Know

Children will enter your care with a variety of needs. All programs must be prepared to serve children with allergies, asthma, diabetes, health impairments, physical disabilities, and more. This lesson will help you follow a plan for meeting these children's needs. It also includes strategies for addressing common health concerns.

每个孩子identifi进入程序ed health care need should have an individual care plan in place. This care plan is developed by a primary care provider and the family. It will give you information about how to care for the child and signs or symptoms to watch for. It is your job to work with the family to put the plan in place.

A care plan typically includes information like:

• The child's diagnosis or diagnoses
• 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
• 儿童所需的修改（饮食，活动，环境，行为，避免什么 - 例如，花生等）
• Symptoms to look for
• Emergency response plan
• 你可能需要接受特殊训练来照顾孩子

Source: Caring for Our Children (3rd ed., 2015)

在某些情况下，它可能有助于您或您的计划与家庭和儿童的初级保健提供者进行沟通。请记住，获得的任何通信和信息都是保密的，并受《家庭教育权利和隐私法案》（FERPA）和《健康保险便携性和责任法案》（HIPAA）的保护。熟悉这些规定，如有需要，可以寻求帮助；请参阅您的计划的指导方针和政策关于谁应该与儿童的初级保健提供者交谈。保健顾问是一个很好的资源。

Common Health Care Needs

Some of the most common health care needs among infants and toddlers are allergies and asthma. The following information provides you an overview of each health care need, what to watch for, and ways to support children with these needs.

过敏

过敏are one of the most common health care needs in children. Allergies cause a wide variety of symptoms and include an even wider set of causes. According to the American Academy of Pediatrics (AAP), allergies are "reactions that are usually caused by an overactive immune system. These reactions can occur in a variety of organs in the body, resulting in diseases such as asthma, hay fever and eczema. During an allergic reaction, the immune system overreacts and goes into action against a normally harmless substance, such as pollen or animal dander. These allergy-provoking substances are called allergens." As an infant or toddler caregiver, you should be aware of allergens that children in your care have, their common symptoms and reactions to these allergens, and what you can do to make your classroom allergy-friendly.

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.

Food Allergies

食物过敏正在崛起（疾病控制和预防中心，2013）。根据美国儿科学院，8％的18岁以下的儿童具有食物过敏或多种食物过敏。该数字等同于美国大约600万儿童（AAP，2011）。各种蛋白质，对没有过敏的人无害，可以引发食物过敏的人的严重反应。反应可以从轻度到严重，包括死亡。在食物被食用后通常发生过敏反应。

Recent scientific and medical advances have provided the technology to diagnose food allergies more easily and precisely. We now know that many children suffer from food allergies, some of which can be severe, even life-threatening. For example, we have seen an increase in children with peanut allergies, so much so that entire classrooms and care environments have become花生免版税区域努力防止严重过敏反应。

显然婴儿无法沟通食物过敏，很可能大多数幼儿没有完全意识到他们拥有的食物过敏，或者可能无法沟通;大多数人都不知道他们可以和不能吃的食物。如果对您的护理中有任何婴儿和幼儿是否有重要意义，那么。记录过敏列表应在您的计划中发布。保持警惕，以确保儿童没有暴露于含有已知过敏原的食物。如果您的护理，您，教练，培训师或管理员，以及护士或保健援助，应与家庭会面，讨论任何药物或卫生援助，讨论任何药物或卫生援助。

食物过敏可能会影响身体的许多部位。常见的症状包括：

• 荨麻疹、皮疹和肿胀
• 打喷嚏，喘息，喉咙紧绷
• Nausea, vomiting, and diarrhea
• Lightheadedness, and loss of consciousness

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.

虽然有超过160种类型的食物，可导致敏感性的过敏反应，但这八种食物占90％的食物过敏反应：

• Milk
• 蛋
• Fish
• Crustacean shellfish (e.g. crab, lobster, shrimp)
• Tree nuts (e.g., almonds, walnuts, pecans)
• Peanuts
• Wheat
• Soybeans

This topic is explored in greater detail inLesson Seven of the Essentials in Child Care Food Servicecourse.

Non-Food Allergies

还有许多其他过敏原（人造和天然），可能会导致流鼻涕或打喷嚏，咳嗽，喘息，胸闷，皮疹，发痒和水汪汪的眼睛等过敏症状。常见的非食物相关过敏原包括：

• Dust mites
• Animals or animal dander
• Mold
• Pollen (trees, grasses, weeds, flowers)

如果你怀疑一个孩子在你的关心have an undiagnosed allergy, talk with your coach, trainer, or administrator and with the child's family to discuss the symptoms you notice. If the child has an allergic reaction to an environmental allergen that is specific to your program, the symptoms may not be as noticeable at home.

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.

哮喘

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).

哮喘可能难以诊断。虽然航空公司总是刺激和发炎，但症状并不总是存在，但通常是零星的：有时它们经常发生，但在其他时候可能存在症状之间的长期。哮喘往往误认为是其他健康问题，例如呼吸道感染，肺炎，支气管炎或慢性咳嗽。出于这些原因，重要的是，家庭和护理人员会对哮喘的可能性进行警告，如果看到以下任何症状，请寻求帮助：

• Wheezing
• 常规咳嗽
• 胸部紧绷感
• Shortness of breath

哮喘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.

See

本视频将提供您在照顾婴幼儿特殊保健需求时可能遇到的一般信息。

Special Health Care Needs

Do

对宠物或食物过敏

婴儿和学步儿童可能会因过敏而进入您的计划，或者在他们开始参与计划后可能会发现过敏。无论哪种方式，你都必须与孩子的家庭交谈，了解他们孩子的个人保健需求。不要以为有类似过敏症的婴幼儿也能得到同样的治疗。婴幼儿过敏是独特的；同一种过敏在不同的儿童身上可能表现出不同的症状。与所有特殊的健康需求一样，过敏需要每个孩子都有自己的护理计划。该计划应包括有关儿童对食物或动物过敏的书面信息、书面治疗计划、工作人员培训计划以及储存任何必要药品的计划。孩子的过敏症应该清楚地、显著地张贴在教室里。

If an allergic reaction occurs while the child is at the program, you should administer the prescribed medicine right away, contact the family, contact emergency medical services if necessary, and encourage the family to contact their primary care provider. Be sure to take a copy of the plan, any medication, and a cell phone with you whenever the child leaves the building on a field trip.

Caring for Less Common Health Needs: Medical Procedures

偶尔，有更严重医疗需求的孩子可能会进入你的教室。他们的医疗需求可能包括管饲、导管插入术、吸痰或检查血糖。在这些情况下，必须由儿童的初级保健提供者制定护理计划。如果希望员工执行程序（并且根据州法律这是可以接受的），则计划必须包括培训程序中员工的指南。如果您觉得该程序超出了您的专业知识或培训范围，请与您的教练、培训师或管理员联系，以获得您需要的帮助。

Administering Medication

为孩子提供药物是一个严肃的事件。您必须在遵循课程关于儿童个人护理计划的政策之后这样做。遵循这些权利以防止错误和事故：

Any medication or medical equipment should be safely stored in the classroom, office, or nurse's office. Prescription medications should be in a container that has been labeled by the physician or pharmacist. Over-the-counter medication should be stored in its original package. All medications should be stored according to the directions on the containers or as directed by health care professionals. Some may require refrigeration, while others may not. If a child has severe allergies and might go into anaphylactic shock, they may be prescribed an epinephrine auto-injector (EpiPen, etc.). Keep the auto-injector available at all times, including field trips.