2011-07-28

anaphylaxis at daycare

Due to an unfortunate series of misunderstandings, the daycamp offered Lucas a fudgecicle (with modified milk ingredients) last Thursday.

He started vomiting (a lot, reportedly) and got a red puffy face, so they gave him benadryl (which we've told them was ok for MINOR reactions when allergens weren't actually known or suspected). They also called to inform me (but neglected to say he had milk). Since it was close to pick up time anyway, I choose to go get him to comfort him at home.

When I arrived, Lucas was flush but playing with his friends. They pulled the box out of the trash and I zoomed right in to where it said "modified milk ingredients" in the main ingredients. I whisked him off to the hospital, and ran carrying both children from the car to the ER on the hottest day on record. "Anaphylaxis" I told the nurse, ignoring the queue. I must not have been in good shape, because she asked "You or them?" Other nurses came in right away, relieved me of the kids and guided me to a gurney to recover.
Regaining composure momentarily, I was brought to see Lucas plugged in to oxygen, IV and a bunch of monitors. Again. I was out-of-my-mind furious at the daycamp for being so negligent and careless despite all our awareness-raising efforts and trust I had in the staff.
The daycamp operator listened to what I had to say, conducted a quick investigation and convened an emergency board meeting to decide what to do.
No single person was responsible for the popsicle, but his assigned instructor was the last in line and was reprimanded partly for not double-checking the ingredients, and mostly for not recognizing the severity of the reaction or troubleshooting its cause for appropriate treatment.
The center's food policy is still being discussed - there is resistance among the members as to whether they should stop serving any food at all to anyone (saving everyone from any possibility of error) or just isolate Lucas by never giving him anything.
In the short term, we had signed him up for this week and intended to have him return, but he's had a fever and has stayed home most of the time. Perhaps tomorrow, so he can enjoy the (hopefully food-free) last day of the summer camp.

Recognition

Interesting that our pediatrician used Lucas as a case study in allergies this morning, going through all the steps of the "allergic march", from constant gastro-intestinal issues as a baby, to eczema and asthma. She also recounted the anaphylactic reactions he had after vaccines at 12 and 15(?) months in surprising detail.

Though I questioned her ability to manage emergencies at the time, I acknowledge she knows a lot about allergies now, and appreciate that she cares to share that knowledge so others can benefit from that experience as well.