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Children will enter your care with a variety of needs. All programs must be prepared to serve children with allergies, asthma, diabetes, health impairments, physical disabilities, and more. This lesson will help you follow a plan for meeting these children’s needs. It also includes strategies for addressing common health concerns.

通过确定的医疗保健需求进入该计划的每个孩子都应该有个人护理计划或包含支持计划。此护理计划由主要医疗保健提供者和家庭制定。它将为您提供有关如何关心儿童和迹象或症状观看的信息。与家人合作，将计划到位是您的工作。

根据照顾我们的孩子，a care plan typically includes information like:

• The child’s diagnosis or diagnoses
• Contact information for the primary care provider (usually a doctor)
• Medications along with the schedule in which the medicine should be given
• Medications to be given on an as-needed basis along with clear instructions about signs and symptoms that warrant giving the medication
• 施用药物的程序
• Allergies
• Modifications necessary for the child (diet, activity, environment, behavioral, what to avoid--for example, peanuts, etc.)
• 症状寻找
• 应急响应计划
• Special training you might need to work with the child

在某些情况下，您可以与家人和儿童的初级保健提供者沟通可能会有所帮助。获得的任何沟通和信息都是机密和保护的家庭教育权和隐私法（FERPA）和健康保险流通和问责法（HIPAA）保护。熟悉这些规定，如果需要，请求帮助;请参阅您的许可机构的指导方针和有关谁应与儿童的主要医疗保健提供者交谈的指导方针。医疗保健顾问可以是一个很好的资源。

常见的医疗保健需求

孩子中最常见的医疗保健需求是过敏和哮喘。以下信息将为您提供每种医疗保健需求的概述，以及为满足这些需求支持儿童的方法。

Allergies

过敏症是儿童中最常见的医疗保健需求。过敏会导致各种各样的症状，包括更广泛的原因。根据美国儿科学院（AAP），过敏症是“通常由过度活跃的免疫系统引起的反应。这些反应可以发生在体内的各种器官中，导致患有哮喘，花粉和湿疹等疾病。在过敏反应期间，免疫系统充分反应，并反对通常的无害物质（例如花粉或动物皮屑）的作用。这些挑衅性的物质被称为allergens。作为家庭护万博体育下载官方网站理提供者，您应该了解您在护理中儿童的过敏原，他们的常见症状和反应，以及您可以做些什么来使您的家用过敏友好友好。

过敏可能难以诊断，可以在任何年龄发生。儿童可能在1岁时可能没有任何过敏症状，但截至3岁，甚至5年，他们可能会产生严重的过敏。婴儿和幼儿通常暴露于新的食品和材料，这些暴露可以识别孩子，家庭和护理人员以前没有意识到的过敏。当孩子在您的照顾时，这些过敏可能首先是显而易见的。这就是为什么监测您在护理中儿童的健康是重要的。如果您涉及一个孩子可能有过敏，请立即引起孩子的家人或监护人的关注。

食物过敏

食物过敏正在崛起（疾病控制和预防中心，2013）。根据美国儿科学院，8％的18岁以下的儿童具有食物过敏或多种食物过敏。这是美国大约600万儿童（AAP，2011年）。各种蛋白质，对没有过敏的人无害，可以引发食物过敏的人的严重反应。反应可以从轻度到严重，包括死亡。在食物被食用后通常发生过敏反应。

Recent scientific and medical advances have provided the technology to diagnose food allergies more easily and precisely. We now know that many children suffer from food allergies, some of which can be severe, even life-threatening. For example, we have seen an increase in children with peanut allergies, so much so that entire child care programs have become peanut-free zones in an effort to prevent any serious allergic reactions.

Although some children may be aware of their own food allergies and the precautions they must take, not all children will. In most cases, especially the youngest you care for, children will not fully understand what it means or what foods they can and cannot eat. Therefore, it is of utmost importance for you to know if any children in your care have food allergies. A list of documented allergies should be posted in your program, but covered to protect children’s privacy. Stay vigilant at mealtimes to ensure children are not exposed to foods that contain known allergens. If there is a child with a severe allergy in your care, you should meet with the family to discuss any medications or emergency plans.

Food allergies can affect many parts of the body. Common symptoms include:

• Hives, skin rashes, and swelling
• Sneezing, wheezing, and throat tightness
• Nausea, vomiting, and diarrhea
• 灯头，并失去意识

如果症状严重或者身体的几个区域受到影响，则反应可能是危及生命的。如果孩子有瘙痒，喉咙肿胀，并且低血压，它们可能有过敏反应，并且需要立即医疗。如果您注意到儿童具有严重或普通的过敏反应，请立即寻求紧急医疗。

虽然有超过160种类型的食物，可导致敏感性的过敏反应，但这八种食物占90％的食物过敏反应：

• 牛奶
• Eggs
• 鱼
• 甲壳类贝类（例如蟹，龙虾，虾）
• 树坚果（例如，杏仁，核桃，山核桃）
• 花生
• 小麦
• 大豆

This topic is explored in greater detail in儿童保育食品服务的七节课程课程。

非食物过敏

There are many other allergens (manmade and natural) that can cause allergic symptoms, like runny nose or sneezing, coughing, wheezing, chest tightness, skin rashes, itchy, and watery or red eyes. Common non-food-related allergens include:

• 尘螨
• 动物或动物皮屑
• 模子
• 花粉（树木，草，杂草，花）

If you suspect that a child in your care may have an undiagnosed allergy, talk with the child’s family to discuss the symptoms you notice. If the child has an allergic reaction to an environmental allergen that is specific to your home, the symptoms may not be as noticeable at their home.

请注意，有些孩子可能会有动物过敏。某些家庭宠物可能对这些孩子有害。所有孩子都应该在处理动物之前和之后洗手。

Asthma

根据疾病控制和预防的中心（CDC），超过2600万美国人患有哮喘，其中四分之一在18岁以下（CDC，2018）。随着哮喘哮喘的人数持续上升，所以可以使用更准确的方法来诊断和治疗疾病。哮喘可以在任何年龄开始;然而，大多数具有哮喘的哮喘发育症状5岁（克利夫兰诊所，2019年）。AAP将哮喘定义为慢性呼吸道的管，其携带空气肺部。这些空气通道变窄，衬里变得肿胀，刺激性和发炎，使呼吸困难（AAP，2015）。

哮喘可能难以诊断。虽然航空公司总是刺激和发炎，但症状并不总是存在，但通常是零星的：有时它们经常发生，但在其他时候可能存在症状之间的长期。哮喘往往误认为是其他健康问题，例如呼吸道感染，肺炎，支气管炎或慢性咳嗽。出于这些原因，重要的是，家庭和护理人员会对哮喘的可能性进行警告，如果看到以下任何症状，请寻求帮助：

• 喘息
• Regular coughing
• Tight feeling in chest
• 气促

哮喘发作

Asthma attacks are a scary experience for anyone, but they are particularly frightening for children. A child diagnosed with asthma will probably be taught strategies to cope with an attack and may be prescribed an inhaler. It is important that you know how to respond to an asthma attack and how to comfort a scared child. Make sure you know and follow the child’s care plan or inclusion support plans in the event of an asthma attack. If a child has their first asthma attack while in your care, seek emergency medical attention immediately. Do your best to keep the child calm, and encourage them to take slow breaths.

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Specific policies for caring for children with health needs will vary from child to child. This video provides general information about what you might encounter in different family child care programs.

Special Health Care Needs

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Allergies to Pets or Food

孩子可能与previousl进入您的程序y-identified allergies, or allergies may be identified after they start care with you. Either way, it’s essential that you talk with a child’s family to understand their child’s individual health care needs. Do not assume children with similar allergies are treated the same way. Children’s allergies are unique; the same allergy may present different symptoms in different children. As with all special health needs, allergies require a care plan for a child. This plan should include written information about the foods or animals the child is allergic to, a written treatment plan, a training plan for providers, and a plan for storing any medicine. You, and any back-up care providers must know how to appropriately administer and store any medication. The child’s allergies should be clearly and prominently posted in your program.

如果孩子在您的程序中发生过敏反应，请务必：

• follow the child’s individual care plan or inclusion support plan, specifically following the guidance of what to do in the event of exposure to the allergen and/or display of allergic reaction
• 如果计划国家，请立即管理规定的药物
• contact the family, contact emergency medical services if appropriate, and encourage the family to contact the primary health care provider.

Be sure to take a copy of the plan, any medication, and a cell phone with you whenever you and the child leave your home, such as on a field trip or walk to the park.

Caring for Less-Common Health Needs: Medical Procedures

偶尔，有更严重的医疗需求的儿童可能会进入您的计划。它们的医疗需求可能包括管喂养，导管，抽吸或检查血糖。在这些情况下，必须从儿童的初级保健提供者到位护理计划。如果提供商预计执行程序（如果在国家法律下可接受），该计划必须包括培训提供者的准则。如果您觉得该程序超出了您的专业知识或培训，请与您的教练，教练或家庭儿童保育管理员讨论，以获取所需的帮助。万博体育下载官方网站

Cultural Considerations

膳食和餐饮时间可以从提供的食物类型中具有文化的影响，以分享食物和自助技能。食物选择可能受到宗教习俗或文化偏好的影响。一些练习犹太教，伊斯兰教和基督教的人不吃猪肉，一些宗教团体在宗教纪念期间限制肉或快速。世界上大多数成年人口都是乳糖不宽容。这些个人体验难以消化乳制品。在美国，乳糖不耐受最常见的美国原住民，亚洲，非洲和西班牙裔人中的成年人。非常幼儿通常不会经历乳糖不耐受，因为大多数婴儿出生有足够的乳糖酶。然而，在34周之前出生的早产儿出生的妊娠可能对乳制品有困难，因为他们的消化道没有完全发展。（NIH，N.D.）

饮食注意事项是否健康,personal, or cultural, families must be informed as far in advance as possible of your family child care program's policies and practices around meals and mealtimes, day-to-day menus, and available substitutions. This way, if families need to request a change for a certain day, they have time to do so.

Soliciting families' cultural preferences not only keeps children and youth healthy, but also shows respect for the family -- the child's first and most important teacher.

施用药物

为孩子提供药物是一个严肃的事件。您必须通过遵循孩子的个人护理计划或包含支持计划来这样做。遵循这些权利以防止错误和事故：

Any medication or medical equipment should be safely stored in your family child care program out of children’s reach. Sometimes, this involves storing the medication in a locked cabinet or container, but check with your coach or licensing agency to make sure you follow the appropriate procedures. Prescription medications should be in a container that has been labeled by the physician or pharmacist. Over-the-counter medication should be stored in its original package. All medications should be stored according to the directions on the containers or as directed by health care professionals. Some may require refrigeration, while others may not. If a child has severe allergies and might go into anaphylactic shock, they may be prescribed an epinephrine auto-injector (EpiPen, etc.). Keep the auto-injector available at all times, including field trips and walks to the park.