Unlicensed daycare provider kills infant with adult dose of Benadryl. (legal, toddler)
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Apart for the potential for training on what not to do in similar situations that licensing may provide, the threat of losing one's license should one screw up may serve as a powerful deterrent against doing foolish things like this. That said, as others have mentioned, licensed daycare providers have screwed up as well, including with incidents resulting in the death of children.
Or if you have Good Samaritin medical assistance laws
Quote:
Originally Posted by CarnivalGal
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I work at a preschool. A child was having an allergic reaction to cashews. He had never had a reaction before, so this was an unknown allergy. He was 18 months old. We contacted the parents (got a hold of Dad) to tell him what was going on. We also told him that we were going to administer Benadryl. He insisted that we don't because "you can't give Bendryl to anyone under 2." He would be there to pick him up in about 20 minutes. For the record, every, single person who works in that school is CPR and First Aid certified. This could have gone very bad within 20 minutes. Anyway, after getting no where with him, we informed him that either we give him the Benedryl or the paramedics will give it to him when they get there. He relented and let us give him the meds. The paramedics were there when he arrived, and the dad tried to tell them that he told us not to give him Benadryl, yada, yada, yada. The paramedic looked right at him and said, "Why the hell would you do that?"
The moral of the story is that the belief that you can't give anyone under 2 Benadryl could have had very dire consequences in this instance.
Yah, if you have a dr. or paramedic or even someone certified in medical care for young children - you could go with it. But even so, you might want to check your preschool's licensing - because how you manage & dispense meds varies from state to state. Even if you're covered under the K-12 public school system - some preschools are - it would still be worthwhile to look into this question.
Best of luck, yours sounds like a good operation. As you can figure from seeing the responses all over the map just in this thread, state oversight of meds in daycare situations is very variable. If the licensing agency never looks in, never inspects for diet, managing meds, minimum square footage/child, maximum child load/adult, fire drill & on & on - all the minutia that goes into a successful daycare - then the odds are very good that you'll get substandard operations that run until they hit some kind of problem. How serious that problem is determines what happens to that center & the operator & staff.
Yah, if you have a dr. or paramedic or even someone certified in medical care for young children - you could go with it. But even so, you might want to check your preschool's licensing - because how you manage & dispense meds varies from state to state. Even if you're covered under the K-12 public school system - some preschools are - it would still be worthwhile to look into this question.
Best of luck, yours sounds like a good operation. As you can figure from seeing the responses all over the map just in this thread, state oversight of meds in daycare situations is very variable. If the licensing agency never looks in, never inspects for diet, managing meds, minimum square footage/child, maximum child load/adult, fire drill & on & on - all the minutia that goes into a successful daycare - then the odds are very good that you'll get substandard operations that run until they hit some kind of problem. How serious that problem is determines what happens to that center & the operator & staff.
If this woman was licensed, that means she was (or should have been) certified in first aid and CPR. Our school does not fall under the K-12 system. But we do not dispense medication at all unless it is an emergency. We have Benadryl for just this very reason. Those children with known allergies have Epi Pens at the school. Those are the only meds we will administer and we will only administer them if there is an acute reaction. We will also call 911 at the same time (and parents). And like I said, every person who works at the school is required to be certified.
To be honest, this Dad was just kind of a jerk. The paramedics picked up on that pretty quickly, which is why they responded to him like they did. If we had seriously waited until he picked him up, this kid could have stopped breathing. And even if he didn't what was Dad going to do when he picked him up? Take him home? Like that would have helped him.
If this woman was licensed, that means she was (or should have been) certified in first aid and CPR. Our school does not fall under the K-12 system. But we do not dispense medication at all unless it is an emergency. We have Benadryl for just this very reason. Those children with known allergies have Epi Pens at the school. Those are the only meds we will administer and we will only administer them if there is an acute reaction. We will also call 911 at the same time (and parents). And like I said, every person who works at the school is required to be certified.
To be honest, this Dad was just kind of a jerk. The paramedics picked up on that pretty quickly, which is why they responded to him like they did. If we had seriously waited until he picked him up, this kid could have stopped breathing. And even if he didn't what was Dad going to do when he picked him up? Take him home? Like that would have helped him.
That's crazy. Stupid dad (sorry).
The first time my son tried black cherries (under 2) he had a delayed allergic reaction (shallow breathing, rapid heart rate). I gave him Benadryl and albuterol via nebulizer immediately then drove him to the ER. The ER doc was (jokingly) like "what did you bring him here for? You've already done everything we were going to do!" Lol. Parenting classes - every parent should take them.
Location: Stuck on the East Coast, hoping to head West
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Interesting. My training and protocol would not have included administration of Benadryl--mainly b/c benadryl isn't effective for severe reactions and works quite slowly. It can also mask more serious reactions, like breathing problems.
Also, administration of OTC drugs of any kind were prohibited under my license unless the drugs were provided by the parent along with written permission and instructions.
I'd call 911 immediately. Ideally, I wish I could have an EPI pen just in case, but that's not permitted in my jurisdiction.
In the case of a suspected allergic reaction, I would have called 911 first and the parents second.
Interesting. My training and protocol would not have included administration of Benadryl--mainly b/c benadryl isn't effective for severe reactions and works quite slowly. It can also mask more serious reactions, like breathing problems.
Also, administration of OTC drugs of any kind were prohibited under my license unless the drugs were provided by the parent along with written permission and instructions.
I'd call 911 immediately. Ideally, I wish I could have an EPI pen just in case, but that's not permitted in my jurisdiction.
In the case of a suspected allergic reaction, I would have called 911 first and the parents second.
Benedryl is absolutely effective for severe reactions. It won't get you out of the woods, but it buys time until medical help arrives. Ideally there would be an Epi Pen present, but barring that Benedryl is the next best thing. In fact, every doctor's protocol I have ever had for a child with allergies and an Epi Pen has Benadryl and the dosage listed as the first course of action.
I am curious how you can have children in your care with severe allergies and NOT be allowed to have Epi Pens. A child could easily die from a reaction before help arrived. I don't even think I would feel comfortable working in a center that had children with known allergies and prescribed Epi Pens but didn't allow you to use them. That's like not allowing you to do CPR if someone's heart stops.
Location: Stuck on the East Coast, hoping to head West
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Quote:
Originally Posted by CarnivalGal
Benedryl is absolutely effective for severe reactions. It won't get you out of the woods, but it buys time until medical help arrives. Ideally there would be an Epi Pen present, but barring that Benedryl is the next best thing. In fact, every doctor's protocol I have ever had for a child with allergies and an Epi Pen has Benadryl and the dosage listed as the first course of action.
I am curious how you can have children in your care with severe allergies and NOT be allowed to have Epi Pens. A child could easily die from a reaction before help arrived. I don't even think I would feel comfortable working in a center that had children with known allergies and prescribed Epi Pens but didn't allow you to use them. That's like not allowing you to do CPR if someone's heart stops.
Three scenarios: the child knows they have severe reactions and give me a pen to keep on hand. I use it AND call 911. Benadryl doesn't enter the equation.
Other scenario is child is having a first reaction. Ideally, you'd use an epi. Epi is always first. Some jurisdictions allow you to keep epi's on hand for this. Mine didn't. Protocol is to call 911.
3rd scenario: child has hay fever or other mild reaction. They are given Benadryl per the dr. Parent sends not authorizing and provides benadryl.
Using benadryl in a life-threatening reaction doesn't work. Only thing that does is epi.
All of this was part of my training (presented by drs and nurses) and per my physician's guidelines.
Three scenarios: the child knows they have severe reactions and give me a pen to keep on hand. I use it AND call 911. Benadryl doesn't enter the equation.
Other scenario is child is having a first reaction. Ideally, you'd use an epi. Epi is always first. Some jurisdictions allow you to keep epi's on hand for this. Mine didn't. Protocol is to call 911.
3rd scenario: child has hay fever or other mild reaction. They are given Benadryl per the dr. Parent sends not authorizing and provides benadryl.
Using benadryl in a life-threatening reaction doesn't work. Only thing that does is epi.
All of this was part of my training (presented by drs and nurses) and per my physician's guidelines.
Oh, I was under the impression that you weren't allowed to administer Epinephrine at all. That would be scary.
We keep Benadryl for the second scenerio. When it has happened (which was only twice), 911 actually instructed us to use Benadryl if we have it. We kept it for just that reason and had already administered it per our first aid training.
Interesting about the first scenario. Every child I've had in my class who had allergies and had an Epi Pen also had Benadryl as a course of treatment written on the accompanying instructions and paperwork filled out by their doctor.
My daughter has severe allergies, and if she has a reaction she gets an arsenal of medicine. Doctors don't just give epinephrine shots during severe allergic reactions, though it is definitely the first line of defense and is crucial. Doctors also will administer antihistamines and sometimes steroids as well. My daughter always has Benadryl and two epinephrine shots, and she also carries Zantac (H2 antihistamine) now since the hospital gave her that the last time she had a severe reaction. If she has a reaction, we give the shot and antihistamines at about the same time. The shot buys you much-needed time and stops severe reactions in its track, but when it wears off, you often need the antihistamines to start working. If they aren't working yet, then you may need the second shot, which is why it is recommended that you carry two shots.
There are instances where it is appropriate to give a child under 2 Benadryl. My pediatrician even has a dosing schedule for children ages 6 months - 2 years. If a child is having an acute allergic reaction, the first line of defense is Benadryl.
Many allergists prefer you just go with the epi-pen.
Quote:
Originally Posted by CarnivalGal
If this woman was licensed, that means she was (or should have been) certified in first aid and CPR. Our school does not fall under the K-12 system. But we do not dispense medication at all unless it is an emergency. We have Benadryl for just this very reason. Those children with known allergies have Epi Pens at the school. Those are the only meds we will administer and we will only administer them if there is an acute reaction. We will also call 911 at the same time (and parents). And like I said, every person who works at the school is required to be certified.
To be honest, this Dad was just kind of a jerk. The paramedics picked up on that pretty quickly, which is why they responded to him like they did. If we had seriously waited until he picked him up, this kid could have stopped breathing. And even if he didn't what was Dad going to do when he picked him up? Take him home? Like that would have helped him.
I would have your medical person review that. As I said above, a lot of allergists now prefer you go right to the epi-pen. There are lots of "ifs, ands and buts" with Benadryl administration.
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Or if you have Good Samaritin medical assistance laws
