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mikeb

Peanut Allergy

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My son has a mild nut allergy. He is allergic, no doubt about it, but we got off easy:

 

If he eats something with any kind of nuts in it. he doesn't pass out, develop hives or have trouble breathing. He gets kinda quiet - to the point you notice even if you don't know why - and in almost 2 minutes...he will vomit! You can almost set your watch by it.

 

But once he vomits, he is fine. Other than a vomit smell and mortal embarassment on his part.

 

Now, this is from any kind o nut and wether raw , cooked or even a minor ingredient.

 

Incidentally, he is not diagnosed as an asthmatic, but is considered "asthma prone". Meaning if he gets the same cold you or I do, he is more likely to go into pulmonary distress faster than you or I.

 

He also used to have eczema really bad, but is slowly outgrowing it.We still have to put a band-aid over the nickel or brass button or snap on the inside of his pants.

 

He is also alergic to dander and fur. Not irritated, but allergic. His eyes swell up and his chest tightens and sometimes leads to the congestion that is "asthma prone" but not actually asthma.

 

Yes, that does make sense..trust me.

 

Now, I only mentioned those other things because ...in my son's case at least..it is related to the nut allergy.

 

So if you have a scout who is allergic to nuts and you take all the necessary precations - it could still be a total waste if that scout ends up sleeping in the same tent as the scout who's mom has 20 cats, a big ole furry Chow or works in a seafood restaurant. If it's in the scouts house, it can and WILL get onto the scout and everything he touches.

 

Now, my son can wrestle with kids who eats peanuts, but confine them in a close space for a long time...such as sleeping in a tent during the night..can have effects too.

 

 

Now, I am still in the pack and not the troop settimng, but we ask ( repeatedly) our parents to keep and eye out, to notify us and to make sure the scout himself is aware in case we happen to miss something!

 

Afterall, stuff happens sometimes!

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Thanks everyone for all of the great advice and info thus far, you have given me so much more than I expected. Interestingly enough I did a site search for peanut allergy before I started this thread and I found very little on the topic, although from this thread it seems like it is something that a lot of folks are dealing with.

Anyway, from the advice given I think my first step should be finding out the reaction level this boy has. How we go forward is certainly dependant on that.

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Beware the parent who poo poos the idea of any such problem. "one little taste..."

 

We have some friends with which we went to a minor league baseball game. Their boy was 8, ours was 10. Both loved Baseball. We were sitting in the stands behind and beyond first base, about 7 or 8 rows up. Foul ball gets hit toward us, lands in the stands and rolls right up to our feet. Friend's son picks it up happily, and within 30 seconds, his throat starts to close up. The ball had rolled thru some peanut shells on the floor. The parents knew exactly what needed to be done, and he was fine within minutes. But without that knowledge, it might have been diffferent. He only needed a special inhaler.

 

Take it seriously.

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We sort of have a cub like that in our pack. He joined as a bear, allergy did not seem to be much of a factor, but I did know about it. Web 1 year, he started having inconsistent attendance. So, he after coming to the popcorn kickoff, which could have been a problem, he did not come again. Parent called the day of the Christmas party to see if he could come; of course, but no warning was given to the pack to not bring food that might contain peanuts.

 

Certainly, nothing is more important than preserving this scout's life. I'm not medically trained, so I would not be willing to take responsibility for the Epipen, especially now that you guys have informed me that you don't get a 2nd chance.

 

Would it be unfair to require his parent to attend all troop functions so that the responsibility is not on the shoulders of leaders?

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No, it wouldn't be unfair if you don't want it, as the responsibility to act swiftly and correctly to save a life can be a heavy burden to put on someone who doesn't want it. But, why not go get trained yourself? Talk to your council about Red Cross training -- it's my understanding that the Red Cross has partnered with the Boy Scouts to offer training classes at $5/person, if you have 12 or more people who want that training. It's really not difficult. You just take the epipen, then stab the kid in the thigh, basically -- it's designed to be as foolproof as possible. That being said, if the parent is going to hanging around all the time, perhaps see about making them an Assistant Scoutmaster or committee member, or something, just so they are more useful than a bump on the log. Or, maybe you could get a boy first aid/cpr/aed certified and put him in charge of doing that.

 

By the way, I'm pretty sure that I'm allergic to peanuts because I feel my throat swelling shut and my eyes start watering every time I look at my paycheck. ;)

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I second, third and fourth the idea of multiple injectors, especially on campouts where you are more than minutes away from EM help.

 

I daughter always carried two in her school backpack and 4 always went on field trips/overnight trips etc.

 

If you are in a full-blown attack situation, one EpiPen can solve the problem or only last 15 minutes, so if you are off in the deep somewhere, you need more than one. The high-powered anti-histamines (Rx Only) don't come into play until much later (1-3 hrs), after the lungs have had a chance to clear.

 

I would also think that guaranteed communications is a must...most of the camping locations that my Scout attends have no wireless communcations coverage...so adventure type campouts/hikes might have to be limited, unless someone is carrying a radio or sat-phone.

 

The one thing I want to stress the most it that this situation should only be handled by adults. At no time should another Scout be responsible for this issue. The victim will most likely be unconscious (or if he isn't, aware enough to know what needs to be done and how).

 

An improperly administered EpiPen can be lethal in and of itself.

 

 

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The one thing I want to stress the most it that this situation should only be handled by adults.

 

Nah, gotta disagree with this, E61, though I agree with everything else.

 

When yeh have a time-critical emergency response like responding to cardiac arrest, yeh want everybody to be trained, eh? Yeh can't guarantee that an adult or an EMS vehicle is going to be immediately available, so we train everybody, even the scouts, in CPR and AEDs.

 

Same with anaphylaxis and lifesaving treatments like Epi auto injectors. The nearest adult might be in da latrine, eh? Yeh don't want to be in a position where someone is there who could help but was never trained. Epi pens are straightforward for even relatively young lads to use themselves. They aren't hard to train older scouts to assist with,and that's a much better choice than not training a scout and having him improvise or watch his friend die.

 

In an actual emergency, of course, we'd expect the person with the highest level of training and experience to take over. That's probably an adult, but it may very well be a scout. I know a lot of boys who have a higher level of certification than the average adult.

 

Beavah

 

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Absolutely agree with Beavah here (which is something that doesn't happen very often). In my opinion, if you have a Scout in your unit whose allergies require him to carry an EpiPen, then EVERY Scout in your unit should receive some instruction on how to use it. It is not necessary to have any formal medical training or certifications to learn how to appropriately use an EpiPen - the procedure can generally be taught in less than 30 minutes of explanation, demonstration and practice with a training device. It is easy enough for all adults, and probably all Boy Scout aged kids, to understand. While some have correctly pointed out that incorrect usage of an EpiPen can be ineffective or even lethal, this should NOT be a reason to avoid receiving training or to decline to use the device in the event it is truly necessary. Consider the wonderful tool that is a pocket knife - for all the useful things it can do, it too can be ineffective or even lethal if used inappropriately. But, its still a skill we teach to all of our Scouts. Now, consider a tool that is essentially the ONLY thing that can save the life of a Scout having an anaphylactic reaction - wouldn't it be worth learning how to use it correctly? Also, it is essential to use an EpiPen QUICKLY, at the first signs of respiratory symptoms. I'm thinking that if a Scout gets to the point where he is unconscious (a possibility that others have raised), that will be too late for the EpiPen to be effective. Now, ideally the Scout would use the EpiPen himself when he notices he needs it, but another Scout or adult may need to assist if the Scout is too scared, too panicked, or too focused on breathing to use it on himself effectively. So, you can see why it is important have a at least a majority of your unit members familiar with how to use an EpiPen - you definitely don't want to waste time waiting for someone who has been trained to show up, or looking for someone whose not uncomfortable about "taking responsibility" for keeping the kid alive.

 

Now, as far as adult responsibility, I do believe that in the great scheme of things, there are a few responsibilities that lie totally with the unit's adult leadership: namely, ensuring that a majority of the unit's Scouts and adults have received training on the topic, and that the Scout requiring the EpiPen carries it with him at all times while camping with the troop, and carries it in a location where others will know to look for it.(This message has been edited by dScouter15)

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Another issue came to mind....

 

Epipens are fairly fragile devices, I have had cases where they have fired in their storage tube, presumably because they were bashed around a bit. A dropped back pack, shock from a trip/fall on the trail could cause them to fire. The medication itself it a little more heat and light sensitive than other injectables as well.

 

My thoughts on dScouter (and my extension Beavah's) comments...

 

While I'm sure that pure-Scouters believe that it is perfectly acceptable and normal for every Scout in the Troop to learn how to identify when to use an Epipen and how to use it, I am equally sure that there is not a parent of one of these kids that would want a 12-18 year-old to be the person making the call and administering the device.

 

And there's probably not a lot of kids that what 60-100 kids that they see once a week and a few weekends a year to know their medical details to that level. I worked with a gentleman for several years who had this allergy (but to fish) I and one other coworker in the area knew about it... it wasn't something he wanted publicized.

 

Are there emergency situations where such an action by a Scout could be necessary? That is, the adults are dead or incapacitated, the boys are unsupervised, whatever? Ideally, the adults would not have allowed that situation to become reality to begin with.

 

 

 

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E61 - Ideally, it wouldn't be necessary for a 12-18 year old to make a call and administer an EpiPen. It should be that the scout having the reaction that decides to use the EpiPen, with additional trained scouts familiar with its operation to assist him in using it. Assistance might be as simple as saying "Where's your EpiPen? Can you reach it?" to a Scout beginning to have a reaction, or may involve helping the scout get the safety caps off, or positioning it steady and in the right place. You're right, a 12 year old shouldn't be deciding when its time to use Epinephrine on another scout - but he should be prepared to assist a scout in using his own EpiPen when that scout knows he needs it.

 

There are absolutely situations where a Scout may need to assist another Scout, most of them not involving dead or incapacitated adults. Unsupervised patrol hikes and camp outs, for instance, which are approved activities in the Boy Scout program. In some people, an anaphylactic reaction can come on within minutes. So, even if a patrol is hiking even just a mile or two away from the troop base camp, that may not be enough time to run for adult help. If the Scout loses consciousness before the EpiPen is used, it probably won't do any work. Can't hurt at that point, but its less likely to be as effective as it would be early on in the anaphylactic process. Because the BSA encourages Scouting activities where adults are hovering over the youths' shoulders, I feel its that much more important for Scout troops to "be prepared" in this sense.

 

Sure, a scout or his family may not want his medical conditions to be publicized, though I've noticed less hesitation when it comes to severe peanut or food allergies, just because Scouting events offer such a broad spectrum of possibilities for exposure. But, if they don't want that information shared, that's at their own risk. And, that hypothetical possibility is not a good enough reason to withhold training from Scouts, regardless of whether or not they know whether a scout has an allergy or not.

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Kind of an interesting side story from a couple years back:

 

Monday night dinner at camp everyone had gone through the line and was sitting down to eat when the food services director came running out of the kitchen looking for me.

 

"Where is your peanut allergy kid?" she asked, with a little panic in her voice.

 

"Wrong troop. We don't have anyone allergic to peanuts."

 

"Yes you do, Chris or Christopher or something. We been fixing him special meals, but he didn't show up tonight."

 

About that time she recognizes the kid, who is already mostly through with his regular dinner from the serving line.

 

"You shouldn't be eating that," she says, "We have your dinner in the back."

 

"No, this is okay," Christopher says.

 

"No sir," she said sternly. "I don't know for sure that meal doesn't have peanut in it."

 

"It's okay, I'm not really all that allergic."

 

To make a long story not quite so long, I made a bee-line from dinner to the health lodge and pulled Christopher's medical form. No mention of any allergies anywhere, except "peanut allergy" on the check-in sheet. The nurse remember checking Christopher in and says, "Oh yeah, I remember him. He very specifically said he is allergic to peanuts."

 

"But if his parents and doctor didn't put it on the form....." I asked.

 

The nurse shrugged as we both grabbed for the phone to call the boy's parents.

 

Bottom line is the kid is a bit of a hypochondriac. The peanut allergy was totally made up, although one of his sister's friends is very allergic so his family takes all the precautions so the friend can visit their house. I've since suffered through many nights of "stomach aches" and trips to the health lodge with this kid.

 

And we sent flowers to the kitchen staff.

 

No real point here -- and I'm certainly not suggesting you shouldn't believe a kid when he tells you he's allergic -- just an interesting aside.

 

 

 

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Twocub,

 

I gotta say, that story is pretty funny...it reminds me of a kid we had in my troop when I was a youth, but that's a different story for a different time.

 

Nevertheless, I have to agree with Beavah and the others, as far as the Epi-Pen goes. I understand that in most cases, you want an adult to administer it to the Scout. However, say the boys are off playing some kind of game or another and the allergic kid comes in contact with some sort of tree nut (often peanut allergic individuals are usually allergic to tree nuts)? No adults around...what do you do? I seem to be forgetting here...what's that motto thing, "Be what?". I'm not trying to come off as sarcastic and critical, by the way, I'm just saying that there are times when it may be necessary. Hopefully, it won't be...hopefully, you go your entire Scouting tenure without ever having to issue an Epi-Pen. As mikeb said in the original post "Peanut butter, trail mix, energy bars, etc., all staples of scouting", with that in mind its better to have the Scouts know how to use it and not need it...than to have them need it and not know how to use it.

 

Safe Scouting,

 

Ryan

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Update: New scout and dad attended our troop meeting this week, so with an ASM we pulled them aside for a friendly chat about the peanut allergy. It seems that dad and mom are recently separated/divorced and dad isn't very clear on the extent of the allergy! He was generally unable to answer questions on the boy's reaction level to peanut vapor/contact/ingestion, although he did say he has been involved in 3 incidents that required a trip to the hospital. The most recent involved eating chocolate chip cookies made in a factory that also handles peanuts. The boy on the other hand was able to answer all of our questions and it sounds like there is serious trouble only when peanuts are ingested. We told the dad we need a full medical report with painful detail of the peanut allergy. As a side comment I mentioned to the dad that we have a couple of other boys with tree nut allergies and he said his son does too! I told dad that he would likely have to come to all campouts with his son and keep a close eye on him. Dad said he likes to camp and that won't be a problem. I told the boy he would probably have to cook his food separate from his patrol on his own personal gear. He seemed ok with that.

One other thing I almost forgot, I asked if the boy carries Epipens. The answer, "all of the time!" So I asked to see them, "Oh we forgot to bring them tonight." I asked that they remember in the future.

I can't say I'm feeling a lot better about this. We'll see what the doctors report says and go from there.

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There is a lot of general public confusion about this new allergy. I'm one of the confused.

 

How come none of my classmates in elementary school, high school, etc., weren't falling down right and left?

 

Is this something entirely new?

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The rate of peanut allergies in all first world countries is indeed climbing and nobody really knows why. It might be something like polio -- as we introduced more and more hygienic controls in public water supplies, reducing cholera rates, etc., people just weren't getting as many water-borne illnesses and instead of easily contracting a mild form of polio (which would protect against contracting a harsher strain) people were being hit with something their body was completely unprepared for and thus the cleaner America got the worse polio got until the polio vaccine was created.

 

Unfortunately, from what we understand of allergies, you can't create a vaccine for one as it's not really a sickness -- it's like your body already has a super vaccine against the allergen and tries to destroy the allergen as quickly as possible, even when mobilizing to a possible threat so quickly will kill you. It's not a question of giving your body another tool to combat the disease, like a new vaccine would, it's a case of your body just going crazy with the tools it already has. It's believed that our current higher standard of cleanliness is what is causing these peanut allergies (stop using antimicrobial wipes on the counters at home?). Also, try to avoid giving your kids peanut butter until they're four years old.

 

Perhaps a doctor who just had some roasted peanuts as a snack needed to wash his hands better before he tapped on the needle before giving a child a vaccination while in the hospital? I don't know, nobody knows.

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