Get the free EpiPen Order Form/Care Plan - stlouisparish

Form for ordering EpiPen and medications for students with allergic reactions to be filled by a physician or authorized prescriber.

How to fill out epipen order formcare plan

How to fill out EpiPen Order Form/Care Plan

1. Begin by downloading the EpiPen Order Form/Care Plan from the official website or obtain a physical copy from your healthcare provider.
2. Fill in the patient's personal information, including name, date of birth, and contact details.
3. In the section for medical history, provide details of any known allergies or previous anaphylactic reactions.
4. Fill out the information regarding the prescribed dosage and usage instructions for the EpiPen.
5. Include emergency contact information for caregivers and medical professionals.
6. Review the form for accuracy and completeness.
7. Sign and date the form where required.
8. Submit the completed form to the designated healthcare professional or school nurse.

Who needs EpiPen Order Form/Care Plan?

1. Individuals with known severe allergies that may require emergency epinephrine treatment.
2. Parents or guardians of children with allergies that potentially lead to anaphylaxis.
3. School administrators and teachers who need to ensure the safety of students with allergies.
4. Healthcare providers who manage patients at risk for anaphylaxis.

People Also Ask about

What is the correct order for administering an EpiPen?

Place the orange tip against the middle of the outer thigh (upper leg) at a right angle (perpendicular) to the thigh. Swing and push the auto-injector firmly until it “clicks.” The click signals that the injection has started. Hold firmly in place for 3 seconds (count slowly 1, 2, 3).

Can nurses administer epinephrine without an order?

Can the registered nurse administer epinephrine for anaphylaxis without an order? The registered nurse may carry and administer epinephrine under the direction of an authorized health care practitioner.

What can a RN do without a physician's order?

The registered nurse may administer medications and perform treatments or procedures without an authorized health care practitioner on the premises. A prescription or order from an authorized provider is required for legend drugs, controlled substances or for medical treatments.

Can a nurse give an EpiPen without an order?

The registered nurse may not administer epinephrine without an order from an authorized health care practitioner. The order or prescription may be for a specific patient or through the use of standing orders. Another option is for the facility or employer to become an authorized entity.

Can a nurse give medication without doctor's order?

No, you are not permitted to initiate the insertion of an IV in this situation. Initiation occurs when an RN or RPN independently decides, in the absence of an order, that a specific activity is required and then performing it in compliance with the regulations.

How do you use an EpiPen step by step?

2:22 4:24 Hold the leg. And the child steadily press the orange. Part firmly against the thigh. So that itMoreHold the leg. And the child steadily press the orange. Part firmly against the thigh. So that it clicks. Stay there don't bounce hold for 10 seconds.

How to prescribe epipens?

Dosage and administration: ADULTS: Administration of 0.3mg adrenaline (EpiPen®) intramuscularly. CHILDREN: The appropriate dosage may be 0.15mg (EpiPen® Jr.) for children 7.5-25kg body weight and 0.3mg (EpiPen®) adrenaline for children >25kg body weight, or at the discretion of the physician.

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What is EpiPen Order Form/Care Plan?

The EpiPen Order Form/Care Plan is a documented plan outlining the use of an EpiPen in case of allergic reactions. It ensures that individuals, especially those with severe allergies, have a clear understanding of when and how to use the EpiPen.

Who is required to file EpiPen Order Form/Care Plan?

Typically, parents or guardians of children with severe allergies are required to file the EpiPen Order Form/Care Plan with schools and care facilities to ensure proper administration in case of an emergency.

How to fill out EpiPen Order Form/Care Plan?

To fill out the EpiPen Order Form/Care Plan, one must provide the patient's personal information, details of their allergies, physician's information, and specific instructions on EpiPen usage. It may also require signatures from a healthcare provider and the patient's guardian.

What is the purpose of EpiPen Order Form/Care Plan?

The purpose of the EpiPen Order Form/Care Plan is to ensure that there is a clear, actionable plan in place for administering an EpiPen during an allergic reaction, thereby potentially saving a life by providing timely treatment.

What information must be reported on EpiPen Order Form/Care Plan?

The EpiPen Order Form/Care Plan must include the patient's name, specific allergies, EpiPen dosage instructions, emergency contact information, and signatures from the physician and guardian.