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ACTION PLAN FOR An ap h y l axis www. allergy. org. au For adrenaline epinephrine autoinjectors Name Date of birth SIGNS OF MILD TO MODERATE ALLERGIC REACTION Swelling of lips face eyes Hives or welts Tingling mouth Abdominal pain vomiting these are signs of anaphylaxis for insect allergy Photo For insect allergy - flick out sting if visible For tick allergy - freeze dry tick and allow to drop off Stay with person and call for help Locate or Jr adrenaline autoinjector Give other medications...
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How to fill out ascia action plan for
How to fill out ascia action plan for
01
Step 1: Download the ASCIA Action Plan form from the ASCIA website.
02
Step 2: Read the instructions on the form carefully.
03
Step 3: Fill out your personal information, including your name, date of birth, and contact details.
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Step 4: Indicate your allergic conditions and triggers by checking the appropriate boxes.
05
Step 5: If needed, provide additional details about your allergies in the designated section.
06
Step 6: Specify any emergency medications you require and the dosage instructions.
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Step 7: If applicable, provide information about other health conditions or medications you are currently taking.
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Step 8: Sign and date the form.
09
Step 9: Keep a copy of the completed ASCIA Action Plan for yourself.
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Step 10: Share the completed form with your healthcare provider, school, or any relevant individuals who may need the information.
Who needs ascia action plan for?
01
Individuals with severe allergies
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Individuals at risk of anaphylaxis
03
Children with allergies attending schools or daycare centers
04
Individuals participating in activities that may expose them to allergens (e.g., sporting events)
05
Individuals taking regular medication for allergies
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Individuals with a history of severe allergic reactions
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