Anaphylaxis Checklists

ASCIA has developed the following five checklists to assist in the management of patients who are at risk of severe allergic reactions (anaphylaxis).

Anaphylaxis Checklist for Adrenaline Prescribers Updated September 2021

Anaphylaxis Checklist for Pharmacists Updated September 2021

Anaphylaxis Checklist for Patients Updated September 2021

Anaphylaxis Checklist for Young Adults with Severe Allergies who are Transitioning from Paediatric to Adult Care

Updated August 2020

Anaphylaxis Checklist for Travelling with Allergy, Asthma or Anaphylaxis Updated August 2020

Anaphylaxis Checklist for Prescribers of Adrenaline (Epinephrine) Injectors

The aim of this checklist is to assist doctors and nurse practitioners who prescribe adrenaline injectors for patients who are at risk of having a severe allergic reaction (anaphylaxis).

Anaphylaxis Checklist for Prescribers of Adrenaline (Epinephrine) Injectors107.96 KB

There are two brands of adrenaline injectors, EpiPen^® and Anapen^®:

EpiPen^®(300 mcg) and EpiPen^®Jr (150 mcg) are available in Australia on the PBS, and in New Zealand.
Anapen^® 500, Anapen^® 300 and Anapen^® 150 are available in Australia on the PBS.

Adrenaline injectors are prescribed as follows:

150 mcg devices for children weighing 7.5 to 20kg.
300 mcg devices for children weighing over 20kg and adults, including pregnant women.
500 mcg or 300 mcg devices for children weighing over 50kg and adults, including pregnant women.

Record history of the allergic reaction and suspected triggers using the ASCIA event record form. allergy.org.au/hp/anaphylaxis/anaphylaxis-event-record
Prescribe adrenaline injector and check that the dose is appropriate (see above).
Check that the prescription is for two devices, which are rebated by the PBS in Australia. No devices are currently rebated by Pharmac in New Zealand.
For newly diagnosed patients contact a specialist (allergy, respiratory, paediatrician), if necessary, for authority prescription, pending specialist appointment. allergy.org.au/hp/anaphylaxis/adrenaline-injector-prescription and inform patient/carer about patient support organisations, Allergy & Anaphylaxis Australia www.allergyfacts.org.au or Allergy New Zealand www.allergy.org.nz
Ensure that the patient has been referred to a clinical immunology/allergy specialist, who is listed on the ASCIA website. allergy.org.au/patients/locate-a-specialist
Complete and sign ASCIA Action Plan for Anaphylaxis (RED) - the latest version is on the ASCIA website allergy.org.au/hp/anaphylaxis/ascia-action-plan-for-anaphylaxis
Complete ASCIA Travel Plan if required allergy.org.au/hp/anaphylaxis/ascia-travel-plan-anaphylaxis
Inform patient that they should always carry their adrenaline injector/s and ASCIA Action Plan.
Ensure the patient/carer understands that that adrenaline is the first line treatment for anaphylaxis and that antihistamines should not be used for the treatment for anaphylaxis. If antihistamines are used to treat mild to moderate allergic reactions, only non-sedating antihistamines should be used.
Educate patient/carer on how to give the adrenaline injector (using trainer devices), recognition and treatment of allergic reactions, carrying and storage of the adrenaline injector and appropriate allergen avoidance measures. For information go to allergy.org.au/anaphylaxis
If patient has asthma, review and optimise asthma management and educate about asthma and anaphylaxis. allergy.org.au/patients/asthma-and-allergy/asthma-and-anaphylaxis
Inform patient/carer to check and note the expiry date of their injector/s.
Encourage an appointment every 12 to 18 months, to prescribe new adrenaline injector/s before they expire, to review if new allergies have developed or more severe allergic reactions have occurred, and to renew the patient’s ASCIA Action Plan for Anaphylaxis.