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ALLERGY/ANAPHYLAXIS ACTION PLAN Student Name D.O.B. Teacher Student Photo School Nurse Phone Number Health Care Provider Preferred Hospital History of Asthma No Higher risk for severe reaction ALLERGY:
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How to fill out an anaphylaxis action plan:

01
Begin by gathering all the necessary information. This includes the person's personal details such as name, age, and contact information, as well as their emergency contact's information.
02
Next, list all the known allergens that the person is allergic to. This can include food allergies, insect allergies, medication allergies, and any other known triggers.
03
Provide detailed instructions on how to recognize the signs and symptoms of an anaphylactic reaction. This should include information on symptoms such as difficulty breathing, swelling of the face or throat, hives, and rapid heartbeat.
04
Specify the steps to be taken in case of an emergency. This should include clear instructions to immediately administer an epinephrine auto-injector, call 911 or seek emergency medical help, and notify the person's emergency contact.
05
Include any additional instructions or precautions that are specific to the individual. For example, if the person has asthma, you may need to provide instructions on how to use an inhaler during an allergic reaction.
06
Ensure the plan is signed and dated by the person and their healthcare provider.

Who needs an anaphylaxis action plan?

01
Individuals with a history of anaphylaxis: Any individual who has experienced a severe allergic reaction in the past, known as anaphylaxis, should have an anaphylaxis action plan. This includes people with known allergies such as food allergies, medication allergies, insect allergies, or latex allergies.
02
Children with allergies: Children who have been diagnosed with allergies, especially severe ones, should have an anaphylaxis action plan in place. This ensures that caregivers, teachers, and other individuals responsible for the child's well-being are aware of what to do in case of an emergency.
03
Individuals at risk of anaphylaxis: Some individuals may not have had an anaphylactic reaction in the past but are at risk due to a known allergy or condition. For example, individuals with a severe peanut allergy or those with a stinging insect allergy may be at risk of anaphylaxis and should have an action plan in place.
Remember, it is important to consult with a healthcare professional to create a personalized anaphylaxis action plan that suits the individual's specific needs and medical history.
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An anaphylaxis action planbdoc is a document that outlines steps to be taken in case of an anaphylactic reaction.
Certain individuals or entities, such as schools, daycare centers, and healthcare facilities, are required to file an anaphylaxis action planbdoc.
An anaphylaxis action planbdoc can be filled out by providing information about the individual with allergies, their triggers, symptoms of anaphylaxis, and emergency contact information.
The purpose of an anaphylaxis action planbdoc is to ensure that proper protocols are in place to quickly and effectively respond to an anaphylactic reaction.
Information such as the individual's allergies, triggers, symptoms of anaphylaxis, emergency contact information, and steps to be taken in case of a reaction must be reported on an anaphylaxis action planbdoc.
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