Peanut Allergy

[Beavah]

Yah, both food allergies (especially peanuts) and Autism are epidemic now compared to when we were young fellows, Mr. Boyce. Nobody knows why.

 

There are some things where keepin' medical stuff confidential is necessary or appropriate. This isn't one of 'em. I'd say if the parents insist on it being confidential, you tell 'em that you can't accept the boy as a member. The PL and patrol members need to know. If the boys know, then they'll be more careful about the peanut stuff they bring, about offering the lad food, about planning meals, about GORP, on and on. And they'll be able to recognize a problem and get help or assist more quickly.

 

Beavah

 

[thriftyscout]

My son has been challenged by both autism and a peanut allergy, it is a difficult combination. I agree that it should not be a secret, it is a potentially deadly situation. While my son knows he cannot eat peanuts, he doesn't always ask about ingredients. He is not hypersensative so he is not going to react to a reasonably clean serving spoon.

 

He carries an epi pen and an antihistamine (Benedryl) in his pack but we have not had to use it on a campout. His patrol is aware of his allergy and where he carries his epi pen. They often come with a trainer pen which makes it easy to review with adults and Scouts. It is a good skill to know as there are many different allergies that may require an epi pen.

 

His allergist also filled out a Food Allergy Plan which spells out what to do for situation like suspected ingestion, hives, shortness of breath, etc. This should be with the Scouts epi pen and his medical forms. It takes some of the uncertainty out of how to handle the situation. For adults it is often more a fear of the unknown or doing something wrong.

 

As the SM, I have always been camping with him so it hasn't really been much of a burden to the rest of the Troop. Patrol shoppers are asked to check for ingredients and avoid peanut products, it is not that difficult. It is a good opportunity to review food labels which should be a part of the meal planning advancement requirement.

 

I would think that most Troops would want to make reasonable accomodations for dietary requirements. I look at it as somewhat of a balancing act between what accomodation the Troop should make vs. what the Scout family needs to provide. My son eats most meals/snacks with his patrol but always has some peanut free trail mix in case something is overlooked.

[Gags]

At one of our recent pediatric appts for my now almost 2 year old, our Doctor has pretty much lifted the restriction of "no peanuts until (2, 3, 4) years old", for those families with no history of allergies (important caveat there).

 

His reasoning (and I'm paraphrasing here), and I'm assuming he's not some "lone quack" with this theory, is that millions of children world-wide are exposed to nuts from birth, and there does not appear to be a increase in infant deaths due to allergic reaction. I haven't done the research to see if there's been actual studies to verify this, but it's an interesting (and obvious) thought.

 

That being said - we have a 4 year old neighbor allergic to everything - eggs, nuts, wheat, sweet potatoes, garlic, soy. Ever see what they charge for infant formula that doesn't contain milk or soy? And you definitely don't want to smell the stuff. Something about the shorter the chain of amino acids (to aid digestion), the worse the smell.

 

Back to the topic - our troop also now has a severely allergic boy - so it will be interesting to see how the Patrol handles it.

 

--Gags

[Scoutfish]

Yeah, gotta go with Beavah here: There are times you may not want others to know about something: Wind burn on your bottom from a all bean weekend, maybe you got a cold sore from kissing the dog, or a wart from just not taking a bath often enough.

 

But that stuff doesn'tkill you.

 

Me personally, I'd rather an educated and infromed scout try to help my son that have a bunch of people standing around looking at my blue faced son if he were on the ground not breathing.

 

Funny thing about embarassment - it means you are not only alive, but also mentally aware!

[Engineer61]

Oh...a few more comments...

 

dS15 remarked:

 

"Assistance might be as simple as saying 'Where's your EpiPen? Can you reach it?'"

 

First off, your first indication of a severe allergic reaction may be the victim passing out. You won't be able ask the victim anything. I'd even venture to say that in a majority of the time, the victim going to the ground as the first indicator is more the norm, not less.

 

"There are absolutely situations where a Scout may need to assist another Scout, most of them not involving dead or incapacitated adults. Unsupervised patrol hikes and camp outs, for instance, which are approved activities in the Boy Scout program."

 

Then as his parent I would have to insist that my Scout not participate in activites were adults are not present. It would be irresponsible as a parent to allow otherwise. I cannot honestly rely on a 12-18 year old to make an accurate assessment an apply the proper treatment in the proper way.

 

"In some people, an anaphylactic reaction can come on within minutes."

 

Minutes? Try seconds.

 

===============================

 

As for the increase in peanut allergy over the years...there's a bunch of theories, these two were the highest on my allergist's list.

 

1) Increased usage of peanut products in the food supply. Even in non-food products. This is increasing the exposure level causing a wider pool of sensitive individuals.

 

2) Population pool of those with the allergy is increasing, as those with the allergy have not died off at an early age. Thanks to the Epipen. They then propagate the allergy to their offspring.

 

[dScouter15]

E61, You are correct that an anaphylactic reaction may come on within seconds, rather than minutes, in some severely allergic individuals (though an onset of several minutes to hours is more common). However, the context of that quote of mine involved a situation in which Scouts are out hiking without adult supervision, so in that particular example seconds vs. minutes really isn't a huge distinction.

 

Your claim that in the majority of cases the first symptom of an anaphylactic reaction will be the victim "passing out" is surprising to me. It definitely is contradictory to my own experiences, the fairly extensive collection of emergency medicine literature I have access to, and a cursory Google search of the topic. Could you please refer me to the evidence supporting this claim, as I'd really like to review the data first-hand.

 

Finally, while I can respect your decisions on how to parent your own children, I'd have to point out that other parents may have other, equally reasonable ideas on how to handle a situation. For example, if a responsible, well-prepared and educated Scout with a peanut allergy wanted to go on a patrol hike or campout with a group of responsible, well-prepared and educated patrol members, I certainly would not have a problem with this, provided that the group was trained and prepared to deal with a potential medical emergency.

 

(This message has been edited by dScouter15)

[Mr. Boyce]

I'm just curious what particular molecule triggers the thing. THAT should be figured out by now, one supposes.

[Scoutfish]

Actually, it wasn'r " a majoritry" but it was : "First off, your first indication of a severe allergic reaction may be the victim passing out.:

 

And in that case, you do not have to rely on every single scout being a seasoned. board certified alergy specialist, but just bing aware that the peanut allergic scout has the allergic reastion.

 

So they eat dinner, the scout in question starts acting funny, distressed or passes out...well, the ones who are aware check and find out there was peanut oil in dinner can then give the shot becuase...............

 

They were made aware of the allergy and know what to do.

 

 

No, scouts are not perfect mentally mature EMS providers....But they don't sit around and ponder the consequences of lawsuits, PC mentality, or who has the brightest shoulder loops either.

 

Reminds me of my CPR training I took during my Emergency Medical Technician. The CPR is actually taught by the Red Cross, and not the Office of Emergency Management as the rst of the course is.

 

Anyways, the instructors mentioned that many people wil sit and watch a person in cardiac arrest die just because they are not sure they can help. Truth is, the best CPR is only 22% effective ( okay, as all other stuff, numbers may have changed with better research).

 

Soconsidering what odds you are working with, doing anything is still better than doing nothing. You may be doing it wrong, but even then, there may be a 5% chance of helping out. If you just stand there, I garanntee you have 0% chance of heloping out.

 

Now think about various stories you read about how this scout or that scout saved somebody's life when everybody elsestod around in shock or just not knowing what to do.

 

Don't sell the scouts short.

[dScouter15]

Mr. Boyce - The specific chemical that triggers an anaphylactic reaction will differ from individual to individual (and allergy to allergy). In peanuts, its often a protein called "Ara h 2". In fact, there has been some research over the past couple years to develop peanut products that don't have these types of proteins, thus reducing their likelihood for triggering a severe allergic reaction.

 

Scoutfish, I believe that exact wording was: "First off, your first indication of a severe allergic reaction may be the victim passing out. You won't be able ask the victim anything. I'd even venture to say that in a majority of the time, the victim going to the ground as the first indicator is more the norm, not less." I'm certainly not trying to under-emphasize the potential severity of anaphylactic reactions, but I do think its important to be discussing it in actual realistic terms, rather than unsupported exaggerations. While I suppose that its possible that some people are so hyper-sensitive that unconsciousness may occur before other signs and symptoms and be noticed and treated, the majority of cases will develop over a slightly longer period, giving educated and prepared Scouts and Scouters and opportunity to act, and hopefully reverse a life-threatening situation. And, as I've pointed out before, an EpiPen will generally not be as effective after an individual loses consciousness.

 

As a parallel - you brought up bystander CPR. I'm not certain what the numbers you mention really represent, but there have been studies done to investigate the benefits of providing wide spread "lay person" CPR education. One of the more commonly cited studies compares cardiac arrest statistics between the cities of Seattle and New York City. Seattle has made extensive efforts to provide CPR training to "lay people." Thus, lay people have been more likely to provide quality CPR when confronted with a case of sudden cardiac arrest (SCA). This education, tied with a quality EMS system, has yielded a 30% survival rate for victims of SCA. In New York, on the other hand, there is not wide spread CPR training efforts, and bystanders are less likely to provide CPR, or perform correct CPR. Also, there are poorer EMS response times. Survival rates in New York are roughly 1-2%, so its easy to see the benefits of lay person training. Even more striking are statistics involving the training by lay people who staff high-volume facilities (airport and mall security, school teachers, department store staff, etc). Rapidly reacting to a SCA with quality CPR and the availability of an AED raises survival rates to around 70%!

 

Clearly SCA and anaphylaxis are two different things, but I think its easy to see the parallels between the proven benefits of lay person CPR education, and the need for lay person EpiPen education.