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Waltzing Australia


Wednesday, August 31, 2011

28. Anaphylaxis - Child-Care Centres

Early Learning Centres and the Anaphylactic Child
When a child attends an early learning centre (child-care/creche) you want to know that your child is in a safe and friendly environment and those responsible for his/her care are following the guidelines set out.

An early learning centre in a Melbourne suburb seems not to have been following these guidelins and is embroiled in food-related safety issues. A child attending this centre has a nut allergy and this was made known to the director at the beginning. She was informed that the child has a nut allergy and cannot eat any products that contain nuts, cannot have products that state "May contain traces of nuts" and/or products that state "Produced on equipment that may contain traces of nuts". You would think this would be a simple thing - yes? Not. Not so.
There have been a number of "Incidents" at this early learning centre.

The centre provides morning and afternoon tea, and a hot lunch - the lunch is catered and is brought in each day.
Some of the foods provided for morning/afternoon tea were not nut free. The child was given Arnotts biscuits and it was pointed out that Arnotts biscuits are not nut free (the packaging actually states this product may contain traces of nuts) - this was brought to the attention of the director and a website for nut free foods was given to her. A food management plan was instituted where staff would write down each day what the child had eaten.
The mother checks this each day when she picks up her child. Recently she saw that a staff member had written down that the child had morning tea and what food had been eaten. The mother asked which staff member wrote this down - the child had arrived at the early learning centre at a later time and had not had morning tea. Quite rightly, she wanted to know how this error had been made. Of what use is a food management plane if false information is being recorded?

The director has denied this occurred and says it didn't happen. She states a staff member wrote down the child had morning tea and realised the child had not and so amended it. She states she refutes everything. Why would the director wish to deny this? Why lie?

A notification was made to the relevant government department earlier.

The mother collects her child at around 5.00pm and yesterday received a phone call at 4.55pm from a staff member who informed her they noticed the child had swelling around the mouth and nose at approximately 3.10pm and it was worse at 4.30pm. The mother asked had they given the child Zyrtec? The staff member answered no.
Staff have not followed the action plan in place for this child.

There is an Action Plan for Anaphalaxis - see below.

Above: Action Plan for Anaphalaxis

The form can be found HERE. This form shows the child's photo, name and DOB, and other relevant information relating to each individual child. On the right hand side is "Mild to moderate allergic reaction"
* Swelling lips, face, eyes
* hives or welts
* tingling mouth
* abdominal pain, vomiting (these are signs of a severe allergic reaction to insects)
This is followed by "Action"

The plan is a personal plan for the individual child and on this child's plan it clearly states under "Action" To moniter the child, give Zyrtec (medication), contact the mother and to stay with the child and moniter that child.

The mother took the child to a doctor's clinic which is next door to this early learning centre and the child was seen straight away. The doctor asked was the child given Zyrtec to which the mother answered no. The doctor said to give the child Zyrtec and keep an eye on her.

NOW, there is an Action Plan for Anaphalaxis for this child, both Zyrtec and an EpiPen are kept there for this child. There is an Anaphalaxis model policy which requires that all proprietor's of licensed children’s services to have an anaphylaxis management policy in place. This policy is required whether or not there is a child diagnosed at risk of anaphylaxis enrolled at the service. In services where a child diagnosed at risk of anaphylaxis is enrolled the proprietor shall also:

• conduct an assessment of the potential for accidental exposure to allergens while child/ren at risk of anaphylaxis are in the care of the service and develop a risk minimisation plan for the centre in consultation with staff and the families of the child/children (Schedule 3 of the Regulations).
• ensure that a notice is displayed prominently in the main entrance of the services stating that a child diagnosed at risk of anaphylaxis is being cared for or educated at the service
• ensure all staff members on duty have completed recognised anaphylaxis management training (r. 26(3) and that practice of the adrenaline autoinjection device such as the EpiPen® administration is undertaken on a regular basis, preferably quarterly, and recorded annually.

These are just some of the points outlined in the policy - you can read the full points of the policy HERE.

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