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More on Medicine:
Adverse & Allergic Reactions
Giving medicines safely to children in childcare settings is important. As stated in earlier issues of Healthy Childare (April/May, 1999; April/May 1998), proper administration of medication requires preparation. Child caregivers must know and follow guidelines on written authorization and communication with parents, storage and disposal of medicine, and documentation. All this is in addition to the actual administration of medicine or procedures.
Even though the caregiver correctly administers a medication, there can be problems. Many medications have side effects. Also, a child (or an adult) may have an allergic reaction to a medication. The caregiver must be able to recognize and handle these situations promptly.
A drug side effect is an adverse or undesired reaction to a medication by one's body. Many side effects are well known and expected, and are usually mild problems. Some of the more common drug side effects are drowsiness, headache, stomach aches, fatigue, muscle aches, or dizziness. Drugs may cause several side effects, and children may react differently to the same drug.
Whether administered at home or in the childcare setting, parents should always tell the caregiver about medicines, possible side effects, and what to do if they occur. While a side effect may be uncomfortable or irritating, it is not always necessary to stop the medication. Often, these side effects will decrease or stop after several doses. However, caregivers should always inform parents of any observed side effects or reactions. If the side effects could harm the health of the child, the doctor should be told.
Allergic reactions to medications are less common but can have more serious consequences. Common signs of an allergic reaction include rash, itching, swelling, dizziness, or breathing difficulties. If a child has an allergic reaction, the doctor should be notified immediately. As in any emergency situation, if the child is having breathing difficulties, call 911 or emergency medical help immediately! Some children with allergies may have an "Epi-Pen" auto-injector. An Epi-Pen has lifesaving epinephrine, a drug used to counteract severe allergic reactions. Parents should show childcare providers how to use an Epi-Pen. Providers should always call 911 after using an Epi-Pen.
In giving medicines to children, attention to the Five Rights can help protect against serious incidents:
- Right child: Check the name on the medicine label and the child's name--twice!
- Right medication: Medicine should be in the original labeled container--check the medication name against the parent authorization form--twice!
- Right dosage: Practice measuring dosages using a medicine spoon, dropper, or syringe. Check the dosage on the label, the authorization, and the spoon--twice!
- Right time: Know when the medicine was last given. Make sure the parent authorization for time of dosage matches the label on the medication. Look at the clock and document the time.
- Right route: Check the label and the parent authorization. Know how the medicine is to be given. Is it by mouth? Eye drops? Nose drops? Ointment for skin?
In addition to the Five Rights of medicine administration mentioned above, the childcare provider may consider adapting the following recommendations:
- Post emergency numbers (911, medical response) and keep parent contact information handy.
- Establish a working relationship with a local pediatrician and a pharmacist. These professionals can help evaluate your policy and procedures related to administration of medication and response to potential adverse reactions. They will then be familiar with your program and will be available, and better able, to advise you if the need arises.
Another way child caregivers can provide the best possible care for all children is to know about medicine side effects and allergic reactions.
Larry W. Owens, R.Ph., (Registered Pharmacist)
Medicine Chest Pharmacy, Birmingham, AL
Safety Tips for Medicines
- Parents tell the childcare provider about medicines the child is taking.
- Providers use and document the Five Rights when giving medicines.
- Providers observe children and report side effects and allergic reactions.
- Providers treat emergencies as directed and call 911.
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