't think she needs to be here. I am not comfortable dosing the child. If I allowing her to attend I would ask for a parent/family member to come by and dose the child.

Thoughts?

[Cat Herder]

I'd give it. It is a beta2-adrenergic bronchodilator, not a cough suppressive. It will allow her to breath more effectively. It won't mask symptoms.

Think situational asthma.

[lblanke]

My little one needed nebulizers several times under age 3, and even though grandma (a retired school teacher) kept her, I went home to set up the nebulizer. It is relatively easy to give, but you have to set it up, mix in meds, place mask over mouth and nose, and it is a little bit loud (which scared my little one a bit). I am a parent not a provider, but in your shoes, I would allow child in care if otherwise medically stable but would require mom or another family member to administer medications. The process takes about 5 minutes, but that is a big ask for someone watching several other children. An inhaler is 1 or 2 quick puffs, but a nebulizer is time consuming (mine was usually on albuterol and budesonide or another steriod, so 10 minutes total and adding meds twice).

[lblanke]

I may have mis-read...if it is oral albuterol (as in give with a spoon, cup or syringe), it would be quick and easy to give, so I would have allowed grandma or a provider to give in my absence. I originally mis-read and thought you were asking about albuterol nebulizer. I know that is not exactly what you are asking...of course mom will allow because she asked you to do it, but it is not something that will mask symptoms and I would be comfortable having someone else give if they were comfortable with it.

[lovemykidstoo]

I have a little guy that has asthma, so when his allergies flare up, he needs a breathing treatment during the day. I do give it to him. I also give antibiotics if they require a daytime dose also because sometimes they're on it for 10 days, so not sick to exclude and if they don't get their medicine on schedule, they could get sick again. I just have them sign the gov't issued medication form. The little guy that has the nebulizer is 3 1/2, so I sit on the floor with all of the kids and he sits there right next to me and holds it in his mouth. Very easy.

[coloradoprovider]

medication

In my state providers are required to take a "Medication Administration" class to be licensed. We are not allowed to refuse to give prescribed medication. Do licensed providers in other states have different requirements? Curious because it seems some requirements are stricter in other states whereas some are more lax.

[Cat Herder]

In my state providers are required to take a "Medication Administration" class to be licensed. We are not allowed to refuse to give prescribed medication. Do licensed providers in other states have different requirements? Curious because it seems some requirements are stricter in other states whereas some are more lax.

The 5 R's.

The doctor would have to write a specific order that said the medication could not possibly be taken at any other time, in any other manner or in any other location for that to be enforced. My bet is no doc would write that, there are too many options available today.

Most medications are 8, 12 and 24 hour dosing meaning all can be administered by a parent with a little planning. Kids can also be excluded from care based on the side effects of any medication.

Giving medications during daycare hours is fully at the discretion of the owner, here. Most base it on experience and comfort level with a particular illness or drug. Some choose not to be exposed to constant inhaled drugs for their own health reasons.

[Blackcat31]

A parent can still manage 3X's a day on their time unless child needs meds at a specific time of the day and if that is the case, can the parent come over to the child care and administer the meds themselves?

Overall, I would allow the child to be in care UNLESS there are additional symptoms and/or behaviors that are disruptive to others or create issues causing her to not be able to participate as normal.

The overall big picture would be my deciding factor

[sammie]

In my state providers are required to take a "Medication Administration" class to be licensed. We are not allowed to refuse to give prescribed medication. Do licensed providers in other states have different requirements? Curious because it seems some requirements are stricter in other states whereas some are more lax.

I am in CO also. I wasn't aware of this. My policy states something along the lines of: due to increased liability, I will not adminster any type of medication.

I guess I should probably look into this.

[Blackcat31]

In my state providers are required to take a "Medication Administration" class to be licensed. We are not allowed to refuse to give prescribed medication. Do licensed providers in other states have different requirements? Curious because it seems some requirements are stricter in other states whereas some are more lax.

I wonder if this is an area interpretation?

I have a provider friend who lives in Colorado Springs and she said providers can choose to administer meds IF they want but are not required to.

I went and read the state rules daycare(dot)com has listed for Colorado and I interpret it the same. You must take the medication administration course but aren't required to dispense meds.

Honestly, if required to dispense it would be a deal breaker for me. I don't like that the state feels they can force that type of liability without protection.

[Cat Herder]

Administrative Guide Rules Regulating Family Child Care Homes; 7.707 - The Office of Early Childhood (OEC), Division of Early Care and Learning (DECL) - https://dcfs.my.salesforce.com/sfc/p...RLJF2KlKS4m_7U

7.707.71C1 Any routine medication, prescription or nonprescription (over-the-counter), homeopathic or vitamin, may be administered by the provider only with a current written order of a health care provider with prescriptive authority and with written parental consent. Home remedies may never be given to a child.

7.707.71C1 - If the routine medication involves the administration of unit dose epinephrine or a nebulized inhaled medication, the administration must be accompanied by a written health care plan by the prescribing health care provider that identifies the factors for determining the need for the administration of the medication;

7.707.71C1b - If the routine medication involves the administration of a nebulized inhaled medication, the administration must be accompanied by a written health care plan by the prescribing health care provider that identifies the factors for determining the need for the administration of the medication;


So, if I were in Colorado I could not choose to give it without the physicians specific order. I actually have more freedom in giving medications. Who knew. :confused:

[coloradoprovider]

I was mistaken. I looked it up also, I assumed we HAD to administer if prescribed. We can choose not to unless medication is for a disability. Thanks for the information!

[Baby Beluga]

Thank you everyone lovethis

I would never deny life saving medication. Inhaler, insulin, epi pen, etc. I however do not feel comfortable dosing a oral medication for an illness here. I am okay with a nebulizer treatment because the vile is already closed and I am the one opening it. But to give an already opened med to someone makes me uneasy. I don't think anyone would purposefully tamper with a med...but at the same time do we ever really know? I've had parents (in centers) bring bottles with meds in them without telling us until pick up. I am probably paranoid, I realize this.

Mom checked with the doc and she is able to give the 3rd dose when she picks up (she is here 7.5 hours/day). I offered for mom to appoint someone to come before nap and give it but she does not have anyone who can.

[Blackcat31]

Sounds like a good plan of action! I am glad you got it figured out!

No, you don't sound paranoid. Just cautious and to be honest I would much rather be overly cautious than held liable later....

[Baby Beluga]

I saw the tag, for anyone wondering this is not for asthma. DCG was outside a lot over the weekend and in an area where she inhaled a lot of gnats. The think this caused lung irritation to her and she is on this medication for a short course (without looking at the script, I believe it is 5 days.) I just don't want anything thinking I am denying an asthmatic medication