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  #41  
Old 01 August 2013, 03:31 PM
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Quote:
Originally Posted by Avril View Post
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.
That's not what the literature he quoted says though.
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  #42  
Old 01 August 2013, 03:45 PM
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It's worth noting that (and it's hard to pin down a good source to cite right now) food allergy deaths in the US per year are estimated between 10 and 200 depending on who you ask.. Even assuming it's 200 that makes it already very disproportionate with the level of response and media attention it gets in terms of mandatory safety action.

Don't get me wrong, nobody want's to be (or have their kid be) a statistic and safe practices are always good as is respect for those who do have a problem but 'America' in general is already giving food allergy safety far more care, support, and legal action than any other similarly-risked issue that I can think of (and again, that's assuming the highest realistic estimates are accurate, if the estimate of '10' is correct then that puts it lower than shark attack deaths).
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  #43  
Old 01 August 2013, 04:26 PM
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Originally Posted by Beachlife! View Post
That's not what the literature he quoted says though.
It says you administer it ever 5-15 minutes, as directed by your physician, until the symptoms abate, or you show sign of adrenaline overdose...

the chance for which would probably increase, the more doses you inject.

ETA:
The site for Epi-pen also says:

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
and this:
Quote:
After using EpiPenŽ, seek medical attention immediately. Take the used EpiPenŽ with you to the nearest Emergency Department and give it to the Emergency Department staff for proper disposal. You can also bring any used EpiPenŽ Auto-Injectors to your pharmacy.
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.
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  #44  
Old 01 August 2013, 04:32 PM
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Quote:
Originally Posted by Beachlife! View Post
That's not what the literature he quoted says though.
He added that after I responded (as you see it's an edit), but beyond this, what he said doesn't contradict what I said.

Yes, you can administer more, if you wait to let it take effect and the person isn't already experiencing overdose symptoms. It says the father administered three doses within the span of a few minutes. That's not enough time to be sure that it's not going to work or that the epinephrine isn't itself causing problems.

The instructions one gets with every epipen are clear about calling 911 the moment you have to use it, not only because of the possibility of still needing help for the allergy, but also because you may need medical attention to deal with the effects of epinephrine.
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  #45  
Old 01 August 2013, 04:55 PM
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The article never mentions when the ambulance was called but looking on Google, the nearest ambulances were South Lake Tahoe (22 miles or so) and Camino (35 miles) on a dark mountain highway. So drive time alone was around 30 minutes just to get to camp.
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  #46  
Old 01 August 2013, 05:45 PM
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Like I said it's hard to tell, depending on how you read it it may have been called right away or after the dad monitored his daughter for a while.
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  #47  
Old 01 August 2013, 06:01 PM
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Quote:
Originally Posted by Kallah View Post
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.
Aside from the fact that paramedics were about 30 minutes away and we don't know when the 911 call was made, according to the article:

Quote:
Natalie's Sutter Medical Group allergist, Dr. Mark Grijnsztein, spoke with the family Monday, and said they responded to the incident in textbook fashion.

"The family did all the right things," he said. "The child ate peanut butter and looked fine, and she had no history of such a severe reaction. …

"I deal with families who don't even have epinephrine pens and teens who don't have the pens on them. They'll come rushing in to me because they have hives.

"This family was as prepared and knowledgeable as a family can be. It's a tragic scenario."
If someone knowledgeable in the field feels the family responded appropriately I'm wondering what information some in this thread think they have that demonstrates that they did not.
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  #48  
Old 01 August 2013, 06:12 PM
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If the girl has never had such severe reactions before, then, of course what happened was accidental and unpredictable.

I still stand by my statement that the kitchen that prepared the food could have posted a simple sign that says "may contain peanuts" on the squares with peanut products.

That's the simplest precaution anyone can take and it works for people with major allergies or minor ones. If they disregard the sign, it's on them, not on the camp.
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  #49  
Old 01 August 2013, 06:17 PM
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Quote:
Originally Posted by Alarm View Post

I still stand by my statement that the kitchen that prepared the food could have posted a simple sign that says "may contain peanuts" on the squares with peanut products.
Completely agree, I'm not going to say the camp was at fault in any legal sense of the word but it's just common sense IMO to label food or do as many restaurants do nowadays simply post a general "may have come into contact with nuts". And don't dim the lights so no one could read the ingredients or warning signs in the first place!
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  #50  
Old 01 August 2013, 06:47 PM
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I would think the sign should say "contains peanuts" as there was no "may" about it.
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  #51  
Old 01 August 2013, 06:49 PM
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The items that contained peanuts should have been labeled "contains peanuts." All items prepared in the same kitchen should have been labeled "may have come into contact with peanuts."
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  #52  
Old 01 August 2013, 07:06 PM
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Quote:
Originally Posted by erwins View Post
I would think the sign should say "contains peanuts" as there was no "may" about it.
You probably need both. "Contains peanuts" for dishes made with peanuts and "may contain peanuts" for pretty much everything else made in the same kitchen.
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  #53  
Old 01 August 2013, 09:13 PM
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Quote:
Originally Posted by Sue View Post
If someone knowledgeable in the field feels the family responded appropriately I'm wondering what information some in this thread think they have that demonstrates that they did not.
Perhaps the article was worded poorly then, because it read (to me) as if the ambulance was not called until after the reaction was present, which was sadly much too late. It also doesn't take a trained medical professional to know that you do not screw around with peanut allergies, ever. There's a well documented, high chance that even in a patient who never had a life threatening reaction before, that this time things will escalate. What did they have to lose by calling 911 the moment they knew their daughter had a peanut product in her mouth? The father's a doctor; they must have both health insurance and the funds for a trip to the ER in case something wasn't covered. There are times when "better safe than sorry" applies, and peanut allergies are one of them because the price is just too damn high.

That said, if it turns out the ambulance was called immediately after finding out she had a peanut product in her mouth, my point is moot.
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  #54  
Old 02 August 2013, 02:46 AM
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However, it does take a medical specialist who was completely informed of all actions taken to decide if said actions were appropriate. As he went to medical school and all, not to mention this girl's personal physician, I'll side with him. I'm sorry I just can't get on the "These parents are stupid and at fault" wagon. This is particularly so since I'm not a medical expert nor was I present during the incident, nor was I one of the people involved with this poor kid's care. We are again experiencing "Just World" phenomenon here.
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  #55  
Old 02 August 2013, 03:03 AM
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As I've noted a few times now I am giving the guy the benefit of the doubt, however being a doctor, particularly a doctor not trained in emergency medicine, doesn't make one anything approaching an expert or specialist in the subject of emergency medicine.

This guy may be an expert urologist, he's probably a good go to person for UTIs, and the like, he may even be trained in some of the more emergent issues, but until proven otherwise he probably don't know a whole lot more than the average Joe parent of a kid with allergies about emergency management of a patient.

In fact, the fact that he's a doctor may even have made it worse as he may have had a false sense of security about his ability to manage such a situation.

That said, as noted, there are lots of factors at play here.
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  #56  
Old 02 August 2013, 03:09 AM
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Little Pink Pill Little Pink Pill is offline
 
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I could be wrong, Mickey, but I think Sylvanz was referring to the allergist Sue quoted in post #47.
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  #57  
Old 02 August 2013, 03:09 AM
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Quote:
Originally Posted by Sylvanz View Post
...I'm sorry I just can't get on the "These parents are stupid and at fault" wagon...
Who is on that wagon?
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  #58  
Old 02 August 2013, 03:15 AM
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Perhaps a bit hyperbole but Kallah seems to be riding that wagon quite securely. YMMV of course.
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  #59  
Old 02 August 2013, 05:34 AM
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Quote:
Originally Posted by Sylvanz View Post
I'm sorry I just can't get on the "These parents are stupid and at fault" wagon.
The parents weren't stupid, they're just people who made a very poor choice. They took what sounds like a very well educated risk, gambled with their daughter's life, and lost. That doesn't make them stupid - but it does put them partially at fault. There was something as easy as making a phone call that could have dramatically changed the outcome of the situation. The notion that the victim(s) is never at fault a popular one in these forums, and while that might be the case in many, or even most situations, this just isn't one of them. All they had to do was call 911 the moment the mother confirmed it was peanuts (or, more cautious yet) the moment the daughter reported having had the allergen in her mouth.

There are plenty of times where observing and waiting is as great plan - it's one my own doctors have used, and that have served my health well, but it was never done with a life threatening condition. I'm not suggesting they send their daughter to the emergency room every time she stubs her toe. I'm not even saying she should be hauled in to the doctor every time she comes in contact with any allergens, assuming she has other triggers. 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?

Quote:
Originally Posted by Sylvanz View Post
Perhaps a bit hyperbole but Kallah seems to be riding that wagon quite securely. YMMV of course.
I think they made a very poor choice, at a very critical moment, and paid a horrific price for that choice. I don't think they were stupid. If I'm going to have my own wagon, please get the label right.

ETA: And if it turns out that the article was wrong and/or vague, and the call was made the moment they found out what happened and not after the reaction happened, all my posts here are pretty much moot.

Last edited by Kallah; 02 August 2013 at 05:41 AM.
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  #60  
Old 02 August 2013, 07:02 AM
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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.
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