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Old 02-08-2018, 05:52 AM
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Default Nebulizers - Yes or No

I do not administer any medication except live saving meds. Insulin, epi pen, inhaler, etc.

What if a child needs a nebulizer treatment throughout the day? Is that considered life saving? Technically it is the same medication as many inhalers (albuterol) but nebs are often prescribed for illnesses, right?

WWYD?
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Old 02-08-2018, 06:25 AM
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Quote:
Originally Posted by Baby Beluga View Post
I do not administer any medication except live saving meds. Insulin, epi pen, inhaler, etc.

What if a child needs a nebulizer treatment throughout the day? Is that considered life saving? Technically it is the same medication as many inhalers (albuterol) but nebs are often prescribed for illnesses, right?

WWYD?
Me personally I wouln't do it. It is most likely an illness and they should probably be at home.
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Old 02-08-2018, 07:11 AM
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I recently had an infant with RSV who needed a neb. Told them that because shes needing breathing treatments, she needs to stay home.
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Old 02-08-2018, 08:41 AM
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Okay, that's good to know.

I haven't come across this situation with a DCK yet...but with all the stuff going around I need to have a plan before it happens.
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Old 02-08-2018, 09:32 AM
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I've never thought of this. good point.
I administer whatever usually, well not fever reducers but if a doc prescribes an antibiotic to be given like 3 times a day but child isn't contagious after the first day or what they were home with mom and that middle dose is while they are in my care i do that for them.

I would do a nebulizer but yes it could be for pneumonia or RSV or bronchitis or lots of lung things that could be contagious. its up to you maybe as the doctor to email something to you about what its for and them you can make a better decision.
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Old 02-08-2018, 11:21 AM
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I will administer them. My son has asthma and has used them from a very young age. However, for an infant, I would not. It can quickly turn bad with such little ones. For my son, using his neb at the first sign of a cold actually helps prevent it from turning into worse things like pneumonia, bronchilitis etc. I would want a physician's note to determine the diagnosis and go from there. It also would depend if the child fights them or is ok taking them.
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Old 02-08-2018, 12:03 PM
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I will administer them. My son has asthma and has used them from a very young age. However, for an infant, I would not. It can quickly turn bad with such little ones. For my son, using his neb at the first sign of a cold actually helps prevent it from turning into worse things like pneumonia, bronchilitis etc. I would want a physician's note to determine the diagnosis and go from there. It also would depend if the child fights them or is ok taking them.
I have a dcb that is 3 and he has asthma and they have brought his nebulizer here for me to do a treatment. Same thing, if he doesn't get it, he could be in much bigger trouble. It's the easiest thing to give it to him and it can help him from getting sicker. I just have them sign the medical form. Really no big deal. I also give antibiotics if they're past the contagious period.
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Old 02-08-2018, 12:18 PM
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I will give nebs for a child after they've turned 1.
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Old 02-08-2018, 12:48 PM
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Quote:
Originally Posted by Baby Beluga View Post
I do not administer any medication except live saving meds. Insulin, epi pen, inhaler, etc.

What if a child needs a nebulizer treatment throughout the day? Is that considered life saving? Technically it is the same medication as many inhalers (albuterol) but nebs are often prescribed for illnesses, right?

WWYD?
Is it an acute illness or chronic?
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Old 02-08-2018, 12:53 PM
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I will give nebs for asthma with a Drs order. I will not give nebs for illness. I am in a unique position b/c most of the children in my care are related to me. That makes me feel a little better about giving meds b/c my family is very close & as long as I have a Drs note I will follow mom's wishes. However, last fall my nephew had pneumonia & they prescribed one. His mom did his first dose here & he seemed kind of off but I just thought it was b/c he didn't feel good. After a second dose at home he ended up in the emergency room b/c of a reaction to the Albuterol. It caused me to really rethink things. If they're sock enough to need one for an illness I feel they should be at home. I do have asthma & often had to take mine to school with me so I understand that side of it too.
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Old 02-08-2018, 12:53 PM
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https://www.daycare.com/forum/showth...ight=nebulizer
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Old 02-08-2018, 01:47 PM
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Most young kids here are given nebulizers because they are too young to effectively use an inhaler.

Breathing is important to life. So yes, I administer nebulizer treatments.

If itís for illness though, it depends on the situation. If a child is recovering from a lung infection, the infection itself is gone, but they need the treatments for the lungs to heal, then yes Iíll do it. But if they are still sick they need to be at home.

FTR, nebulizer treatments can go on for a month or more after some lung infections.
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Old 02-08-2018, 02:17 PM
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While it is far from my favorite task, I will administer Nebulizer treatments.

When I worked in a center I did so daily for two little guys with asthma. My own DS had RSV at 4 months old, and needed nebulizer treatments long after the virus had gone bevause of the damage it did to his lungs. He then got bronchitis at 8 months and again needed the treatments long after the sickness was gone.

IMO, breathing is pretty important, so while I don't enjoy doing nebulizer treatments (imagine trying to put a onsie on an alligator, that is how most infant/toddler neb treatments go down), I will do them.
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Old 02-08-2018, 02:31 PM
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If a child requires a nebulizer due to an illness I will not administer and would more than likely require the child to remain home but if a child was medically diagnosed with asthma, I would absolutely administer a nebulizer.

I've only had 2 or 3 kids in all my years that required a nebulizer and all of them were able to mostly do it themselves. I would get everything ready and they would sit in a chair and hold the mask or mouth piece themselves. They were used to it as it was part of their regular daily lives.

I wouldn't feel comfortable if the child was an infant but the couple times I have had experiences with nebulizers, I had no issues. So I guess for me it would be a case by case thing.
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Old 02-08-2018, 07:31 PM
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I would administer a neb if needed for allergies or asthma. For an illness Iíd likely have to make a case by case decision depending on if itís contagious and what other issues/symptoms go along with it. I typically will administer any medication as needed at the parent and physicianís directive and I keep a detailed log of anything that I administer.
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Old 02-08-2018, 10:19 PM
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I have a 2yr old now that needs a nebulizer. I help him do it before nap, but he mostly does it on his own. If he recently had a cold or is having a rough patch (asthma or allergies) she sends it along. There's big chunks of time we don't have to do it, but when it is needed... it is NEEDED. He sleeps SO much better if we can do it ahead of time. Poor kid had a rough day today, had the nebulizer and still only slept an hour.
I have asthma and allergies, and I know how awful the day can be if either is effecting me. I have no problem making a kid feel a little more comfortable!
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Old 02-09-2018, 08:27 AM
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Quote:
Originally Posted by nannyde View Post
Is it an acute illness or chronic?
Neither yet, just planning ahead
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Old 02-09-2018, 08:35 AM
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The distinction between asthma/allergies and illness is an important one....and one I didn't think of. THIS is why I ask you all

Here is what got me thinking:

DCB had a barking cough, no other symptoms. Told mom he needed to see the doc and I would determine if/when he could return. Doc cleared DCB of everything, doc said cough was just lingering from a cold. Unfortunately here, it IS common to have coughs that last weeks after colds. This DCB's cough didn't last weeks (two days and was very infrequent but when he did cough it sounded barky. The barky sound is what had me concerned) but it got me thinking: what if doc prescribed a neb treatment? How would I handle it?

I suppose if it were for an illness I would require the child to stay home for a certain amount of time and would possibly administer the treatments if child no longer met exclusion policies but was at the tail end of the neb treatment.

For allergies/asthma it makes sense to do it with proper documentation from the doc. Especially if it can help ward off a much worse illness. After DS had a round of RSV and bronchiolitis his ped said if he gets a cough or cold to do neb treatments for two days to try and prevent DS from getting a worse illness so I can see how that could happen to a DCK.
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Old 02-09-2018, 08:38 AM
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Quote:
Originally Posted by Baby Beluga View Post
The distinction between asthma/allergies and illness is an important one....and one I didn't think of. THIS is why I ask you all

Here is what got me thinking:

DCB had a barking cough, no other symptoms. Told mom he needed to see the doc and I would determine if/when he could return. Doc cleared DCB of everything, doc said cough was just lingering from a cold. Unfortunately here, it IS common to have coughs that last weeks after colds. This DCB's cough didn't last weeks (two days and was very infrequent but when he did cough it sounded barky. The barky sound is what had me concerned) but it got me thinking: what if doc prescribed a neb treatment? How would I handle it?

I suppose if it were for an illness I would require the child to stay home for a certain amount of time and would possibly administer the treatments if child no longer met exclusion policies but was at the tail end of the neb treatment.

For allergies/asthma it makes sense to do it with proper documentation from the doc. Especially if it can help ward off a much worse illness. After DS had a round of RSV and bronchiolitis his ped said if he gets a cough or cold to do neb treatments for two days to try and prevent DS from getting a worse illness.
But the difference is you are the parent in that scenario and are the one assuming liability and managing treatment.

If this same scenario occurred with a DCK, I'd want the parent to have to do the "hard work" of managing their child vs putting it on the provider...kwim?
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Old 02-09-2018, 09:01 AM
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Many illnesses cause lung damage that needs to be treated for weeks or months after the illness itself has run its course. neb treatments are needed every 4-6 hours depending on which meds are used. So.....I'd require parents to do the first one of the day so that I only had to do one treatment.
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Old 02-09-2018, 09:31 AM
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If a child needs a breathing treatment I have the parent stop by during lunch hour to administer it. And they can treat in the morning before they come and after theyíre picked up at night. I do not want the liability.
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Old 02-09-2018, 10:10 AM
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But the difference is you are the parent in that scenario and are the one assuming liability and managing treatment.

If this same scenario occurred with a DCK, I'd want the parent to have to do the "hard work" of managing their child vs putting it on the provider...kwim?
Absolutely
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Old 02-09-2018, 10:26 AM
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If the child is needing breathing treatment to survive, i would not feel comfortable being responsible for that. Too much liability. If it can be done in the morning and at night, at home, Then great. If not, then they are too sick for daycare. If its an asthma issue, i like the idea of the parent coming at lunch break to administer.
An old co worker of mine had a 10 month old son with asthma. He died at daycare from an asthma attack. Although the daycare probably did what they were suppose to do, as a grieving parent I would want to blame the daycare provider and accuse her of not doing the treatment correctly.
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Old 02-12-2018, 02:10 PM
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I have twins with lung issues who absolutely require nebs. At first (they were 10 months old then), it was every 2 hours for each of them-levalbuterol followed with saline. I burned out my nebulizer in a few months! I only use my own machine, because I don't want parents stuff around my house and don't like the back and forth of equipment.

A kid with pneumonia who required nebs? They'd stay home.

I base it on the child. A sick child needing nebs is a liability in some cases. A child who needs it as maintenance, I can do that.
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