Know

孩子们将以各种需求输入您的护理。必须准备所有计划为过敏，哮喘，糖尿病，健康障碍，身体残疾等儿童提供服务。本课程将帮助您遵循满足这些儿童需求的计划。它还包括解决共同健康问题的策略。

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。此护理计划由初级保健提供者和家庭开发。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。

A care plan typically includes information like:

• The child's diagnosis or diagnoses
• 初级保健提供商的联系方式（医生）
• Medications along with the schedule in which the medicine should be given
• 可根据需要提供的药物以及有关令人担保药物的迹象和症状的明确指示
• 施用药物的程序
• Allergies
• Modifications necessary for the child (diet, activity, environment, behavioral, what to avoid--for example, peanuts, etc.)
• Symptoms to look for
• Emergency response plan
• Special training you might need to work with the child

Source: Caring for Our Children (3rd ed., 2015)

It may be helpful in some cases for you or your program to communicate with the family and the child's primary care provider. Remember, any communication and information gained is confidential and protected by the Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act (HIPAA). Be familiar with these regulations and ask for help if you need it; refer to your program's guidelines and policies regarding who should talk with the child's primary care provider. A health care consultant can be a good resource.

Common Health Care Needs

婴儿和幼儿中的一些最常见的医疗保健需求是过敏性和哮喘。以下信息为您提供了每种医疗保健需求的概述，观看什么，以及支持这些需求的方法。

Allergies

Allergies are one of the most common health care needs in children. Allergies cause a wide variety of symptoms and include an even wider set of causes. According to the American Academy of Pediatrics (AAP), allergies are "reactions that are usually caused by an overactive immune system. These reactions can occur in a variety of organs in the body, resulting in diseases such as asthma, hay fever and eczema. During an allergic reaction, the immune system overreacts and goes into action against a normally harmless substance, such as pollen or animal dander. These allergy-provoking substances are called allergens." As an infant or toddler caregiver, you should be aware of allergens that children in your care have, their common symptoms and reactions to these allergens, and what you can do to make your classroom allergy-friendly.

过敏可能难以诊断，可以在任何年龄发生。一个孩子可能在1岁时没有任何过敏症状，但到3岁以上，他们可以产生严重的过敏。此外，对于婴儿和幼儿，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。这就是为什么监测您在护理中儿童的健康是重要的。如果您有疑虑，孩子可能有过敏，请将其引起教练，培训师或管理员的注意。

Food Allergies

Food allergies are on the rise (Centers for Disease Control and Prevention, 2013). According to the American Academy of Pediatrics, 8 percent of children under the age of 18 have a food allergy or multiple food allergies. This number equates to roughly 6 million children in the U.S. (AAP, 2011). Various proteins, harmless to people without allergies, can trigger serious reactions in people with food allergies. The reactions can range from mild to severe, including death. Allergic reactions usually happen shortly after the food is eaten.

最近的科学和医学进步已经提供了技术诊断食物过敏，更容易且精确地诊断食物过敏。我们现在知道许多孩子患有食物过敏，其中一些可能是严重的，甚至危及生命。例如，我们已经看到了花生过敏的儿童增加，因此整个教室和护理环境已经成为peanut freezones in an effort to prevent serious allergic reactions.

Obviously infants cannot communicate about food allergies, and it is likely most toddlers are not fully aware of food allergies they have, or may not be able to communicate about it; most would not know what foods they can and cannot eat. If is therefore important for you to know if any infants and toddlers in your care have food allergies. A list of documented allergies should be posted in your program. Stay vigilant at mealtimes to ensure children are not exposed to foods that contain known allergens. If there is an infant or toddler with a severe allergy in your care, you, a coach, trainer, or administrator, and perhaps a nurse or health aid, 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
• 恶心，呕吐和腹泻
• Lightheadedness, and loss of consciousness

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。如果孩子有瘙痒皮疹，喉咙肿胀，并且血压低，它们可能有过敏反应，并要求立即医疗。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。

While there are more than 160 types of foods that can cause an allergic response in sensitive individuals, these eight foods account for 90 percent of food allergy reactions:

• Milk
• Eggs
• Fish
• Crustacean shellfish (e.g. crab, lobster, shrimp)
• 树坚果（例如，杏仁，核桃，山核桃）
• 花生
• Wheat
• Soybeans

此主题将更详细地探讨儿童保育食品服务的七节课程course.

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:

• Dust mites
• Animals or animal dander
• Mold
• Pollen (trees, grasses, weeds, flowers)

如果你怀疑一个孩子在你的关心have an undiagnosed allergy, talk with your coach, trainer, or administrator and 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 program, the symptoms may not be as noticeable at home.

请注意，有些孩子可能会有动物过敏。某些课堂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 - 超过600万岁以下（2018年CDC）。随着哮喘患者的数量持续上升，可以诊断和治疗疾病的更准确的方法。哮喘可以在任何年龄开始;然而，大多数儿童首先由5岁开始发展症状（克利夫兰诊所，2013年）。美国儿科医生协会将哮喘定义为患有空气到肺部的管的慢性呼吸系统疾病。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）。

Asthma can be difficult to diagnose. Although the airways are always irritated and inflamed, the symptoms are not always present, but are usually sporadic: sometimes they occur often, but at other times there may be long periods between symptoms. Asthma is often mistaken for other health problems, such as respiratory infection, pneumonia, bronchitis, or a chronic cough. For these reasons, it is important that families and caregivers be alert to the possibility of asthma and seek help if they see any of the following symptoms:

• 喘息
• Regular coughing
• Tight feeling in chest
• Shortness of breath

哮喘发作

哮喘袭击对任何人来说都是可怕的体验，但他们对孩子们特别令人恐惧。诊断患有哮喘的孩子可能会教授策略来应对攻击，并且可能被规定的药物和设备，以帮助孩子吸入药物。重要的是你知道如何应对哮喘袭击以及如何安慰害怕的孩子。如果发生哮喘发作，请确保您知道并遵循孩子的护理计划。如果孩子在您的照顾时具有第一个哮喘攻击，请立即寻求紧急医疗。尽力保持孩子平静，并鼓励他们慢慢呼吸。

See

This video will provide general information about what you might encounter in caring for infants’ and toddlers’ special health care needs.

特殊医疗保健需求

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Allergies to Pets or Food

Infants and toddlers may come into your program with allergies or allergies may be identified after they start in the program. Either way, it's essential that you talk with children's families to understand their child's individual health care needs. Do not assume infants and toddlers with similar allergies can be treated the same way. Infants' and toddlers' allergies are unique; the same allergy may present different symptoms in different children. As with all special health needs, allergies require that each child has their own care plan. This plan should include written information about the foods or animals the child is allergic to, a written treatment plan, a training plan for staff, and a plan for storing any necessary medicine. The child's allergies should be clearly and prominently posted in the classroom.

If an allergic reaction occurs while the child is at the program, you should administer the prescribed medicine right away, contact the family, contact emergency medical services if necessary, and encourage the family to contact their primary care provider. Be sure to take a copy of the plan, any medication, and a cell phone with you whenever the child leaves the building on a field trip.

Caring for Less Common Health Needs: Medical Procedures

Occasionally, children with more serious medical needs may enter your classroom. Their medical needs might include tube feedings, catheterization, suctioning, or checking blood sugars. In these cases, a care plan must be in place from the child's primary care provider. If staff are expected to perform the procedures (and if this is acceptable under state law), the plan must include guidelines for training staff in the procedure. If you feel that the procedure is beyond your expertise or training, talk to your coach, trainer, or administrator to get the help you need.

施用药物

Providing medication to a child is a serious event. You must only do so by following your program's policy regarding a child's individual care plan. Follow these Rights to prevent mistakes and accidents:

任何药物或医疗设备应安全地存放在课堂，办公室或护士办公室。处方药物应该是由医生或药剂师标记的容器。反柜中的药物应存放在原始包装中。所有药物应根据容器上的方向或按照医疗保健专业人员指示储存。有些可能需要制冷，而其他人可能不会。如果孩子有严重的过敏，并且可能进入过敏性休克，它们可能会规定肾上腺素自动注射器（Epipen等）。保持自动注射器始终可用，包括现场旅行。