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Allergy and Anaphylaxis Action Plan and Medication Orders Student s Name: D.O.B. Grade: School: Teacher: ALLERGY TO: Place child s photo here History: Asthma: YES (Higher risk for severe reaction)
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How to fill out severe allergy anaphylaxis care

How to fill out severe allergy anaphylaxis care:
01
Gather all necessary information about the person needing care, such as their full name, date of birth, and contact information.
02
Fill out the medical history section, noting any known allergies and previous episodes of anaphylaxis.
03
Include information about the person's specific triggers, such as certain foods, medications, or insect stings.
04
Provide details about any prescribed medications for anaphylaxis, including the dosage and administration instructions.
05
Ensure that emergency contact information is accurately recorded, including the names and phone numbers of individuals to be notified in case of an allergic reaction.
06
Include any additional instructions or precautions given by healthcare professionals, such as the need to carry an epinephrine auto-injector at all times.
07
Review and sign the form after completing all relevant sections.
Who needs severe allergy anaphylaxis care:
01
Individuals with diagnosed severe allergies, especially those who have experienced anaphylaxis in the past.
02
People who are at risk of encountering allergens that can trigger anaphylactic reactions, such as food service workers or individuals with outdoor occupations.
03
Anyone who is responsible for the care of a person with severe allergies, including parents, teachers, and caregivers.
04
Individuals who regularly come into contact with allergens, such as healthcare professionals who administer medications or perform tests that could trigger an allergic reaction.
05
Those who have a family history of severe allergies or anaphylaxis and want to be prepared in case of an emergency.
Overall, severe allergy anaphylaxis care is necessary for individuals who have a high risk of experiencing severe allergic reactions and need to have their medical information and emergency procedures documented to ensure their safety.
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What is severe allergy anaphylaxis care?
Severe allergy anaphylaxis care is a plan outlining steps to manage and treat a severe allergic reaction known as anaphylaxis.
Who is required to file severe allergy anaphylaxis care?
Individuals with severe allergies or their caregivers are required to file severe allergy anaphylaxis care.
How to fill out severe allergy anaphylaxis care?
Severe allergy anaphylaxis care can be filled out by including information about known allergies, triggers, emergency contact details, and steps to take in case of an allergic reaction.
What is the purpose of severe allergy anaphylaxis care?
The purpose of severe allergy anaphylaxis care is to ensure proper management and treatment of severe allergic reactions to prevent serious consequences.
What information must be reported on severe allergy anaphylaxis care?
Information such as known allergies, triggers, emergency contact details, medications, and steps to take in case of an allergic reaction must be reported on severe allergy anaphylaxis care.
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