How to Handle Food Allergy Emergencies

This is part of an occasional series on food allergies for classroom teachers. I hope to eventually put the posts all together for a presentation at a conference next year, but I’m having trouble deciding what teachers need to know. As a parent of food allergic children, I know a lot more than teachers should be expected to remember or take care of. I need to find the right balance of information. I’d love to have specific feedback on these posts in order to make them accurate, understandable, and helpful. Other topics will include: Food Allergy Basics, Preventing Food Allergy Emergencies, and Instructional Implications for Food-Allergic Students. Thanks for your input!

Emergency Action Planning
Every child with an emergency medication, including inhalers, EpiPens, and insulin, should have an emergency action plan that you have reviewed and practiced. Anyone who will be responsible for the child’s well-being needs to be made aware of the plan and where to find it.  Emergency action plan forms can be found in many places, including The Food Allergy and Anaphylaxis Network, and Safety Sack.

What should happen during an allergic reaction?
Follow the child’s action plan. Here are the steps that are part of most allergy action plans:

1. Assess severity: For breathing difficulty administer EpiPen and call 911. Remove the allergen (see next step) while waiting for ambulance if possible. If there is no immediate distress go directly to the next step.

2. Remove allergen: If the contact was a spill, remove clothing and wash any areas touched by the allergen. If allergen was ingested, be prepared for vomiting.

3. Antihistamine: If action plan indicates it, administer an antihistamine (such as Benedryl or Zyrtec). If possible, call a guardian to let them know what is happening, never leaving child alone.  If you have to choose between calling a guardian and staying with the child, stay with the child so you can monitor for signs of anaphylaxis.

4. Respiratory Distress: If respiratory distress develops administer EpiPen and call 911. Administer second EpiPen if paramedics have not arrived and breathing does not improve or gets worse after easing for awhile.

5. Call Guardian: Once paramedics have control of the situation, call a guardian. If an extra adult is present the guardian may be called sooner.

After the EpiPen has been administered a child should have constant supervision until the paramedics or a guardian arrives. Allergic reactions can have a rebound effect several hours after the initial incident. Even without a rebound reaction, an EpiPen will make a person jittery and sometimes emotional.

While there are some parents who want their child to stay in school after an EpiPen has been administered, this is not recommended.  They will not be able to focus while the medicine is in their system and they can’t be properly monitored for a delayed reaction.  If a guardian does not want their child to go to the hospital, insist that the child be taken home and supervised carefully.

Where should we keep the EpiPens and antihistamines?
Ideally, medications should be stored where they are most likely to be needed AND where they are most likely to be found. My children have EpiPens in their classrooms (older children should carry them on their persons), in the cafeteria, and in the office. Antihistamines are not emergency medications and can be kept in the office in most cases.  At my children’s school, non-emergency medications MUST be kept in the office. 

At the nursery school where I work we keep medications in each classroom’s backpack, which goes with us whenever we leave the room (even to go outside) and also contains emergency contact information for each child.  We have high hooks inside and outside to keep the backpacks out of harm’s way.

Technorati Tags: emergency,food allergy,epipen

Volcanoes for Preschoolers

You can’t really do a series on baking soda and vinegar without bringing out the volcanoes.  But since most preschoolers have very little practical experience with volcanoes it doesn’t make sense to do any sort of a unit on the things.  Instead, we try to get the sense of one in the hopes that this knowledge helps them learn about them later.

First you need a volcano.  We had made play dough in class with the kids a few days before that had somehow not kept well, so we used that.  The children helped even though they really had no idea what we were going for.  We tried showing them volcano pictures and read a few books but the information didn’t transfer well.  We made two volcanoes and put them on trays that we took outside.  We put a small pile of baking soda inside each model.

Since we’re not going for realism, I let the kids pick the color for the lava.  On the day I took these pictures, they first picked green.  Unfortunately, since the play dough we made was blue, it wasn’t quite the thrill it could have been.  The red lava was much more interesting for the second batch.

As we had practiced with droppers and syringes the day before, that’s what we provided for adding the vinegar to the baking soda.  We were able to do this for quite awhile without reloading.  I was a bit surprised at how little baking soda I had to add for this experience.

Even though we weren’t studying volcanoes we did talk about lava and magma as well as how hot it all would be if they were real.  Some how igneous rocks even got mentioned.

I highly recommend doing this outside or in your sensory table if you can’t go out.  It was spring when we did this, so we all had jackets on and it was still fine.  We had plenty of towels with us but didn’t really need them.  The biggest temptation for them was not to put their hands into the volcanoes.  While that makes for a fun ending, the play dough gets very squishy during the eruptions and can’t support a child’s weight.  Once the hands get in there, it’s all over.  And of course, that’s how it ended!

Allergy Note: We did this with gluten-free play dough.  If you have a gluten allergy in your class, by all means do the same.  It works fine.  If you don’t, regular play dough will work just as well if not better.

Need a refresher on the chemical reaction itself?  Baking soda + vinegar = water + carbon dioxide + sodium acetate (more or less).

Technorati Tags: early science,chemistry,preschool

Baking Soda and Vinegar with Threes

With threes I do a similar setup as I do for the twos, namely on trays.  But instead of squeeze bottles I provide several types of droppers and syringes.  We’re working on our fine motor control as well as investigating how fluids work in addition to our chemistry when we do it this way.  I usually set it out with the droppers and syringes filled so that there’s some instant gratification that encourages the kids to try the droppers and syringes themselves.  Otherwise they sometimes get discouraged before they get success.  Doing it once is usually enough to keep them trying until they get it.

While we’re here, do YOU know how a dropper or a syringe works?  What’s the principle behind it?  Well, I’ll tell you.  It’s a vacuum!  That’s right, you’ve got a little bit of nothing in that dropper when you squeeze out all the air and then put it in the liquid.  When you release the dropper head the liquid fills the vacuum.  For the syringe, you create the vacuum and fill it when you pull up on the plunger.

I put my droppers in a set of watercolor paint cups, but you could just as easily use small cups.  The tricky thing with this setup is refilling the wee cups.  Get yourself a small pitcher and prefill it with the vinegar to make it easy.  But be forewarned: if you put the pitcher in reach of the children you will have helpers!  I’m all in favor of letting kids do the pouring if we’re outside, but our custodian takes issue with saturating the carpet with anything he didn’t do himself so I do the refilling myself when we’re inside.  And yes, I’ve tried to do this with something on the floor to catch the overflow and I’m sure you know how well that worked out if you’ve tried it yourself!  Anyway, I will let the children help me add watercolor to the vinegar, inside or outside.

Threes also enjoy doing this activity in the sensory table.  If you really trust your threes, try putting the vinegar in spray bottles!

Need a refresher on the chemical reaction itself?  Baking soda + vinegar = water + carbon dioxide + sodium acetate (more or less).

Technorati Tags: preschool,chemistry,early science

Baking Soda and Vinegar with Twos

Here’s how I like to set up experimentation for my two-year olds. I use trays on a low table. I spread baking soda on the tray and then fill small squeeze bottles with vinegar.

Tips:

• Keep the tops on the squeeze bottles twisted down low so it doesn’t all pour out so fast that the joy is gone immediately. Then it becomes more about pouring rather than observing the reaction.
• Have a funnel that fits in the top of your squeeze bottles handy for refilling the vinegar. Unless you have an unlimited supply of bottles you will be doing this A LOT.
• Put some dish soap in the squeeze bottles. Not only does it make the vinegar come out a little more slowly but it makes the reaction slower.
• Put a little liquid watercolor in the squeeze bottles. I just use primary colors. This way you have something to talk about with the kids who aren’t impressed by the bubbles.
• Have more baking soda standing by. When the bubbles stop but there’s still vinegar left, you can add more. You may need to dump the trays periodically.

If you do this outside then cleanup is a breeze. Just dump the trays outside and clean them with the hose (or let the kids do it). You can also do this activity in the sensory table, but for some reason there seems to be more squirting in eyes at this age when you do it there.

Need a refresher on the chemical reaction itself? Baking soda + vinegar = water + carbon dioxide + sodium acetate (more or less).

Technorati Tags: chemistry,preschool,early science

Preschool Chemistry, or What Do You Really Know About Baking Soda and Vinegar?

You may have seen baking soda and vinegar in action in a volcano experiment in elementary school or even as an activity at the preschool level. You may even know how to make that volcano. But do you know what the chemical reaction is? Just what’s in those bubbles, anyway? I don’t presume to be a chemistry nerd but here’s what I know.

Baking soda and vinegar leave you with three things once they’re mixed: carbon dioxide (the bubbles), water, and sodium acetate*. I asked a chemist to find out, but you can just as easily find this information on the web. The friendly chemist assured me that sodium acetate tastes really awful and would be hard to consume in large enough quantities to be harmful. Besides, to make sure nothing amiss happens you should be watching kids who are working with chemicals! Vinegar stings in the eyes and on cuts, but isn’t harmful.

Adding dish soap to the vinegar makes the reaction last a little longer. The bubbles are smaller and seem to appear more slowly. This is a great comparison activity and can be useful for children who are intimidated by all the very active bubbling that takes place when large quantities are being used.

I like to add watercolors to the vinegar so children can see color mixing going on. It doesn’t always mix as quickly as you think it would, particularly if you’re also using dish soap.

When you’re working with young children, be brave enough to use the real words for things. This gives them exposure to new descriptive language for the concepts and also give them “hooks” for learning the information in a different context later. Go ahead and say things like, “chemical reaction,” “sodium acetate,” “reactants,” and so forth. You might feel like a dork at first but you’ll warm up to it.

For the next few posts I’m going to explore what we can do with vinegar and baking soda with the early childhood bunch. It’s a favorite activity starting from toddlerhood and going until, well, adulthood for some of us. I’m sure some of you have creative ideas and I’ve love to hear about them. Feel free to leave links in the comments so other people can see what you’ve done, too.

In my own house, my son likes to make a HUGE pile of baking soda and inject vinegar into it using long droppers. We all end up with very soft hands from the salty scrub that ends up happening. It’s like grainy wet sand by the time we’re done with it!

*For the detail-oriented among you, the the water and carbon dioxide start out as carbonic acid but quickly decompose into the water and carbon dioxide.

Technorati Tags: preschool,early childhood,chemistry,early science

Learn About Weaving with Kids

My Monday post inspired me to dig out You Can Weave!: Projects for Young Weavers, which has been very helpful in working with my own children. I’m not a particularly crafty person (with the exception of knitting) so I need to be guided step by step with lots of instructions and pictures. This book does that. The first few projects are great for pre-K and Kindergarten. Some children with good spacial awareness and fine motor skills in the older threes crowd could probably do those projects as well.

What I like about weaving is that for the simpler projects the gratification is immediate. It’s also very easy to do your own thing and still create something of beauty. Even if the end result isn’t something a child can take home, the act of weaving, once the process is understood, can be very soothing for some children. If you’re teaching elementary school you can add math, history, and social studies to the mix while providing a tactile experience for the children who need it. Remember, wigglers behave and learn better when they are able to wiggle while they learn.

Technorati Tags: weaving

Weaving

We have two large weaving looms at school.  Usually we do the warping for the kids with string or yarn and then provide them with all sorts of materials—yarn, ribbon, paper, stuff they find outside--with which to weave.  We also sometimes set out large plastic needles with ribbon if they want to “sew” their materials in.  Sometimes we let the kids warp the loom, but it’s really hard for them to get something all the way across AND lined up because of its size.

The loom itself is a large square someone put together with a matching set of nails on the top and bottom (or right and left, if you’re that kind of person).  I hate to think how hard it was to get the nails all lined up, but they are.  The loom is large enough that several children can work simultaneously in different areas of the loom.

This summer we pulled out the loops, which made the loom something like a big potholder maker.  The loops were made by tie-dyeing t-shirts and then cutting them horizontally, keeping the seams intact.  We have a huge bag of these at school that get reused for various things.

Since we had a day or so with nasty weather this year during camp and some of the kids preferred to stay dry we had several customers at the loom.

And what about the finished product?  Well, there never really is one.  To my knowledge, no one has ever removed a finished piece from the loom and kept it.  It’s all about the process with this one.  I suppose someone could keep it and it would be the size of a large baby blanket.

Food Allergy Basics

I am beginning an occasional series on food allergies for classroom teachers. I hope to eventually put the posts all together for a presentation at a conference next year, but I’m having trouble deciding what teachers need to know. As a parent of food allergic children, I know a lot more than teachers should be expected to remember or take care of. I need to find the right balance of information. I’d love to have specific feedback on these posts in order to make them accurate, understandable, and helpful. Other topics will include: How to Handle Food Allergy Emergencies, Preventing Food Allergy Emergencies, and Instructional Implications for Food-Allergic Students. Thanks for your input!

What is a food allergy?
A food allergy is an immune system response to a protein in a food with which a person has already had at least one contact. Contact can occur through ingestion, inhalation, or skin contact. All foods that humans normally eat contain some protein; therefore it is possible to be allergic to any food, including fruits, vegetables, and grains.

Reactions to chemicals in food may or may not involve the immune system. Some people prefer to call these reactions “poisoning” because the substance in question is entirely man-made so not really a food, but your response as an adult is likely to be the same regardless of the offending substance.

What are some common food allergies in children?
The “Big 8” allergens cause 90% of anaphylactic reactions. These allergens are: milk, eggs, peanuts, tree nuts, wheat, fish, soy, and shellfish. These foods may be highlighted on ingredient lists or in statements on food packaging but the only true requirement is that they appear in easily understood English in the ingredients list. If a separate bold statement does appear on a label then any of the big 8 that are present are required to be on it.

The “made in a factory that also processes…” types of statements on packages are voluntary. About 10% of the packages that contain such statements DO contain the noted allergen regardless of the warning’s wording. There is an exception to this statistic for special manufacturing processes, but it’s better not to serve a food that’s questionable than to make a guess if you don’t already know for certain.

What are some of the symptoms of an allergic reaction?
The allergic response can produce symptoms in the skin, gastrointestinal tract, cardiovascular system, and respiratory system. Symptoms may include one or more of the following: a tingling feeling in the mouth or throat (for example, “my mouth feels funny”), swelling of the tongue and throat, difficulty breathing, hives, vomiting, abdominal cramping, diarrhea, low blood pressure, unconsciousness, and death.

Very young children often do not exhibit symptoms in the way we would expect. Be aware of odd behavior, particularly when accompanied by anxiety or severe worry. Children who cannot verbalize their health status may look extremely stressed for no apparent reason.

What is anaphylaxis (or anaphylactic shock)?
Anaphylaxis is a severe allergic reaction that occurs suddenly and may cause death. It involves two or more systems in the body and may or may not include trouble breathing.

What is the difference between an allergy and an intolerance? What is a food sensitivity?
An allergy involves the immune system’s reaction to a protein. An intolerance involves an inability of the body to digest something, typically a sugar. While an intolerance is not life-threatening it can be just as painful as an allergy and can send some people to the hospital. A sensitivity is something that doesn’t fall neatly into the allergy or intolerance categories. Intolerances and sensitivities do not require emergency treatment but are to be taken seriously all the same because they can develop into an allergy with continued exposure to the offending item.

Where can I get more information on allergies?
A great place to start is the Food Allergy and Anaphylaxis Network, or FAAN. Also useful are the Food Allergy Initiative and Allergy Moms.

Chime Wall

Here is a picture of our fabulous, all-weather chime wall. This sucker is expensive but was purchased because of a grant we got. Our music teacher spent some quality personal time writing grant applications and so we are very, very lucky!

The kids love the chime wall. We had it inside our large motor room for awhile, but it was pretty loud in there. We also had to modify the mallets a bit so they couldn’t be inserted in the chimes, necessitating some roto-rooter action by our custodian (you’d think the company would have thought of that).

We put it outside at the start of alumni camp and there it will stay pretty much permanently. It’s so nice to hear. The kids like to experiment with wiggling the chimes in their pockets, like the boy in the photo. Some of them are convinced that they can get the chimes out.

In the past we've used various metal things attached to the fence for music, and I'm assuming we'll continue to do that. If I ever get a picture, I'll post it. Random metal items and then sticks to bang them with is always a good idea for outside. Kid-made music beats even the nicest thing played on the boom box.