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PostPosted: Tue Jan 29, 2008 5:06 pm 
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Joined: Tue Jan 10, 2006 9:25 pm
Posts: 238
Location: Thornhill
Let's all hope it never comes to that however, my daycare is grappling with the question of "Is it safe to administer epinepherine to an uncounscious child?".
I have instructed (and will change the management plan accordingly) that obviously at first symptom, it is administered.
There is someone who sits on the advisory committee who apparently keeps insisting that it is UNSAFE and that they are to be barred from administering in the event that a child is non-responsive.
I can't find anything to support that in such a case it SHOULD be administered. Do you have any research or instruction? If so, please share

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renie
daughter: ana for egg, sesame, dairy, pistachio/cashew/hazelnut. on contact. allergic+ to soy protein isolate, environmental allergies (e.g. dogs, dust mites). asthma. eczema.
son: peanuts, tree-nuts, OAS, environmental allergies. asthma.


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PostPosted: Wed Jan 30, 2008 8:08 am 
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Joined: Tue Mar 22, 2005 11:17 pm
Posts: 6456
Location: Ottawa
If you go back to your basic first aide, you will recall:
1. Visually inspect for reasons of unconciousness as well as safety to yourself.
2. Shout and clap and try to wake them up.
3. Alert someone else to call 9-1-1 and to then come back to you.
4. Think ABC, A=airway, B=breathing, C=cardiac
5. Do a visual to determin if the child has an obstruction that can be easily removed.

Usually you would look at Heimlik manouver, artificial respiration and the CPR (ABC)
If you saw a MedicAlert bracelete or knew of a history of allergies by all means give the epinephrine. In a case where there is no know history and the symptoms don't match and you are not using their precribed medication...? I would prefer to have the EMS advise me on a case by case scenario.
JMHO

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Daughter: asthma, allergies to egg, milk, peanuts, tree nuts, most legumes (not soy) & penicillin. Developing hayfever type allergies.
Husband: no allergies
Me: allergies to some tree that flowers in May
Cat: allergic to beef, pork and lamb


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PostPosted: Wed Jan 30, 2008 9:17 pm 
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Joined: Tue Jan 10, 2006 9:25 pm
Posts: 238
Location: Thornhill
Thanks for the remider and returning to basics.

That said, has anyone EVER heard a directive NOT to administer when unconscious?

The epi leaflet of course indicates that there is no absolute contraindication in a possible anaphylactic event and I have noticed that there is material "out there" that even has epi administration for non-allergic, unconscious kids....

I just WISH I could get my hands on something that can remove any hesitation factor, G-d forbid that any allergic child in their care have an anaphylactic event that leads to loss of consciousness....

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renie
daughter: ana for egg, sesame, dairy, pistachio/cashew/hazelnut. on contact. allergic+ to soy protein isolate, environmental allergies (e.g. dogs, dust mites). asthma. eczema.
son: peanuts, tree-nuts, OAS, environmental allergies. asthma.


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PostPosted: Thu Jan 31, 2008 8:03 am 
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Joined: Tue Mar 22, 2005 11:17 pm
Posts: 6456
Location: Ottawa
If the veins have already collapsed or if the heart has stopped pumping, the medication will not go anywhere.
But if they have just passed out, you might still have time. Our last reaction was very mild in terms of hives and swelling but dd got very "tired" and started to slump. I gave the Epi-Pen immediately and she was right as rain. Of course we called 9-1-1 and did the emergency route.
I have never seen anything that says do not give epinephrene to a person for which it has been prescribed.

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Daughter: asthma, allergies to egg, milk, peanuts, tree nuts, most legumes (not soy) & penicillin. Developing hayfever type allergies.
Husband: no allergies
Me: allergies to some tree that flowers in May
Cat: allergic to beef, pork and lamb


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PostPosted: Tue Feb 05, 2008 8:33 am 
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Joined: Tue Nov 29, 2005 4:04 pm
Posts: 2044
Location: Gatineau, Quebec
I spoke to a paramedic friend of mine, who suggested a few theories about why this person is thinking that it's unsafe to administer epi to an unconscious person:

"It’s possible that this person might have been told not to administer epinephrine during training (depending on where they received their training) and they may have continued to propagate this myth. Here are two theories about where they got this idea from:

1) Some very technician-based (as opposed to clinician-based) training agencies try to prioritize treatments based on a patient’s level of consciousness, then A/B/Cs [airway, breathing, consciousness], then meds and history. So, to the technician, in the event that someone becomes unconscious, assisting their airway and breathing becomes a priority. This is a prime case of “what comes first - the chicken or the egg?” The technician fails to understand that the cause of the unconsciousness, or the airway problem, or the breathing problem or the circulation problem can in fact be the anaphylactic emergency that may not manifest itself as generalized urticaria [hives] or edema [swelling].

2) The person may have been confused by a common medical directive that suggests patients are not to receive any medication specifically by mouth if they have a reduced level of consciousness or if they are unconscious (this is because people can choke if they cannot properly protect their airway). Some people forget the part about "by mouth" (PO). [I believe PO is for "peri-oral". - K]

Here is the catch-all for civilians: If the patient is symptomatic from exposure to any known or suspect allergen, regardless of level of consciousness, it is recommended to administer epinephrine (as long as the epinephrine belongs to the patient or a medical professional). Then call paramedics.

-----------------------------------------------------------------------------------------------

So there you go - a few ideas about where this idea might have come from.

K.

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Karen, proud Mom of
- DS1 (12 yrs): allergic to cashews, pistachios, Brazil nuts, potatoes, some legumes, some fish, pumpkin seeds; OAS
- DS2 (1o yrs): ana. to dairy, eggs, peanuts; asthma


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PostPosted: Wed Jun 18, 2008 12:32 pm 
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Joined: Wed Jun 18, 2008 12:26 pm
Posts: 1
renie wrote:
Let's all hope it never comes to that however, my daycare is grappling with the question of "Is it safe to administer epinepherine to an uncounscious child?".
I have instructed (and will change the management plan accordingly) that obviously at first symptom, it is administered.
There is someone who sits on the advisory committee who apparently keeps insisting that it is UNSAFE and that they are to be barred from administering in the event that a child is non-responsive.
I can't find anything to support that in such a case it SHOULD be administered. Do you have any research or instruction? If so, please share

I have to agree that it is not safe to adminnister epi to an unconcious child or person and if there are any doubts regarding the saftey of children, a professional should be consulted to be 100% sure of the answer.
All the best.
Willamina

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PostPosted: Sat Jun 21, 2008 7:54 pm 
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Joined: Wed Sep 13, 2006 6:50 pm
Posts: 7
Location: Ontario
Speaking from experience, I have to say that there was no harm done by administering epinephrene to someone who is unconscious.
I had an anaphylactic reaction (resulting in loss of consciousness) and a family member used the EpiPen on me. It helped reduce swelling and gave enough time to have EMS - 911 come take me to the hospital.


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PostPosted: Sun Jun 22, 2008 8:55 am 
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Joined: Tue Jan 10, 2006 9:25 pm
Posts: 238
Location: Thornhill
Thanks so much Rocky!
I am so glad we are finally going to be leaving that care situation however I am still thankful to have positive feedback about using the epi in such a situation
There aren't always medical professionals around at the critical moment

_________________
renie
daughter: ana for egg, sesame, dairy, pistachio/cashew/hazelnut. on contact. allergic+ to soy protein isolate, environmental allergies (e.g. dogs, dust mites). asthma. eczema.
son: peanuts, tree-nuts, OAS, environmental allergies. asthma.


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PostPosted: Sun Jun 22, 2008 9:51 am 
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Joined: Mon Feb 07, 2005 6:39 pm
Posts: 2943
Location: Toronto
Can we use this question in Ask the Allergists in Allergic Living?

If you send it as a question to editor@allergicliving.com, I'll make sure it gets into the questions. A good one to put to either Dr. Waserman or to Dr. Watson as the experts.

(Put "Ask the Allergists" in the subject field of your e-mail.)

Gwen

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Allergic to soy, peanut, shellfish, penicillin


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PostPosted: Sun Jun 22, 2008 8:06 pm 
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Joined: Tue Jan 10, 2006 9:25 pm
Posts: 238
Location: Thornhill
Will do
I would love to hear them weigh in on this one!
Thanks Gwen!

_________________
renie
daughter: ana for egg, sesame, dairy, pistachio/cashew/hazelnut. on contact. allergic+ to soy protein isolate, environmental allergies (e.g. dogs, dust mites). asthma. eczema.
son: peanuts, tree-nuts, OAS, environmental allergies. asthma.


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