An anaphylaxis action plan is a written emergency plan that tells parents, carers, teachers and other adults exactly what to do if a child has a severe allergic reaction. For children at risk of anaphylaxis, having a clear, up-to-date action plan — and knowing how to use an adrenaline auto-injector — can be life-saving.
This article explains what an anaphylaxis action plan contains, who needs one, how to use an adrenaline auto-injector, and how to get a plan from Dr Anandarajan at Belfast Children's Allergy Clinic.
What Is Anaphylaxis?
Anaphylaxis is a severe, potentially life-threatening allergic reaction that affects multiple body systems simultaneously. It typically develops rapidly — within minutes of exposure to a trigger — and requires immediate treatment with adrenaline (epinephrine). Without prompt treatment, anaphylaxis can be fatal.
The most common triggers of anaphylaxis in children are foods — particularly peanuts, tree nuts, egg, cow's milk, fish, shellfish and sesame. Other triggers include insect stings (bee and wasp venom) and certain medications.
Symptoms of Anaphylaxis in Children
Anaphylaxis typically involves symptoms in two or more body systems:
- Skin: widespread hives (urticaria), flushing, swelling (angioedema)
- Respiratory: throat tightening, hoarse voice, stridor, wheeze, difficulty breathing
- Cardiovascular: rapid or weak pulse, drop in blood pressure, dizziness, collapse
- Gastrointestinal: nausea, vomiting, abdominal pain, diarrhoea
- Neurological: anxiety, confusion, loss of consciousness
A child does not need to have all of these symptoms to be having anaphylaxis. Any combination of symptoms from two or more body systems after allergen exposure should be treated as potential anaphylaxis.
What Is an Anaphylaxis Action Plan?
An anaphylaxis action plan (also called an allergy action plan or emergency care plan) is a personalised written document that:
- Lists the child's known allergens
- Describes the child's typical allergic reaction symptoms
- Gives clear step-by-step instructions for what to do in an emergency
- Specifies which medications to give and when
- Includes emergency contact details
- States when to call 999
Action plans are provided by Dr Anandarajan at the time of diagnosis or review. They should be updated at least annually and whenever the child's allergy management changes. Copies should be kept at home, at school, at nursery, and with any regular carers.
Who Needs an Anaphylaxis Action Plan?
An anaphylaxis action plan is recommended for any child who:
- Has been prescribed an adrenaline auto-injector (EpiPen or Jext)
- Has had a previous anaphylactic reaction
- Has a food allergy with risk factors for severe reactions (e.g. peanut allergy with asthma)
- Has a venom allergy (bee or wasp sting)
Not every child with a food allergy needs an adrenaline auto-injector — Dr Anandarajan will assess the severity of your child's allergy and advise on whether a prescription is appropriate. Read more in our article on when children should carry an adrenaline pen.
How to Use an Adrenaline Auto-Injector
There are two main adrenaline auto-injectors available in the UK: EpiPen and Jext. Both are available in junior (150 micrograms) and adult (300 micrograms) doses. The junior device is generally used for children weighing 15–30 kg; the adult device for children over 30 kg.
The general steps for using an adrenaline auto-injector are:
- Remove the device from its carrier and take off the safety cap
- Hold the device firmly in your dominant hand with your thumb closest to the needle end
- Place the tip against the outer mid-thigh (can be given through clothing)
- Push down firmly until you hear a click, then hold in place for 10 seconds
- Remove the device and massage the injection site for 10 seconds
- Call 999 immediately — even if the child improves, they must go to hospital
- Lay the child flat with legs raised (unless they have breathing difficulties)
- A second dose can be given after 5–15 minutes if symptoms do not improve
Dr Anandarajan provides hands-on training in adrenaline auto-injector use at the appointment. Training devices (without a needle) are available for practice at home.
School Allergy Management
Schools in Northern Ireland are required to have policies for managing children with severe allergies. Dr Anandarajan provides school allergy action plans and letters to support parents in communicating their child's allergy needs to school staff. Schools should have a spare adrenaline auto-injector for emergency use, and staff should be trained in its use.
Book an Appointment
If your child has a known severe allergy or has had a previous anaphylactic reaction, Dr Anandarajan can provide a comprehensive allergy assessment, prescribe an adrenaline auto-injector if appropriate, and provide a personalised anaphylaxis action plan.
Call 028 9066 7878 or book online at kph.fyi/Book-MAnandarajan. No GP referral is required.