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认识到有必要规划有特殊医疗保健需求的儿童需求，如哮喘和过敏。
描述您的计划关于药物和个人护理计划的政策。
Provide a healthy environment for all children by following procedures related to allergies, medication, and care plans.

学

Know

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.

Each child who enters the program with an identified health care need should have an individual care plan in place. This care plan is developed by a primary care provider and the family. It will give you information about how to care for the child and signs or symptoms to watch for. It is your job to work with the family to put the plan in place.

护理计划通常包括以下信息：

孩子的诊断或诊断
Contact information for the primary care provider (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
Procedures for administering medications
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

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.

常见的医疗保健需求

Some of the most common health care needs among preschool children are allergies and asthma. The following information provides an overview of each health care need, what to watch for, and ways to support children with these needs.

Allergies

Allergies are one of the most common health care needs in children. Allergies can 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 a preschool teacher, 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.

过敏可能很难诊断和可以开发elop at any age. A child may not have any allergy symptoms at age 3, but by age 5 they could develop a severe allergy. This is why it is important to monitor the health of the children in your care. If you have concerns that a child may have an allergy, bring it to the attention of your coach, trainer, or administrator.

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. That is 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.

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 classrooms and care environments have becomepeanut freezones in an effort to prevent serious allergic reactions.

虽然一些学龄前儿童可能会意识万博体育全站app到自己的食物过敏和他们必须采取的预防措施，但并非所有学龄前儿童都会充分了解它的意思，或者他们可以且不能吃的食物。因此，您要知道您的护理中的学龄前儿童是否有食物过敏症是很重要的。万博体育全站app记录过敏列表应在您的计划中发布。保持警惕，以确保儿童没有暴露于含有已知过敏原的食物。如果您的护理，您，教练，培训万博体育全站app师或管理员，以及护士或卫生援助，应与家庭讨论任何药物或卫生援助，讨论任何药物或卫生援助。

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

If the symptoms are severe or if several areas of the body are affected, the reaction could be life-threatening. If the child has an itchy rash, swelling of the throat, and low blood pressure, they likely have anaphylaxis and require immediate medical attention. If you notice that a child is having an allergic reaction that is severe or out of the ordinary, seek immediate emergency medical attention.

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:

牛奶
Eggs
鱼
Crustacean shellfish (e.g. crab, lobster, shrimp)
Tree nuts (e.g., almonds, walnuts, pecans)
Peanuts
小麦
Soybeans

This topic is explored in greater detail inLesson Seven of the Essentials in Child Care Food Service course。

Non-Food Allergies

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
Mold
Pollen (trees, grasses, weeds, flowers)

If you suspect that a preschool child in your care may 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，一些学龄前儿童可能有动物过敏。万博体育全站app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，超过2600万美国人遭受哮喘 - 超过600万岁以下的人数不到18岁（CDC，2018）。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，大多数哮喘患有5岁的哮喘发育症状（克利夫兰诊所，2013年）。美国的儿科协会将哮喘定义为携带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:

Wheezing
Regular coughing
Tight feeling in chest
Shortness of breath

Asthma Attacks

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。诊断出哮喘的孩子可能会教授应对攻击的策略，并且可能规定吸入器。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有第一次哮喘攻击，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。

看

Specific policies for caring for children with health needs will vary by program and from child to child. This video provides general information about what you might encounter regarding preschool children's special health care needs.

Special Health Care Needs

Each child is different, but it is important to prepare yourself for all health needs you might encounter

Do

Allergies to Pets or Food

When a child with food or other allergies enters your classroom, you must keep the child healthy and safe. 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 staff, and a plan for storing any medicine. The child's allergies should be clearly and prominently posted in the classroom.

如果在儿童在该计划时发生过敏反应，则应立即管理规定的药物，联系家庭，如果有必要，请联系紧急医疗服务，并鼓励家庭联系他们的初级保健提供者。每当孩子在实地考察中留下建筑物时，请务必拿一份计划，任何药物和手机。

照顾不太常见的健康需求：医疗程序

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.

Administering Medication

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:

Seven Rights of Administering Medicine

Right Medication.Staff administering the medication should check the medication against the signed form to ensure that the name of the medication on the bottle or package matches that exactly on the signed form.每一次the medication is administered, this should be checked. The medication should be kept in its original container。
右孩子。During certain seasons of the year when multiple children may need medication or when the program has several children enrolled who need medication support (such as for diabetes, asthma, or attention deficit hyperactivity disorder), the risk is increased for improper medication administration. Forms and medication need to be checked to ensure that the right childis receiving the medication. If administration is conducted by staff not directly working in the classroom, this is even more crucial.
Right Dose.Confirmation needs to be made that the right dose has been measured. An excellent way to double check this point is to use the medication spoon dispensed with the medication by the pharmacy. Medication administration is not the place for guesswork. Any questions should be referred back to the family for clarification.
Right Time.Timing of the medication should be clearly written on the medication itself and on the signed form. Additionally, staff needs to confirm with families when the child arrives as to when the last dose of medication was administered as well as when the next one is due. This information should be documented according to program policy and practice. Likewise, when the child is picked up by the family, staff should provide written documentation of medication administration.
Right Route.Medication can be delivered in a number of ways; usually the medication to be delivered by programs is through oral dispensing or through an inhaler. Confirmation of method should be written on the medication itself as well as on the signed form.
正确的原因。每一次medication is given, the person administering it should assure that the medication is begin given for the right reason (e.g., Tylenol for teething pain, breathing treatment for asthma attack). Consulting the health care plan for the appropriate symptoms can help ensure that the medication is given for the correct reason(s).
正确的文件。每次孩子服用药物,它hould be recorded. The staff member who administered the medication should document the administration immediately each and every time after they have provided a dose (after washing hands). This is an incredibly critical step. Without proper documentation, another staff member or the child's family member may not appropriately provide the next dose of medication (e.g., they may provide the next dose too quickly which could cause seriously health implications for the child).

Note that some states use the first 5 Rights (right child, right medication, right dose, right time, right route) and some states use 7 Rights, also known as “5 Rights PLUS” which include the last two rights (right reason and right documentation). Check with your coach, trainer, or administrator to be sure you know which set of medication administration rights are in use at your program. If any of these Rights have not been met, then it is considered amedication error, must be documented, and the family notified.You can read more on these rights of medication administration by reviewing the resource,Information from the American Academy of Pediatrics on Medication Administration其中位于学习活动部分中。

Any medication or medical equipment should be safely stored in the classroom, office, or nurse's office. 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.

Information from the American Academy of Pediatrics on Medication Administration

Understand the rationale and considerations of 5 of the medication administration rights

7.Rights of Medication Administration

Follow the Rights of Medication Administration in your program

Explore

It is important to identify resources in your own program to meet children’s special health needs. Read the scenario in the遇见艾登activity, and write your answers in the space provided. Then talk to your trainer, coach, or administrator about how you would answer the questions as they pertain to your program.

遇见艾登

考虑如何支持发展新的健康问题的儿童

Required：Complete and review this document with your trainer, coach, or administrator

Apply

In this section you will find two documents that you can use as templates for your own work: a具有特殊健康需求的儿童的护理计划and anInformation Exchange FOrm for Children with Health Concerns。Use these resources as you learn more about the forms required in your workplace.

你可以比较附加的文件和通知ation that already exists in your program related to children’s health care needs. Your program’s Nurse should have a Care Plan Template developed and in use. Review this existing paperwork to ensure you have all required information in order to provide appropriate services and accommodations for children with special health needs.

具有特殊健康需求的儿童的护理计划

Appendix O from Caring for Our Children: make sure a health care provider has completed this special health needs care plan

对儿童健康信息交换让步rns Form

Facilitate information exchange with health care providers regarding children with health concerns

Glossary

Term	Description
Anaphylaxis	极端，往往危及生命，过敏反应。反应严重，涉及全身。除非及时治疗，除非，过敏反应可导致：阻挡气道;心脏骤停（没有心跳）;呼吸逮捕（没有呼吸）;或休克。（MedlinePlus）
Care plan	A plan developed by a child’s doctor and family. It describes the child’s health care needs and how those should be cared for at school
Students with special health care needs	“Those who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally” (Caring for Our Children, 2015)

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学

Know

常见的医疗保健需求

Allergies

Food Allergies

Non-Food Allergies

Asthma

Asthma Attacks

看

Special Health Care Needs

Do

Allergies to Pets or Food

照顾不太常见的健康需求：医疗程序

Administering Medication

Seven Rights of Administering Medicine

Information from the American Academy of Pediatrics on Medication Administration

7.Rights of Medication Administration

Explore

遇见艾登

Apply

具有特殊健康需求的儿童的护理计划

对儿童健康信息交换让步rns Form

Glossary

证明