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Colorado Allergy and Anaphylaxis Emergency Care Plan and Medication Orders Students Name: D.O.B. Grade: School: Teacher: ALLERGY TO: HISTORY: Asthma: YES (higher risk for severe reaction) Place children
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To fill out Colorado Allergy and Anaphylaxis Action Plan, follow these steps:
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Start by providing all the necessary personal information of the individual requiring the plan, such as their name, date of birth, contact information, and emergency contact details.
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Next, provide a detailed medical history, including any known allergies and previous experiences with anaphylaxis.
04
Specify the triggers that can cause anaphylaxis for the individual, such as certain foods, medications, insect bites, or environmental factors.
05
Indicate the symptoms of an allergic reaction or anaphylaxis that the individual may exhibit, including both mild and severe symptoms.
06
Include any specific instructions for managing anaphylaxis, such as the use of prescribed medications like epinephrine autoinjectors and when to administer them.
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Provide emergency contact numbers and any special instructions for contacting medical professionals or caregivers in case of anaphylactic episodes.
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Finally, review the completed form for accuracy and ensure all necessary signatures are obtained, including those of the medical provider and the individual themselves.

Who needs colorado allergy and anaphylaxis?

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Colorado Allergy and Anaphylaxis Action Plan is needed by individuals who have a history of allergies or anaphylaxis. This may include individuals with food allergies, medication allergies, insect sting allergies, or other severe allergic reactions. It is particularly important for individuals who are at risk of experiencing anaphylaxis, a potentially life-threatening allergic reaction that requires immediate medical attention. The plan helps healthcare professionals, caregivers, and school personnel in understanding the specific needs of the individual and provides guidance on managing allergic reactions and anaphylactic episodes.
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Colorado allergy and anaphylaxis program is a state-wide program designed to track and monitor allergic reactions and anaphylaxis cases.
Healthcare providers, schools, and other entities are required to file reports of allergic reactions and anaphylaxis cases in Colorado.
The reports can be filled out online through the Colorado Department of Public Health and Environment's website.
The purpose of the program is to collect data on allergic reactions and anaphylaxis cases in order to improve prevention, diagnosis, and treatment.
The reports must include information about the individual experiencing the allergic reaction or anaphylaxis, the triggers, symptoms, and treatment provided.
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