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  #21  
Old 31 July 2013, 05:17 PM
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Originally Posted by Little Pink Pill View Post
A father who was also a doctor.
Not every doctor is trained* in emergency treatment, and the panic of having it be your own kid could easily make it harder to follow what they do know even if they do remember it.

*Ok I'm sure they are trained in medical school to some degree, but whether they really 'know' or not is another story. We have ACLS class with MDs sometimes and while they are very knowledgable they rarely know what to do in an emergency situation, even a mock one.
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  #22  
Old 31 July 2013, 05:50 PM
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I've seen what you're talking about (it was scary), but a dad who is a doctor is still better equipped to make emergency medical decisions than a dad who is, say, an insurance broker.

And this is pure assumption on my part, but I'd be willing to give him the benefit of the doubt when it comes to how prepared he was to handle his child's allergic reaction. Even parents who aren't medical personnel are usually pretty well read on their own kids' conditions, at least the ones I know personally, and all have emergency plans in place.


ETA- Having said that, now I'm wondering if he had an intubation kit, or if her dr didn't think it was necessary, or if it just happened too fast.

Last edited by Little Pink Pill; 31 July 2013 at 06:12 PM.
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  #23  
Old 31 July 2013, 06:24 PM
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Originally Posted by Alarm View Post
ETA: and if it's more of a "campground" than a camp, then you are right, it's on the parents, but then, why did the parents not bring their own snacks, like I've seen many parents of alleergic kids do?
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Originally Posted by Beachlife! View Post
I think you are missing the part where it was a family camp. The parents weren't turning their kids over to the camp. They were all living there together.

The reason I asked about the ingredients is because there are people allergic to much more than just peanuts with similar life threatening effects.
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Originally Posted by Beachlife! View Post
My point was that a family camp is probably not asking for medical forms for the kids present when their parents are there the whole time too.

I don't think posting ingredients is such a big deal, though isn't there still an issue of cross contamination in the kitchen? My guess would be that all three types of rice crispy treats were made in the same place at close to the same time.
I addresed the idea that it's a familly camp in my previous post.

I also have a niece with severe allergies. She has lost many of them but at one time, she had severe allergies to milk, eggs, gluten, peanuts, tree nuts and shellfish. Her parents never travelled anywhere without bringing her own food.

I don't think it was an issue of cross contamination, in this case, because the girl clearly stated to her mother that the treat "tasted of peanuts". ( I don't know how she would know what peanuts taste like, though, given her allergy.) The mother tasted it too and said it tasted like peanuts.
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  #24  
Old 31 July 2013, 09:35 PM
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My daughter had food challenges to determine if her allergies had diminished. At the allergist's office which is in a children's hospital they would give her gradually larger amounts of the food in question. She was on the third or forth dose of peanuts before she had a mild reaction so she had some idea of what peanuts taste like. Also, other nut butters taste similar enough. (DD eventually passed the challenge for peanuts and my food world changed a lot.)
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  #25  
Old 31 July 2013, 09:36 PM
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Originally Posted by Beachlife! View Post
The reason I asked about the ingredients is because there are people allergic to much more than just peanuts with similar life threatening effects.
Non-peanut allergies are all too often treated with something between halfhearted dismissal and complete disbelief. I'm extremely bitter about it.

For most of my life I had a strong allergic reaction to tomatoes, both cooked and raw, and when I was a child I wound up in the ER more than once before my parents found out what it was. The second time I was brought in my ambulance, covered in hives and having extreme difficulty breathing, the emergency room staff recognized it as a severe allergy. This was in back in '84 or '85. The tomato allergy, and several more minor ones, were confirmed by a specialist shortly after. I recall having my entire back covered in little injections, dozens of them, when they were more or less throwing darts at the board and seeing what stuck and got a reaction. The doctor told my mother they normally did this test on a patient's arm, but I was such a little kid they needed my back for more room. My father bribed me with a new toy every time we had to go back, on the promise that I would be well behaved and not cry. I usually wound up sobbing anyway. I had to be about six or seven by the time they were done with the allergy shots, but either it wasn't as effective back in the 80s, or my immune system was just not having it, because the tomato reaction landed me back in the ER when I was about ten (and old enough to be keenly aware of what not being able to breath right meant), and shortly after my family lost our health insurance. So I went through life obsessively reading labels, turning down shared foods, and generally being terrified that if I slipped up I'd wind up in the hospital again - or dead. I was taught what dead really meant from a very young age. In my mid-20s I had health insurance again, and one of the first things I did was have my allergies retested, which was a much less horrifying experience 15 years later. I had blood drawn, and that came back negative, and then I had a skin test, and that came back negative, and then I sat in a room with a nurse, who had emergency meds ready and on the counter (I was also assured that an ambulance would be there in a heart beat if anything even started to go sideways) and bit into a tomato. My hands were shaking. I couldn't even do it at first. It was exactly how I would have felt if they told me to take a swig of drain cleaner. Every instinct in my body screamed this is poison. You will die. You will never see your nieces grow up! That poor woman, who had been bantering with me not 20 minutes earlier as she took my vitals, assured me that fear was normal. I have no idea at what point my immune system decided it had more important shit to do, because there was no reaction. Not a single hive. Not a single off rhythm breath or heart beat. Just - nothing. It was just a tomato.

In the months and years that followed I was assaulted with a sea of "I told you so!" from people were convinced I was never had an allergy at all, because hey, it's not peanuts. This included my own brother, who was at the hospital with me when I had the reaction around 10yo. He was a teenager at the time. Almost every server I mentioned it to, or asked about tomatoes being in a food, would either be flippant about it, fail to answer my question at all, or make the innocent (but potentially deadly) mistake of not checking everything (such as a sauce). Even people on this very forum, in another thread about life threatening allergies, flat-out dismissed my claim of being allergic to tomatoes. More than one poster likened me to those who claim to have an allergy to something, but they just don't like the taste of it, and accused me and 'those like me' of making things harder for people with real allergies. You know, like peanuts.

So my extremely bitter, but well justified response is that people need to take a step back and admit that life-threatening non-peanut allergies exist, before we can ever hope to be treated with the same respect as those with more common allergies or other medical conditions. In the mean time, let's hope no one dies because someone thought they were "just faking it".
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  #26  
Old 31 July 2013, 09:57 PM
Aud 1 Aud 1 is offline
 
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Hugs Kallah. I know what you mean. We're still not out of the woods either since DD is still allergic to eggs. It is occasionally difficult to get people to care but egg at least doesn't seem to be in too much random stuff or involved in cross contamination. Herself had trouble with tomatoes for a while too. It was only in sauce not fresh so people thought we were making it all up.

Your telling of eating a tomato reminded me of the beginning of the last round of food challenges. The nurse handed DD the cup of pudding that contained peanut. She looks at me and asks as she often did with unfamiliar food "Is this Little_Aud safe?" I had to say "No, that's the point." and explained a bit more. She just looked at me like I was insane. She eventually ate the stuff but, damn, how much trust do you have to have to eat the poison because mom tells you too.
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  #27  
Old 31 July 2013, 10:35 PM
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Wow, Aud.

DD had the allergy test done on her back when she was pretty young. It was horrible. No food allergies, fortunately. Plenty of animal allergies, but fortunately none so severe she can't manage the symptoms. She loves animals -- it would have been very difficult to keep her away from them, and hard on her emotional well-being, I think.
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  #28  
Old 31 July 2013, 11:44 PM
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I'm allergic to viruses--as in, actually allergic, and sometimes exposure, particularly in vaccine form, will provoke anaphylactic shock. This is not so much an allergy as a wonky immune system, but the treatment is the same. I've had extensive testing, too.

Of course many people will believe I just don't like needles.
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  #29  
Old 01 August 2013, 12:44 AM
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Quote:
Originally Posted by Lainie View Post
Wow, Aud.

DD had the allergy test done on her back when she was pretty young. It was horrible. No food allergies, fortunately. Plenty of animal allergies, but fortunately none so severe she can't manage the symptoms. She loves animals -- it would have been very difficult to keep her away from them, and hard on her emotional well-being, I think.
I was 5. I still remember it.
They do still use your back in some cases - I had a very bad reaction to Micropore tape and had to go to a dermatologist to figure out which ingredients were the culprits. I had each of the ingredients in a patch on my back - the whole thing covered all my upper back - for several days and then I came back and found out I was allergic to nickel and cobalt. I can't have anything with mineral oil or paraffin (because mineral oil is paraffium liquidum). The skin reaction has become so severe that having it on my face long enough to wax my eyebrows results in red, puffy, burned looking skin, to say nothing of when I ingest it. It's in some pills and candies, as well as a lot of lip balms, moisturizers, and just about every Olay bath product, for example.
For a while they thought I had Celiac and I had to completely eliminate gluten and that is in just about everything. Fortunately I am just gluten sensitive so I just have to limit it.
I am very grateful that my allergies don't include foods. Nickel, cobalt, mould and latex are quite enough.
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  #30  
Old 01 August 2013, 01:21 AM
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Quote:
Originally Posted by Little Pink Pill View Post
And this is pure assumption on my part, but I'd be willing to give him the benefit of the doubt when it comes to how prepared he was to handle his child's allergic reaction. Even parents who aren't medical personnel are usually pretty well read on their own kids' conditions, at least the ones I know personally, and all have emergency plans in place.
Unfortunately the saying (paraphrased) "No plan survives contact with the enemy" seems to apply to a lot of parents with such plans, I've witnessed it personally.


Don't get me wrong, a lot are great, and most are better than with no plan, but when your kid is laying there dying it can be hard to remember what you are supposed to do clearly.

Your average urologist is going to have stable patients with non-emergent problems, even if he treats emergency patients they are in the confines of a hospital (a familiar location) with lots of support staff).

Obviously I don't know, but I'd suspect he has limited training and experience to deal with situations like this.

Quote:
Originally Posted by Little Pink Pill View Post
ETA- Having said that, now I'm wondering if he had an intubation kit, or if her dr didn't think it was necessary, or if it just happened too fast.
Obviously there is no way to know the degree of training and (continued) experience the father has but I'd be very hesitant to have a urologist intubate anybody.

I mean I know that today we have king airways that make things a lot easier but still, I'd be much more comfortable (if the girl lost consciousness before emergency services arrived, I certainly wouldn't trust your average doctor to RSI a patient) to just have them to high quality CPR (if he can't do that he definitely has no business trying to intubate) and wait until professionals arrive.

I wouldn't want to receive a urithroscopy from a paramedic, but similarly I wouldn't want to get intubated by a urologist, speaking generally.
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  #31  
Old 01 August 2013, 05:32 AM
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I would assume that if he (Dr. Father) had an intubation kit he would know how to use it, you know being a doctor with a kid with a potentially deadly allergy and all. I also think if it came between dying and having a urologist intubate me I'd vote for the urologist.

Lastly, I'm uncomfortable with the tone in this thread that is in a veiled way trying to find blame in the parents. I don't know if the camp has any liability here legal or otherwise, though I would think labeling the food would have been a wise thing to do. I, however, do not think the parents are to blame even a little bit for this child's death. They did everything they could possibly do. It was a tragic accident. People have to live their lives even with risk. It is not a just world and bad things can and do happen to the most good and the most careful people.
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  #32  
Old 01 August 2013, 06:10 AM
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Quote:
Originally Posted by Mickey Blue View Post
Unfortunately the saying (paraphrased) "No plan survives contact with the enemy" seems to apply to a lot of parents with such plans, I've witnessed it personally.
I have no trouble believing that, some people just seem to have a personality that gets overwhelmed in an emergency, with or without a plan, and sometimes with kids all bets are off. I was on the scene of a fatal accident once and a woman ran up, grabbed me by the arm, and cried frantically, "Are there any children? Are the children ok??" I was trying to calm her down and move her away when she yelled, "I'M A PEDIATRICIAN!!"

On the other hand, some parents are intensely focused and clear headed at the time, and fall apart later. Those are the ones people stare at in suspicion like something is wrong because they aren't hysterical. Yet. You really can't win.

Quote:
Obviously I don't know, but I'd suspect he has limited training and experience to deal with situations like this.
As your average urologist, I'm sure you're right. But this was a urologist with a child with a specific medical condition. I'm not arguing that he was as trained as a specialist in this field, but I would be hesitant to assume he wasn't prepared for this, or incapable of handling it, unless I saw direct evidence to the contrary.

However, I imagine that of all the people in the world, his biggest critic and scrutinizer right now is himself.

Last edited by Little Pink Pill; 01 August 2013 at 06:16 AM.
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  #33  
Old 01 August 2013, 09:48 AM
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Originally Posted by Sylvanz View Post
They did everything they could possibly do. It was a tragic accident. People have to live their lives even with risk. It is not a just world and bad things can and do happen to the most good and the most careful people.
ETA: My original post was needlessly inflammatory; I've removed it, but I stand by my basic point. These parents knew the dangers of a peanut allergy, and should have called 911 the moment they knew their daughter had come into contact with peanuts. It's unfortunate that their choice to sit back and observe lead to the death of their daughter, but it doesn't change the fact that they made that choice when they were perfectly capable of calling in emergency services. This man was a doctor. He should have known that severe reactions can come on a delay - and he clearly thought her reaction could be severe, why else would have had three doses of epinephrin? The whole situation is heart breaking, because it (possibly) could have been prevented by a single phone call.

Last edited by Kallah; 01 August 2013 at 10:08 AM.
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  #34  
Old 01 August 2013, 10:53 AM
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Originally Posted by Kallah View Post
he clearly thought her reaction could be severe, why else would have had three doses of epinephrine
Each of them might have carried one epipen.
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  #35  
Old 01 August 2013, 11:15 AM
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If you are prescribed an epipen, you are always supposed to carry two. This is in case one shot doesn't work. So she would have had two if she had one. Someone else might have also had one--we don't know where the third came from, but not necessarily from the family.

It does look like panic, though, if you give three shots in a few minutes. If you've never had a shot of epinephrine...well. I can't even imagine what it might be like to have two. Just one makes me feel like death via a heart attack is coming. (And this medication is extremely risky; even through normal use it can cause permanent heart damage.) As already pointed out, just because he was a doctor doesn't mean he understood allergies or emergency procedures, or that he had a clear enough head at the time to access rational thought anyway.
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  #36  
Old 01 August 2013, 11:38 AM
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Yes. My point was that the fact that there were three epipens used didn't mean that he must have known exactly how severe her reaction might be. They might have come from the family as a whole, or someone else might have contributed as well.
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  #37  
Old 01 August 2013, 02:44 PM
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Quote:
Originally Posted by Aud 1 View Post
Your telling of eating a tomato reminded me of the beginning of the last round of food challenges. The nurse handed DD the cup of pudding that contained peanut. She looks at me and asks as she often did with unfamiliar food "Is this Little_Aud safe?" I had to say "No, that's the point." and explained a bit more. She just looked at me like I was insane. She eventually ate the stuff but, damn, how much trust do you have to have to eat the poison because mom tells you too.
My niece is 4 and her mom found out she's no longer allergic to peanuts because she asked her mom for some peanut butter and when my SIL said "No, honey, you're allergic remember" my niece replied "but grampa gave me some and I'm ok."



Great baby-sitting grampa! what's next, giving her some drano?

ETA: regarding the Epi-pen: As a scout leader and uncle to an allergic child, I was told NOT to administer more than two doses, as there could be fatal circumstances. I did not see any thing written about that and I haven't used my google -fu, so feel free to disprove me!
EETA:
Quote:
Physicians may determine that a single dose of epinephrine may not be enough to reverse the symptoms of a severe allergic reaction. As such, your healthcare professional may prescribe more than one EpiPenŽ to have on hand. Epinephrine can be re-injected every 5 to 15 minutes until there is resolution of the severe allergic reaction or signs of adrenaline excess (such as palpitations, tremor, uncomfortable apprehension, and anxiety).
Epipen FAQ

Last edited by Alarm; 01 August 2013 at 03:04 PM.
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  #38  
Old 01 August 2013, 03:00 PM
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Calling 911 might have made a difference, but "sit back and observe" is not, IMO, an accurate description of the parents' choice.
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  #39  
Old 01 August 2013, 03:02 PM
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Yes, Alarm--there could even be fatal consequences for using one, but you weigh that against certain death, and you take your chances. But the risk is VERY high with three.
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  #40  
Old 01 August 2013, 03:29 PM
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Really the problem is you don't know that, you can give CPR effectively and summon help and potentially have this all turned around. A young, otherwise healthy person who has effective CPR done and 911 called ASAP has a much higher chance of survival than one who is overdosed on epinephrine while waiting to call 911.

What I always tell people (regarding serious allergies) is if it is bad enough for you to use your epi-pen you should be dialing 911, simple as that. If it turns out you don't need them I assure you they won't mind and if you do.. Well it's much better to have them on the way than to be calling them after the patient is unconscious.

Quote:
Originally Posted by Sylvanz View Post
I would assume that if he (Dr. Father) had an intubation kit he would know how to use it, you know being a doctor with a kid with a potentially deadly allergy and all.
Maybe, but going to a class now and again on how it's done and actually doing it are very different things. I haven't intubated anybody in almost three years and were I to go back into the field I suspect (And in fact would hope) that they would put me with a more experienced medic until I got a few under my belt, and this is from a person that actually has intubated real people in an emergency setting.

Quote:
I also think if it came between dying and having a urologist intubate me I'd vote for the urologist.
Not me, unless I guess I had the power of foresight and knew I'd definitely die if anything else was/wasn't done. What I'd prefer to be done if I needed similar help and the only person there were your average urologist would be fore them to do CPR with or without rescue breaths and call 911.

Quote:
Originally Posted by Little Pink Pill View Post
As your average urologist, I'm sure you're right. But this was a urologist with a child with a specific medical condition. I'm not arguing that he was as trained as a specialist in this field, but I would be hesitant to assume he wasn't prepared for this, or incapable of handling it, unless I saw direct evidence to the contrary.
See above.


As for blaming the parents.. I don't really, in fact that's the whole point of my post, that just cause he's "a doctor" doesn't mean he would respond flawlessly in an emergency (particularly one involving family) and even if the parents did everything right beforehand in terms of 'having a plan' it doesn't mean there wouldn't be problems.

I think the thing to do, if you are even sort of worried, is to call 911; they can at the very least monitor her for a bit to see how the medication you do give is taking, they have additional medication should it become necessary, and of course if things go south they can perform emergency treatment and transport to a hospital more safely and quickly than you can.

If 911 was not called until much later (from a few sources it's unclear to me) then that was, without a doubt, a bad mistake that may well have cost this kid her life. It also makes me think that, if that is the case, the father has even less training (or is less good at following it) because even for trained medics nearly the first step (when you are 'out in the world', not at work) for a similar emergency is "call 911" (technically I think it's "Summon advanced care" but it means the same thing).

That said, mistakes happen, panic happens, and sometimes bad things simply happen, and the best you can do is learn from them and try to do better should they ever come up again.

It's unclear, from the articles I've found, if anybody is really at fault in a legal or "This is all your fault!" way; it would be better if the food was labeled better perhaps, it would be better if somebody who had a deathly allergy used more caution, and it would be better if the parent's had followed common emergency guidelines more effectively; but life happens.
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