7/29/2019 Allergy Care Plan

1/1

Pt

1

Fr fist arn

EpiPen an

Pull oFF BluE

SAFETY RElEASE.

PlAcE oRANGE

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i-tig (it r

itt ting).

PuSh dowN

hARd nti a iks ear r fet

an in pae

r 10 sens.

REmovE EpiPen.

massageinjetin site fr

10 sens.

Hw e EpPe

Nae:

date f birt:

cnfire aergens:

Faiy/eergeny ntat nae(s):

wrk P:

he P:

mbie P:

Pan prepare by:

dr:

Signe:

date:

AaphaA c t i o n P l A n f o r

For insect allergy, flick out sting if visible. Do not remove ticks.

Stay it persn an a fr ep

late EpiPen r EpiPen Jr

Gie ter eiatins (if presribe) ....................................

dse: ..........................................................................................

Pne faiy/eergeny ntat

For use with EpiPenadrenaline autoinjectors

A c t i o n

m i l d t o m o d E r A t E A l l E r g i c r E A c t i o n

diffit/nisy breatingSeing f tnge

Seing/tigtness in trat

diffity taking an/r arse ie

weeze r persistent g

Persistent izziness r apse

Pae an fppy (yng iren)

1 Lay person flat. Do not allow them to stand or walk.If breathing is difficult allow them to sit.

2 Give EpiPen or EpiPenJr

3 Phone ambulance*- 000 (AU), 111 (NZ), 112 (mobile)

4 Phone family/emergency contact

5 Further adrenaline doses may be given if no response after

5 minutes (if another adrenaline autoinjector is available)

If in doubt, give adrenaline autoinjectorAfter giving adrenaline:

Commence CPR if there are no signs of life

Give asthma medication if unsure whether it is asthma or anaphylaxisEpiPen is generay presribe fr ats an iren er 5 years.

EpiPen Jr is generay presribe fr iren age 1-5 years.

*meia bseratin in spita fr at east 4 rs is reene after anapyaxis.

A n A P H y l A x i s ( s E v E r E A l l E r g i c r E A c t i o n )

A c t i o n

Aitina infratin

www.allergy.org.au

Seing f ips, fae, eyeshies r ets

Tinging t

Abina pain, iting (tese are signs f a seere aergi

reatin t insets)

2

3 4

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developedbyAScIA

Instrtins are as n te eie abe

an at .aergy.rg.a/eat-

prfessinas/anapyaxis-resres Nte: Tis is a eia ent tat an ny be pete an signe by te patient's

treating eia tr an annt be atere itt teir perissin.

Watch for any one of the following signs of Anaphylaxis

Mild to moderate allergic reactions mayor may not precede anaphylaxis