Important Information to Include in an Emergency Action Plan
Your child’s plan should be individualized and outline vital information caregivers should know. Here’s what you should consider including.
1. Basic Information About Your Child
It might sound simple, but be sure to include essential details about your child, such as:
- Their full name
- Their age and weight
- Whether they have a history of anaphylaxis (a severe allergic reaction that can be life-threatening)
- A list of symptoms they typically experience during mild and severe reactions
- Whether they have asthma (which puts them at higher risk of a severe reaction)
- Their emergency contacts
- Their doctor’s name and contact information
- A recent photo
It’s also important to list all of your child’s known allergies. “With peanut allergy being one of the most common culprits, the reaction may, of course, be triggered by peanut, but it can also be caused by other food allergens as well, such as milk, soy, egg, wheat, tree nuts, fish, shellfish, and sesame,” says Stanislaw J. Gabryszewski, MD, PhD, an attending physician in the division of allergy and immunology at CHOP.
2. Allergic Reaction Symptoms
As mentioned, your child’s emergency action plan should list both mild and severe symptoms that could occur.
A mild reaction typically involves just one organ or system; most commonly, the nose, mouth, skin, or the gut. These symptoms are uncomfortable but usually not dangerous. Examples are:
- Itchy or runny nose
- Sneezing
- Itchy mouth
- A few hives (not widespread)
- Mild itch
- Mild nausea
“A child may have had only mild symptoms in the past, but still be at risk for a more serious reaction in the future,” Dr. Hill says.
- Shortness of breath
- Wheezing or a repetitive cough
- Pale or bluish skin
- Faintness or dizziness
- A weak pulse
- Trouble breathing or swallowing
- Tight or hoarse throat
- Swelling of the lips or tongue
- Many hives (widespread)
- Severe vomiting or diarrhea
- Anxiety or confusion
- A sense of doom or feeling like something bad is going to happen
- A combination of symptoms in two or more organs or systems can indicate anaphylaxis, even if the airway isn’t involved and blood pressure is normal.
3. Step-by-Step Instructions for Symptoms
Your plan should provide straightforward instructions about what to do if your child experiences allergy symptoms. “A good emergency plan turns a frightening and confusing situation into a set of clear, rehearsed steps,” says Hill.
The instructions should depend on your child’s specific signs and symptoms. For instance, if they only have mild symptoms in just one area of the body, they may need an antihistamine or inhaler. Be sure to include which drug to give them and the dose.
If symptoms are severe, affect more than one system of the body, or worsen, emphasize that your child will need an epinephrine shot or nasal spray immediately.
4. Epinephrine Instructions
It’s extremely important that your child’s emergency plan stresses that epinephrine, whether it’s administered as an injection or a nasal spray, should be given right away if severe allergic symptoms occur.
“Remember that epinephrine is safe and effective, and when in doubt during a reaction that seems to meet the criteria for anaphylaxis, it is generally better to use epinephrine promptly rather than wait,” says Dr. Gabryszewski.
The plan should clearly state:
- When it’s appropriate to use epinephrine
- How to use epinephrine (including how long to wait before giving each additional dose)
- Where the medicine is stored
- How many doses of epinephrine are available
- Whether or not your child can self-administer the medication
Hill says to also include a note that a second dose of epinephrine may be needed if symptoms persist or come back before emergency help arrives. “Importantly, the plan should be simple enough that someone who is not medically trained can follow it during a stressful situation,” he says.
Parents and caregivers should practice injectable epinephrine administration with a trainer device and know where it’s kept, he says.
5. Post-Reaction Steps
Your child’s emergency plan should instruct caregivers to call emergency services immediately after giving epinephrine. The caregiver should tell the 911 dispatcher that the child is experiencing anaphylaxis, so emergency responders can prepare.
After the event, medical professionals may need to monitor your child or provide additional treatments.
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