The Australasian Society of Clinical Immunology and Allergy

There are four types of ACTION PLANS (two versions for three out of the four types of ACTION PLANS) available from www.allergy.org.au the website of the Australasian Society of Clinical Immunology and Allergy (ASCIA) and these were last revised in September 2009.

Red – to be completed by a doctor  

 EpiPen Action Plan for Anaphylaxis Personal 696.58 Kb

 Anapen Action Plan for Anaphylaxis Personal 489.25 Kb 

Orange – for use as a poster or in first aid kits

 EpiPen Action Plan for Anaphylaxis General 697.59 Kb

 Anapen Action Plan for Anaphylaxis General 514.30 Kb 

Yellow – to be completed by a doctor  

 EpiPen Action Plan for Insect Allergy Personal 695.65 Kb

 Anapen Action Plan for Insect Allergy Personal 489.20 Kb 

Green – to be completed by a doctor 
for use where no adrenaline autoinjector has been prescribed so there is only one version.

 ASCIA Action Plan for Allergic Reactions Personal 494.24 Kb

The ASCIA action plans for anaphylaxis and allergic reactions are colour coded and should be printed from the website in colour, if possible.  They can be used in Australia or New Zealand as they each contain both Ambulance phone numbers. If older versions of these action plans are still in use they do not have to be replaced immediately as the information is still valid. It should be replaced when the person is next reviewed by their doctor.

The following are the most frequently asked questions and answers regarding the ASCIA action plans.

Q: Can schools or parents complete an ASCIA Action Plan for their students or children? 

A: No, the Action Plans have been developed by the Australasian Society of Clinical Immunology and Allergy (ASCIA) as medical documents and must be completed, signed and dated by the patient's medical doctor.  If copies are required then the original signed copy can be photocopied. 

Q: Is it possible to obtain an electronic copy of the ASCIA Action Plans so that a student's photo and information can be inserted by school staff? 

A: No.  The ASCIA Action Plans have been developed in a PDF format to ensure the documents are concise (A4 size), consistent (changes could not be made) and easily understood, for use throughout Australia and New Zealand.

Q: How often does an ASCIA Action Plan need to be updated? 

A: ASCIA Action Plans should be reviewed when patients are reassessed by their doctor, and each time they obtain a new adrenaline autoinjector prescription.   If there are no changes in diagnosis or management the medical information on the Action Plan may not need to be updated.   If the patient is a child, the photo should be updated at least every two years, so they can be easily identified.

Q: The ASCIA Action Plans on the ASCIA website www.allergy.org.au are copyrighted. Does this mean that we can't print them out and make copies? 

A: ASCIA Action Plans can be printed off the website and/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:  Who has the ASCIA Action Plan for Anaphylaxis been designed for?

A:  ASCIA Action Plans for Anaphylaxis have been designed 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.    

Q:  Why doesn't the ASCIA Action Plan for Anaphylaxis include CPR?

A:  Adrenaline is life-saving and must be used promptly. Withholding or delaying the giving of adrenaline can result in deterioration and death of the patient. This is why giving the adrenaline autoinjector is the first instruction on the ASCIA action plans fro 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 be administered to the patient by paramedics in the ambulance.     

Q: Can an organisation obtain an adrenaline autoinjector for their first aid room or kit and if so, do they require an Action Plan for Anaphylaxis?

A: Adrenaline autoinjectors can be purchased without a prescription from pharmacies.

The Australasian Society of Clinical Immunology and Allergy (ASCIA) has developed an information sheet titled 'Adrenaline Autoinjectors in First Aid Kits, which is available on the ASCIA website under Anaphylaxis resources.  The ASCIA Action Plan for Anaphylaxis (general) has been developed for use as a poster or as an instruction guide to include in first aid kits which include an adrenaline autoinjector, as we are aware that some organisations purchase a spare adrenaline autoinjector for their first aid kit.    

ASCIA has also developed an information sheet titled 'ASCIA First Aid for Anaphylaxis' which is also available under Anaphylaxis Resources.

Q: Where can we go to obtain further resources?

A: Patient information is available from the ASCIA website www.allergy.org.au.           

Resources are also available from Anaphylaxis Australia http://www.allergyfacts.org.au/ and Allergy New Zealand http://www.allergy.org.nz/ which are the national patient support groups for Australia and New Zealand.

Anaphylaxis Australia and some government websites also have information translated into several languages.

Q: How have the revised action plans (2008, 2009) changed from the original 2003 versions?

A: Following anaphylaxis all plans now recommend that patients should be observed for at least 4 hours in hospital. This is because in cases of anaphylaxis there is often significant improvement following an initial reaction, only to be followed by a relapse which often occurs several hours later.  The approximate age range for prescription of Junior versions of adreanlien autoinjectors (1-5years) is now provided.

Changes and new individual action plans are outlined below.

1      Action Plan for Anaphylaxis (Red)

This is similar to the original plan, with additional instructions under the heading ACTION to:

• ‘Watch for any one of the following signs of Anaphylaxis' which has replaced the instruction ‘watch for signs of Anaphylaxis'. This emphasises the point that adrenaline should be administered if any of the signs of a severe allergic reaction develop.
• ‘Lay the person flat and elevate the legs'. This can increase cardiac recovery where there is low blood pressure. 
• ‘If breathing is difficult allow to sit but do not stand'. Standing can cause blood pooling in the lower extremities and further reduce cardiac output. 
• ‘Further adrenaline autoinjector doses may be given if there is no response after 5 minutes.' This is because a  significant proportion (10-20%) of anaphylactic reactions may require more than a single dose of adrenaline. 

Under personal information, there is now a heading Allergens to be avoided. The previous heading ‘Severe Allergies' was confusing as a range of food allergens may need to be avoided although they may not necessarily cause a severe allergic reaction. 

2    Action Plan for Anaphylaxis general (Orange)

The same changes have been made to the right hand section as in the personal (red) plan, with the addtion of an explanation about the different signs of insect allergy anaphylaxis and the instruction 'for insect allergy, flick out sting if it can be seen (but do not remove ticks)'  

3      Action plan for Allergic Reactions (Green)

There are many children with food allergies who should avoid particular foods, but do not necessarily require an adrenaline autoinjector.This plan has been developed so medical practitioners can  advise childcare services and schools what foods the child should avoid and what to do in the unlikely event that the child does develop an anaphylactic reaction.  

4      Action plan for Insect Anaphylaxis (Yellow)

This plan has been developed because the signs of anaphylaxis in insect allergy are somewhat different from food allergies. In particular abdominal symptoms such as pain and vomiting are more likely to develop into anaphylaxis and thus an indication to give the adrenaline autoinjector. Other  features of the Insect Anaphylaxis Action Plan include:

• An instruction to flick out the sting.  It is important to flick the sting out rather than grab and squeeze it as this is likely to inject more venom into the patient.
• An instruction not to remove ticks, as this can cause further problems.  The ticks should either be freeze dried before removal, or removed by medical staff.
• Space to write the specific insect causing the allergy as well as other allergies. 

Content Updated September 30, 2009