Any one of the following are signs of anaphylaxis:

• difficult/noisy breathing
• swelling of tongue
• swelling/tightness in throat
• difficulty talking and/or hoarse voice
• wheezing or persistent cough
• persistent dizziness or collapse
• pale and floppy (young children)

The Australian Society of Clinical Immunology and Allergy (ASCIA) provide the ASCIA Action Plan for Anaphylaxis (RED), which is a medical document that is to be completed by the treating medical or nurse practitioner.

The ASCIA Action Plan for Anaphylaxis (RED) is for patients who have been prescribed an adrenaline injector and provides specific instructions for administering the patients prescribed adrenaline injector (i.e. either the EpiPen® or Anapen®).

The ASCIA Action Plan for Allergic Reactions (GREEN) is for patients with allergies who have not been prescribed an adrenaline injector.

ASCIA Action Plans Allergic Reactions and Anaphylaxis have been developed as an easy to follow, single page document to assist in emergency treatment of severe allergy and anaphylaxis.

The form is personalised and confirms allergens to be avoided, what response should be made if the student has an anaphylactic reaction and how to use an adrenaline injector.

As it is the emergency response plan for anaphylaxis, it should be part of the student's individual health support plan. Read more about ASCIA action plans.

The parents of each student diagnosed with anaphylaxis should provide the school with an ASCIA Action Plan for Anaphylaxis (RED) signed by the treating practitioner for that student and an adrenaline injector. The ASCIA Action Plan provided must be a full colour copy and align with the adrenaline injector prescribed to the student.

Schools must maintain a minimum of one general use adrenaline injector (EpiPen®) stored within a school first aid kit with the ASCIA First Aid Plan for Anaphylaxis (Orange) 

If an adrenaline injector is administered, it is important to note the time of administration because if there is no improvement in the student's condition after 5 minutes or the student’s condition gets worse, a second adrenaline injector should be administered to the student (if available).

Information about the time that a student has been administered an adrenaline injector should be provided to ambulance personnel when they arrive at the school.

Yes, a school’s planning and risk management processes should consider this and put appropriate strategies in place. Schools should always have one spare adrenaline injector for general use so that no student has to provide an adrenaline injector for another student.

However, in an emergency it may still be necessary to use another student’s adrenaline injector. If another student's adrenaline injector has been administered and there are concerns that the other student may be placed at risk, he or she can be transported in an ambulance to hospital.

Schools are reminded that the NSW Ambulance Cover assists schools by meeting the cost of ambulance accounts for students where an ambulance is called for a student illness or injury while at a NSW government school or a school related activity. For further information refer to the Health Safety and Staff Wellbeing, Ambulance Cover.

ASCIA Action Plans should be reviewed when patients are reassessed by their doctor. If there are no changes in diagnosis or management, the medical information on the ASCIA Action Plan may not need to be updated. However, it is important that the patient has and supplies to the school the most recent version of the ASCIA Action Plan as these reflect best practice in anaphylaxis management.

It is recommended that the student’s photo on their ASCIA Action Plan should also be updated annually so they can be easily identified.