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  #61  
Old 02 August 2013, 10:15 AM
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I'm saying that when you have someone with a peanut allergy, and that person had a peanut product in their mouth, that is the time you throw caution to the wind (especially if you have the magic combination of insurance + money + time, which this family clearly did) and call 911. Instantly. Every time it happens. How come that's so easy for me, a person who doesn't even have an allergy to peanuts, to understand - but a doctor didn't get it?
Kallah, I've been looking online and can't find anything that recommends calling 911 for an asymptomatic allergen encounter. I can find stuff that says 10 Americans a year die from peanut allergy, and 140 from other food allergies. I can find stuff that says call 911 at the first sign of a reaction.
I can't find anything that says peanut allergy is more dangerous than other food allergy in the way you seem to suggest.
Maybe the girl's specialist who was quoted as saying the family did a textbook job knows what he is talking about.
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  #62  
Old 02 August 2013, 11:16 AM
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Originally Posted by Alarm View Post
Now hindsight is always 20/20 and all that... but according to this, the parents should have injected her immediately and called 911 right away.
Not quite. Here's what you quoted, minus the bolding:

Quote:
It is recommended that epinephrine be given at the start of any reaction associated with a known or suspected allergen contact. For people with a history of a severe cardiovascular collapse on exposure to an allergen, the physician may advise that epinephrine be administered immediately after exposure to that allergen, and before any reaction
It says "a physician may advise" injection immediately on exposure, even absent a reaction, for people with a specific history. If the girl didn't have that history, the recommendation in the first sentence would apply: to use the EpiPen "at the start of any reaction."

Quote:
Originally Posted by catty5nutz View Post
I once saw a documentary comparing the state of child health care in various countries. One of the schools featured was Scandinavian - not exactly which country. This school provided lunch for the children, and signs were posted everywhere, listing everything that was in each dish and meal they served. It was rather nanny-statish, but it seemed to work.
It doesn't even sound nanny-statish to me. I've seen the same thing done at supermarket prepared foods bars and work potlucks/chili cookoffs. In a way, it's more empowering than having school officials try to control allergens.
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  #63  
Old 02 August 2013, 12:43 PM
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Yes, I'm not sure where this idea that you're to call 911 the moment an exposure occurs has come from. My child has a peanut allergy and I was never advised by any of her doctors to take that step. Even FARE (Food Allergy Research and Education) recommends exactly what her parents did. Here's an allergy action plan that states the same thing. Her parents are not to blame here. If we want to hand out blame why not place it on the people who put NFBSKing peanut butter in rice krispie treats! Who does that? My own daughter has been tripped up the same way. Stop putting peanut butter in treats people.

This is a classic case of parents never being able to be right. If you are over cautious and request allergens be removed from a child's environment say in a school setting, people whine and cry and ask why you can't teach the child to manage their allergies and why do all the poor little children have to suffer from peanut deprivation. But when tragedy occurs, suddenly you weren't cautious enough.

Here's the truth, these parents did nothing wrong. This was a tragedy. Once the chain of events started there was probably no stopping it, regardless of who was called when. Notice that the info from FARE says that the only way to stop the reaction is with epinephrine. They gave her that. It didn't work. I don't think it would have mattered if they'd called 911 immediately or not. She wasn't responding to the injections, she probably wouldn't have responded to anything else. Sometimes the universe is NFBSKing unfair and there's nothing that we can do to change that.

Gibbie
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  #64  
Old 02 August 2013, 12:58 PM
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I put peanut butter in Rice Krispie treats. They taste much better that way (and everyone else who has tried them has agreed). I usually eat them all myself, but when I give them to others, I always mention the peanut butter. I wouldn't serve them to a large group I couldn't confirm with, though.

Demanding others stop using a tasty, nutritious, cheap ingredient because a very small number of people are allergic is bullcrap as far as I'm concerned. If one has a allergy that is that serious to an extremely commonly eaten product, they shouldn't eat anything they don't specifically know the ingredients of. Stick to pre-packaged snacks or ones made by their parents. It isn't up to the whole world to change their eating habits to protect a select few.
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  #65  
Old 02 August 2013, 01:02 PM
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Of course, in the OP, they were serving the treats to large numbers of people that they didn't "confirm with."

I agree though, that in ordinary circumstances there's nothing wrong with putting peanut butter in your own rice crispies treats.
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  #66  
Old 02 August 2013, 01:50 PM
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I don't expect individuals or this camp to stop using peanut butter But as I've said above, it's not that hard to post ingredients, and in a setting like a camp I think it's a reasonable expectation.
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  #67  
Old 02 August 2013, 01:52 PM
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ETA: I tend to agree that the over reaction to allergy risks in America (and elsewhere) is due to very successful lobbying and not related to the relative risks of food allergies (which again, depending on whom you ask, sit between 10 and 200 deaths per year in the US, in other words a tiny amount), however I don't think it's a big deal to note when there are common allergens or to note if something that presumably is allergy free is prepared in a kitchen that has allergens in it.

That, to me, seems the most fair; not saying "Nobody can have any peanuts at camp cause a tiny fraction of the populous has a medical issue with it and there is an extremely low chance that they could die over it". Listing ingredients, or at least common allergens (at a camp it would be easy to get a list from the campers and list those when appropriate) seems pretty easy and reasonable to me though.

Quote:
Originally Posted by Moku View Post
Kallah, I've been looking online and can't find anything that recommends calling 911 for an asymptomatic allergen encounter.
Maybe not at first, but once you use the epi pen you should be calling 911, in fact a quick google search has the advice of "Call 911" for every link I could find upon using an epi pen.

ETA: More specifically, you should not be using an epi-pen if you are having an asymptomatic encounter, if you are using it then either you are using it for no reason (which is wrong) or you are having a reaction which you feel an epipen is warranted (which means you should be calling 911 right now if you haven't already).

To use it and then 'watch them' is wrong, simply put; the fact that they were fair from emergency aid makes it more wrong.

I was gonna link but just google "Should I call 911 if I use an epi pen" or something like it and you'll find an endless list of citations telling you to.

Quote:
Originally Posted by Gibbie View Post
This is a classic case of parents never being able to be right. If you are over cautious and request allergens be removed from a child's environment say in a school setting, people whine and cry and ask why you can't teach the child to manage their allergies and why do all the poor little children have to suffer from peanut deprivation. But when tragedy occurs, suddenly you weren't cautious enough.
You are talking about two totally different things; one is parents attempting to get their own kids issues special treatment in schools and/or the public disproportionate to the overall risk to society (which is understandable, it's their kid, but they can't expect others to be happy about it).

The other is the parents making what several people, including medical professionals, say is a bad call (and in fairness the OP is vague). Nobody, so far as I can tell, is saying they are bad people (that is just what people who want to change the tone of the discussion are doing), they are just saying they made the wrong decision and it cost them dearly.

You can, in fact, say somebody did something wrong without calling them bad people or blaming them for the issue at large.

Last edited by Mickey Blue; 02 August 2013 at 02:03 PM.
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  #68  
Old 02 August 2013, 02:33 PM
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Quote:
Originally Posted by Mickey Blue View Post
You can, in fact, say somebody did something wrong without calling them bad people or blaming them for the issue at large.
I don't think you can say, and keep saying, that somebody did something wrong when there is clear evidence that this is not in fact the case. That according to experts in the field they handled things in a "textbook manner". Continuing to insist that they were wrong is blaming them IMO and is saying that had they handled things differently their child would be alive today.
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  #69  
Old 02 August 2013, 02:42 PM
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I was referring to not calling 911 when they used the epipen, which the news here suggested they didn't and the article is unclear on.

Also, more generally, saying that if somebody had done something differently their child would be alive today is not the same thing as blaming them, accidents/mistakes happen.

ETA: Also I've been about as clear about my posts being related to calling 911 once using an epipen and that the OP was vague and there were some conflicting issues.
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  #70  
Old 02 August 2013, 03:00 PM
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But 911 was called, the original article stated that paramedics arrived and performed CPR. I've found no other sources that indicate they might not have been called in a timely manner. I've seen lots of people speculate on here, but I don't find a news source that says that. There's no reason to believe they weren't called as soon as her reaction got to be severe and her epi was administered. The original article even quotes her allergist as saying the parents handled it in textbook fashion.

Gibbie
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  #71  
Old 02 August 2013, 03:20 PM
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Like I said, the original article is vague on when exactly they were called (it says they arrived, not when the call went out (they arrived at 1040PM so depending on when she was eating plus twenty minutes that could be right away or not right away) and a TV news segment here (which easily could have gotten the details wrong) suggested otherwise.

A quick look pretty much only finds reprints of this story.

As noted, the information I've been given is, to me, vague. If they waited post-epi to call they were wrong (though as noted I attributed it to a mistake), if they didn't they weren't.
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  #72  
Old 02 August 2013, 03:21 PM
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I'm not going to blame or even second-guess the parents, but FWIW, if I were their daughter's allergist, I'd say that whether I believed it or not, as often as I thought they needed to hear it.
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  #73  
Old 02 August 2013, 03:36 PM
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That's what I was thinking, Lainie. And I am pointing out that, with respect to the epipen (which in this case I do not believe is what killed her or contributed to her death, by the way), they absolutely did not follow the "textbook."

More is not always better, and epinephrine, wonder drug though it is, is not without serious health risks, up to and including cardiac arrest and death. I'd be a little worried about people who are not trained in the use of an epipen deciding more is better because of an article like this one and overdosing some poor soul. Me, maybe. Maybe someone will find my epipens and give me two shots on top of one another, then borrow someone else's and just keep injecting me until the magic happens. I really hope not, but nothing in this article gives any warning about that. And I think it should.
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  #74  
Old 02 August 2013, 04:01 PM
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On the other hand, there's a certain point where someone is clearly dying and won't make it if nothing else is done. In that situation and with paramedics not due to arrive anytime soon, trying one more time with the Epi pen basically can't hurt. After all, they're going to die if you don't.

Now, maybe most people can't tell when a person will die without intervention. But this guy is a doctor, and although he probably doesn't have much training in dealing with emergencies, he does probably have a better idea of when someone is dying than most people.
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  #75  
Old 02 August 2013, 04:05 PM
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How likely is it that a non-trained bystander is going to be able to recognize when someone is clearly dying though? For example, the Heimlich Institute is very careful to emphasize that the maneuver is only to be used when someone is totally unable to breathe. Someone who is gasping for air may sound like they need it to the layperson, but they are still breathing.
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  #76  
Old 02 August 2013, 04:07 PM
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The father was not, medically, a layperson.
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  #77  
Old 02 August 2013, 04:37 PM
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I was speaking to the general situations that Avril was talking about, not the specific situation from the OP.
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  #78  
Old 02 August 2013, 06:56 PM
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I don't know how people can say the parents called 911 too late, when the article does not say when 911 was called and the source for the information in the article is given as "a family friend" who may or may not have reliable information/timelines anyway.
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  #79  
Old 02 August 2013, 08:52 PM
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I was once in my doctor's waiting room when EMTs arrived then walked a person (on oxygen) out to the ambulance. Obviously the doctor - a GP - realized something could be happening which he could not handle. That is, perhaps, the key for any medical professional - to not be dismissive because of their own experience/expertise, realize the potential for great harm, and get the help they need.
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  #80  
Old 03 August 2013, 01:07 AM
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Quote:
Originally Posted by Jahungo View Post
On the other hand, there's a certain point where someone is clearly dying and won't make it if nothing else is done. In that situation and with paramedics not due to arrive anytime soon, trying one more time with the Epi pen basically can't hurt. After all, they're going to die if you don't.

Now, maybe most people can't tell when a person will die without intervention. But this guy is a doctor, and although he probably doesn't have much training in dealing with emergencies, he does probably have a better idea of when someone is dying than most people.
Sorry but this is wrong; even after a person 'dies' you can perform CPR to buy yourself time until advanced care can arrive, overusing a drug in a way that it isn't designed for is not going to make things any easier.

I don't know whether or not the overdose of epi contributed to her death, but it was without question the wrong call, doctor or no.
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