Action Plans for anaphylaxis and allergic reactions - FAQ
Frequently Asked Questions (FAQ) and Answers
Q 1: How have the revised ASCIA Action Plans (2018) changed from the previous (2017) versions?
The following 2018 versions of ASCIA Action Plans are now available on the ASCIA website www.allergy.org.au/anaphylaxis:
- ASCIA Action Plan for Anaphylaxis Personal (RED) EpiPen version Updated July 2018
- ASCIA Action Plan for Anaphylaxis Personal (RED) Generic version New July 2018
- ASCIA Action Plan for Anaphylaxis General (ORANGE) EpiPen version Updated July 2018
- ASCIA Action Plan for Anaphylaxis General (ORANGE) Generic version New July 2018
- ASCIA Action Plan for Allergic Reactions (GREEN) version Updated July 2018
The main changes to the plans (compared to the 2017 versions) are as follows:
- New generic versions of ASCIA Action Plans for Anaphylaxis have been developed for use with any brand of adrenaline (epinephrine) autoinjector, with no mention of brand names or brand specific instructions.
- Updated EpiPen brand specific versions of ASCIA Action Plans for Anaphylaxis include “How to use EpiPen”. However, to ensure consistency with the generic plans the EpiPen brand name is not mentioned elsewhere.
- To reduce the risk of prescribing or dispensing the incorrect dose of adrenaline autoinjector, ASCIA prescribing guidelines are now included on each plan: Adrenaline autoinjectors (300 mcg) are prescribed for children over 20kg and adults; Adrenaline autoinjectors (150 mcg) are prescribed for children 10-20kg.
- To minimise the risk of inappropriate treatment and prevent allergic reactions to ticks, the following updated information is included on each plan “For tick allergy seek medical help or freeze tick and let it drop off”.
- As a result of new research data, the following wording has been added to each plan
- If adrenaline is accidentally injected (e.g. into a thumb) phone your local poisons information centre.
- Continue to follow this action plan for the person with the allergic reaction.
Q 2: How many types of ASCIA Action Plans are there?
There are two types of ASCIA Action Plans for Anaphylaxis:
- Personal versions (RED) are for individuals who have been prescribed adrenaline autoinjectors. This plan includes personal information and an area for a photo.
- General versions (ORANGE) do not contain any personal information and can be used as posters.
There is also an ASCIA Action Plan for Allergic Reactions (GREEN), for individuals with medically confirmed mild to moderate allergies, who need to avoid certain allergens, but have not been prescribed adrenaline autoinjectors. This plan includes personal information and an area for a photo.
ASCIA Action Plans for Anaphylaxis and Allergic Reactions have text fields that can be directly typed into.
Q 3: Can the older versions (prior to 2017) of ASCIA Action Plans still be used?
No. These previous versions of ASCIA Action Plans should no longer be used.
Q 4: Can schools or parents complete an ASCIA Action Plan for Anaphylaxis (personal) or ASCIA Action Plan for Allergic Reactions for their students or children?
No. ASCIA Action Plans have been developed as medical documents and must be completed, signed and dated by the patient's medical doctor. If copies are required the original signed copy should be photocopied or scanned.
Q 5: Is it possible to obtain an electronic copy of the ASCIA Action Plans so that the child's information can be inserted by parents, school staff or early childhood education/care (ECEC) staff?
No. ASCIA Action Plans have been developed in a PDF format to ensure the documents are concise, consistent and easily understood. They now have fields that can be directly typed into by the treating doctor, but not by parents, school or ECEC staff, as they are medical documents.
Q 6: How often does an ASCIA Action Plan need to be updated?
ASCIA Action Plans should be reviewed when patients are reassessed by their doctor, and each time they obtain a new adrenaline autoinjector prescription, which is approximately every 12 to 18 months, with an updated photo if the patient is a child. If there are no changes in diagnosis or management, the medical information on the ASCIA Action Plan may not need to be updated.
The ASCIA Action Plan includes the date of next Action Plan review, which should coincide with the next scheduled appointment to obtain a new adrenaline autoinjector prescription (approximately every 12 to 18 months).
Q 7: ASCIA Action Plans on the ASCIA website are copyrighted. Can we still print them out and make copies?
Yes. ASCIA Action Plans can be printed off the website or photocopied without infringement of the copyright. ASCIA recommends that the Action Plans are printed in colour, if possible, as they are colour coded.
Q 8: What is the purpose of ASCIA Action Plans for Anaphylaxis?
ASCIA Action Plans for Anaphylaxis provide instructions for first aid treatment of anaphylaxis, to be delivered by people without any special medical training nor equipment, apart from access to an adrenaline autoinjector. All patients who have been prescribed an adrenaline autoinjector should also be provided with an ASCIA Action Plan for Anaphylaxis (personal)
Q 9: Is abdominal pain and/or vomiting without other symptoms a feature of anaphylaxis due to insect allergy?
Yes. The ASCIA Action Plan states that abdominal pain and/or vomiting is a symptom of a mild to moderate allergic reaction unless the individual has been stung or bitten by an insect in which case abdominal pain and/or vomiting is a symptom of anaphylaxis. Therefore, if someone experiences abdominal pain and/or vomiting to a food or medication, this is considered a mild to moderate symptom. However, if someone experiences abdominal pain and/or vomiting after being stung or bitten by an insect, this is a symptom of anaphylaxis and the adrenaline autoinjector should be administered.
It is important to watch for other signs and symptoms.
As stated on the ASCIA Action Plan, if in doubt as to whether the child or adult is experiencing anaphylaxis, give the adrenaline autoinjector and call an ambulance.
Q 10: Why does the ASCIA Action Plan for Anaphylaxis state that CPR should only be given if the person is unresponsive and not breathing normally AFTER giving adrenaline?
Adrenaline is life-saving and must be used promptly. Withholding or delaying the giving of adrenaline can result in deterioration and potentially death of the patient. This is why giving the adrenaline autoinjector is a priority on ASCIA Action Plans for Anaphylaxis, to prevent delays. If CPR is given before this step there is a possibility that adrenaline is delayed or not given. It is important to note that oxygen will usually be administered to the patient ambulance staff.
Q 11: Who should have an ASCIA Action Plan for Allergic Reactions (green)?
The ASCIA Action Plan for Allergic Reactions has been developed for individuals (children or adults) with a confirmed food, insect or medication allergy, who have not been prescribed an adrenaline autoinjector, as they are not thought to be at risk of anaphylaxis. However, allergies to foods, insects or medications have the potential to result in severe allergic reactions (anaphylaxis) and the ASCIA Action Plan for Allergic Reactions provides guidance for carers on how to manage anaphylaxis if it occurs.
Q 12: Should an individual with allergic rhinitis (hay fever) have an ASCIA Action Plan for Allergic Reactions completed by their doctor?
No. Whilst allergic rhinitis can cause uncomfortable symptoms, these symptoms are not potentially life-threatening allergic reactions and hence an ASCIA Action Plan is not required. If the allergic rhinitis affects an individual's asthma, their Asthma Action Plan should be followed.
Q 13: Is there an ASCIA Treatment Plan specifically designed for individuals with allergic rhinitis (hay fever)?
Yes. The ASCIA Treatment Plan for Allergic Rhinitis has been developed for individuals with allergy to grasses, dust mite, mould etc resulting in allergic rhinitis. This Treatment Plan is completed by the individual's medical practitioner and is meant for the individual or the parent and not for schools. Most schools do not play a role in the treatment and management of allergic rhinitis. However, where medication administration is required at school, parents should liaise directly with the school.
Q 14: Can an organisation obtain an adrenaline autoinjector for general use (not prescribed for an individual) and do they require an Action Plan for Anaphylaxis?
Yes. Adrenaline autoinjectors for general use can be purchased without a prescription at full price from pharmacies. More information is available in the ASCIA document "Adrenaline autoinjectors for general use" which is available from the Anaphylaxis Resources section on the ASCIA website. The ASCIA Action Plan for Anaphylaxis (general) has been developed for use as a poster or as an instruction guide to include with an adrenaline autoinjector for general use.
Q 15: Where can we go to obtain further resources?
Patient information and anaphylaxis training is available from ASCIA, the peak professional body for clinical immunology and allergy in Australia and New Zealand www.allergy.org.au/patients
Patient information and support is available from the following patient support groups for Australia and New Zealand:
© ASCIA 2018
ASCIA is the peak professional body of clinical immunology/allergy specialists in Australia and New Zealand
Postal address: PO Box 450 Balgowlah NSW 2093 Australia
This document has been developed and peer reviewed by ASCIA members and is based on expert opinion and the available published literature at the time of review. Information contained in this document is not intended to replace medical advice and any questions regarding a medical diagnosis or treatment should be directed to a medical practitioner. Development of this document is not funded by any commercial sources and is not influenced by commercial organisations.
Content updated July 2018