Anaphylaxis emergency care
The emergency response plan – ASCIA Action Plans for Anaphylaxis
ASCIA Action Plans for Anaphylaxis detail the emergency response for anaphylaxis, including instructions for using the adrenaline autoinjector. A copy should always be stored with the autoinjector.
There are three Australasian Society of Clinical Immunology and Allergy (ASCIA) Action Plans for personal use and for general use:
- ASCIA Action Plan for Anaphylaxis (personal) – for a specific student who has been prescribed an adrenaline autoinjector (different versions of the plan are available for each type of autoinjectors).
- ASCIA Action Plan for Anaphylaxis (general) – that does not include information about a specific student and can be used as a poster (different versions of the plan are available for each of the autoinjectors).
A third ASCIA Action Plan is available for individuals diagnosed with mild to moderate allergies (ASCIA Action Plan for Allergic Reactions-personal) when no adrenaline autoinjector has been prescribed.
Students diagnosed at risk of anaphylaxis must have an emergency response plan as a part of their individual health care plan. For anaphylaxis, the emergency response plan is an ASCIA Action Plan for Anaphylaxis (personal) completed and signed by the child's prescribing doctor.
It is the role of the parent to provide the school with the appropriate ASCIA Action Plan for Anaphylaxis completed and signed by their child's prescribing doctor. Where the doctor prescribes a new adrenaline autoinjector they will issue an updated ASCIA Action Plan for Anaphylaxis. This is approximately every 12 to 18 months. It is important that parents provide the school with a copy of the most recent action plan.
The plan should be posted in suitable locations for easy reference as discussed with the parent and, where appropriate, the student. The original signed document, prepared by the doctor, should be copied where required.
School first aid kits must include a general use adrenaline autoinjector and the ASCIA Action Plan for Anaphylaxis (general) for use with the EpiPen®.
Schools should note that ASCIA review the action plan templates annually and update them as necessary. The latest versions of the ASCIA Action Plans for Anaphylaxis are available from the Australasian Society of Clinical Immunology and Allergy (ASCIA) website.
Asthma and anaphylaxis
Where a student has a medical diagnosis of asthma and anaphylaxis, the student's individual health care plan should take account of both conditions and outline the steps to undertake if staff are unsure if a student’s difficulty breathing is due to asthma or anaphylaxis. ASCIA outlines the steps on their website.
Adrenaline autoinjectors (EpiPen®, Anapen®)
Adrenaline autoinjectors contain a single dose of adrenaline and are designed as a first aid device for use by people without formal medical or nursing training. Two brands are available in Australia, the EpiPen® and the Anapen®. A junior device is available in each brand for small children (who weigh between 10 and 20kg).
It is important for school staff to be aware that EpiPen® devices look and operate differently to the Anapen® devices and that the student’s individual health care plan clearly highlights which device has been recommended for the student.
A student's individual health care plan for anaphylaxis should outline a process for replacing used and expired adrenaline autoinjectors in a timely way.
It is the role of the parent to provide the prescribed adrenaline autoinjector and to replace it when it expires or after it has been used.
Students carrying their own adrenaline autoinjector and asthma reliever puffer
For asthma and anaphylaxis it is important for students to have immediate access to their medication. High school students should carry their own adrenaline autoinjector (EpiPen®, Anapen®) or asthma reliever medication on them while at school if this is age and developmentally appropriate.
It may also be appropriate for students in the upper primary years to carry their own medication to, from, and at school. This can assist students to develop independence in managing their health condition as they transition to high school and as they are often travelling independently to and from school around this time.
It is important that the school knows the students who carry their own medication to, from, and at school. Arrangements will be agreed in writing between the school and the student's parent and be part of the student's planned health care.
Timing of administering adrenaline autoinjectors
If an adrenaline autoinjector is administered, it is important to note the time of administration. If there is no change in the student's condition after 5 minutes (i.e there is no response) a second adrenaline autoinjector if available, should be administered to the student.
Information about the time that a student has been administered an adrenaline autoinjector should also be provided to ambulance personnel when they arrive at the school.
If a second adrenaline autoinjector is required, the school's general use adrenaline autoinjector should be used. However, in an emergency it may be necessary to use another student's adrenaline autoinjector.
If another student's adrenaline autoinjector has been administered and there are concerns that the other student may be placed at risk, he or she can also be transported in an ambulance to hospital if required.
Frequently asked questions about adrenaline autoinjectors can be found on the ASCIA website.
General use adrenaline autoinjectors for school first aid kits
Each school is issued a general use EpiPen® adrenaline autoinjector. The distribution of general use autoinjectors supports schools with the requirement for each public school to have at least one general use adrenaline autoinjector in their first aid kit. Schools should consider, in their planning and risk management, whether additional school adrenaline autoinjectors may be required.