知道

孩子们将以各种需求输入您的护理。必须准备所有计划为过敏，哮喘，糖尿病，健康障碍，身体残疾等儿童提供服务。本课程将帮助您遵循满足这些儿童需求的计划。它还包括解决共同健康问题的策略。

通过确定的医疗保健需求进入该计划的每个孩子都应该有个人护理计划。此护理计划由初级保健提供者和家庭开发。它将为您提供有关如何关心儿童和迹象或症状观看的信息。与家人合作，将计划到位是您的工作。

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)
• 药物以及应给予药物的时间表
• 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
• 过敏
• Modifications necessary for the child (diet, activity, environment, behavioral, what to avoid--for example, peanuts, etc.)
• 症状寻找
• 紧急响应计划
• 特殊培训您可能需要与孩子合作

资料来源：照顾我们的孩子（第3埃德。，2015）

在某些情况下，您或您的计划与家庭和儿童的初级保健提供者沟通可能会有所帮助。请记住，获得的任何沟通和信息都是机密和受到家庭教育权利和隐私法（FERPA）和健康保险便携性和问责法（HIPAA）的保护。熟悉这些规定，如果需要，请求帮助;请参阅您的计划的指导方针和有关谁应与儿童的初级保健提供者交谈的政策。医疗保健顾问可以是一个很好的资源。

常见的医疗保健需求

婴儿和幼儿中的一些最常见的医疗保健需求是过敏性和哮喘。以下信息为您提供了每种医疗保健需求的概述，观看什么，以及支持这些需求的方法。

过敏

过敏症是儿童最常见的医疗保健需求之一。过敏症导致各种各样的症状，包括甚至更广泛的原因。根据美国儿科学院（AAP），过敏症是“通常由过度活跃的免疫系统引起的反应。这些反应可以在身体的各种器官中发生，导致哮喘，花粉热和湿疹等疾病。在过敏反应期间，免疫系统过度反应，并反对通常的无害物质（例如花粉或动物剥皮）的作用。这些过敏挑衅物质称为过敏原。“作为婴儿或幼儿照顾者，您应该意识到儿童在您的护理中，它们的常见症状和对这些过敏原的反应以及您可以做些什么来使您的课堂过热的过敏原。

过敏can be difficult to diagnose and can develop at any age. A child may not have any allergy symptoms at age 1, but by age 3 they could develop a severe allergy. In addition, for infants and toddlers, are often exposed to new foods and materials, and these exposures can identify allergies that the child, family, and caregivers were previously unaware of. 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.

食物过敏

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. This number equates to 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.

最近的科学和医学进步已经提供了技术诊断食物过敏，更容易且精确地诊断食物过敏。我们现在知道许多孩子患有食物过敏，其中一些可能是严重的，甚至危及生命。例如，我们已经看到了花生过敏的儿童增加，因此整个教室和护理环境已经成为peanut freezones in an effort to prevent serious allergic reactions.

Obviously infants cannot communicate about food allergies, and it is likely most toddlers are not fully aware of food allergies they have, or may not be able to communicate about it; most would not know what foods they can and cannot eat. If is therefore important for you to know if any infants and toddlers in your care have food allergies. A list of documented allergies should be posted in your program. Stay vigilant at mealtimes to ensure children are not exposed to foods that contain known allergens. If there is an infant or toddler with a severe allergy in your care, you, a coach, trainer, or administrator, and perhaps a nurse or health aid, should meet with the family to discuss any medications or emergency plans.

Food allergies can affect many parts of the body. Common symptoms include:

• 荨麻疹，皮疹和肿胀
• 打喷嚏，喘息和喉咙紧绷
• 恶心，呕吐和腹泻
• 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
• 甲壳类贝类（例如蟹，龙虾，虾）
• Tree nuts (e.g., almonds, walnuts, pecans)
• Peanuts
• 小麦
• 大豆

此主题将更详细地探讨Lesson Seven of the Essentials in Child Care Food Service课程。

非食物过敏

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
• 模子
• 花粉（树木，草，杂草，花）

如果您怀疑您的护理中的孩子可能有一个未结识的过敏，与您的教练，培训师或管理员交谈，以及孩子的家人讨论您注意到的症状。如果孩子对环境过敏原的过敏反应，这是对您的计划特有的，症状可能不会在家里那么明显。

Be aware that some children may have animal allergies. Certain class pets may be harmful to such children. All children should wash their hands before and after handling an animal.

Asthma

According to the Centers for Disease Control and Prevention (CDC), more than 26 million Americans suffer from asthma--more than 6 million of whom are under the age of 18 (CDC, 2018). As the number of people with asthma continues to rise, more accurate methods are available to diagnose and treat the disease. Asthma can begin at any age; however most children first develop symptoms by age 5 (Cleveland Clinic, 2013). The American Association of Pediatricians defines asthma as a chronic respiratory disease of the tubes that carry air to the lungs. These air passages become narrow and their linings become swollen, irritated, and inflamed, making breathing difficult (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
• 胸部紧绷感
• 气促

Asthma Attacks

对任何人,哮喘是一个可怕的经历but they are particularly frightening for children. A child who is diagnosed with asthma will probably be taught strategies to cope with an attack and may be prescribed medication and a device to help the child inhale their medicine. It is important that you know how to respond to an asthma attack and how to comfort a scared child. Make sure you know and follow the child's care plan in the event of an asthma attack. If a child is has their first asthma attack while in your care, seek emergency medical attention immediately. Do your best to keep the child calm, and encourage them to take slow breaths.

看

此视频将提供有关您在关注婴儿和幼儿的特殊保健需求中可能遇到的一般信息。

特殊医疗保健需求

Do

过敏养宠物或食物

婴儿和幼儿可能会在您的计划中进入，过敏或过敏可能会在计划中开始识别。无论哪种方式，你必须与孩子家属交谈，了解他们孩子的个人保健需求。不要对婴儿和幼儿带来相似的过敏，可以相同的方式对待。婴儿和幼儿过敏是独一无二的;相同的过敏可能在不同的儿童中呈现不同的症状。与所有特殊的健康需求一样，过敏要求每个孩子都有自己的护理计划。该计划应包括儿童对食品或动物的书面信息，书面治疗计划，员工培训计划以及储存任何必要医学的计划。孩子的过敏症应该清楚地张贴在课堂上。

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

偶尔，有更严重的医疗需求的儿童可能会进入您的教室。它们的医疗需求可能包括管喂养，导管，抽吸或检查血糖。在这些情况下，必须从儿童的初级保健提供者到位护理计划。如果有望履行该程序（如果在国家法律上可接受），该计划必须包括培训人员在该程序中的准则。如果您觉得该程序超出了您的专业知识或培训，请与您的教练，培训师或管理员交谈以获取所需的帮助。

施用药物

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:

任何药物或医疗设备应安全地存放在课堂，办公室或护士办公室。处方药物应该是由医生或药剂师标记的容器。反柜中的药物应存放在原始包装中。所有药物应根据容器上的方向或按照医疗保健专业人员指示储存。有些可能需要制冷，而其他人可能不会。如果孩子有严重的过敏，并且可能进入过敏性休克，它们可能会规定肾上腺素自动注射器（Epipen等）。保持自动注射器始终可用，包括现场旅行。