ASCIA Action Plan Allergic Reactions Green 2023
ASCIA Action Plan Allergic Reactions Green 2023
ASCIA Action Plan Allergic Reactions Green 2023
www.allergy.org.au
Allergic Reactions
Name: Date of birth: DD / MM / YYYY
Confirmed allergen(s):
Family/emergency contact(s):
1. Mobile:
Photo 2. Mobile:
Plan prepared by: (doctor or nurse practitioner)
who authorises medications to be given, as consented by the patient or parent/guardian,
according to this plan.
Signed: Date: DD / MM / YYYY
Antihistamine: Dose:
This plan does not expire but review is recommended by: DD / MM / YYYY
This ASCIA Action Plan for Allergic Reactions is for people who have allergies but do not have a prescribed adrenaline (epinephrine) injector.
ALWAYS GIVE ADRENALINE INJECTOR FIRST and then asthma reliever puffer if someone with known asthma
and allergy to food, insects or medication (who may have been exposed to the allergen) has SUDDEN BREATHING
DIFFICULTY (including wheeze, persistent cough or hoarse voice) even if there are no skin symptoms.
If adrenaline is accidentally injected, phone your local poisons information centre. Continue to follow this action plan for the person with the allergic reaction.
© ASCIA 2023 This plan is a medical document that can only be completed and signed by the patient's doctor or nurse practitioner and cannot be altered without their permission.