Allergy Capital

MODEL Child Emergency

Anaphylaxis Action Plan

Version 24 August 2003

IMPORTANT The information provided is of a general nature and should not be used as a substitute for professional advice. If you think you may suffer from an allergic or other disease that requires attention, you should discuss it with your family doctor.

NB: Emergency Anaphylaxis Action Plans need to be designed by the patient's doctor and should be updated refularly. A written Action Plan is required for schools and child-care centres caring for children serious allergic problems. Individual Plans will vary, and should be designed by your doctor. A photo of the child can sometimes help identify children at risk in a group setting.

The Australasian Society for Clinical Immunology and Allergy (ascia) has recently (2003) released

consensus Australasian Anaphylaxis Action Plans (shown below)

which may be downloaded in pdf format from their web site, or by clicking on the graphics below.

For historical reasons, the old version of this page is detailed below.

Name _______________________________________Allergic to___________________________________________________________
Past reactions: anaphylactic to___________________________________________
Other health problems__________________________________________________

Medications__________________________________________________________
Health Plan Dated____________________
Signed by Doctor: _____________________________Tel_____________________
Where EpiPen (adrenaline) is stored:

If exposure to ________________is suspected

Call for help (eg. other staff, ambulance)
Get to spit out the food if possible
Give additional medication eg. antihistamine (if prescribed)
Get Epi-Pen ready in case it is needed
Observe for dangerous symptoms such as difficulty speaking/breathing, gasping, collapse, fainting.
If dangerous symptoms appear, administer Epi-Pen into mid thigh and double check that ambulance was called
Note TIME that Epipen was given

USING EPIPEN (adrenaline injector)

Remove grey cap
Hold in fist grip (do not touch either end)
Press black end of device into the front of the mid-thigh
Listen for a "click" as the device is triggered
Hold in place for 10 seconds
Remove Epipen- be careful not to touch needle
Place in sharps container & hand to ambulance officer
Be prepared to resuscitate (Airways, Breathing, Circulation)

Notify Parents (insert telephone numbers here) ___________________________

NOTES

Have a copy of Action Plan kept WITH the Epipen. That way it can be followed by the person giving First Aid, the steps can be "ticked off" as they are done, and the used Epipen and health information about the child and parent contact details can be given to the ambulance officers when they arrive.
As exercise can make reactions worse, better to either carry child closer to help OR bring adrenalin to the child.
A sharps container is safer than putting Epipen into a glass jar. Small sharps containers can be bought from Totalcare (ACT).