Anaphylaxis prevention, action plans and autoinjectors

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Target exams

Red flags

• A child with a known food allergy who develops hoarseness, throat tightness, drooling, persistent cough, wheeze or collapse — this is anaphylaxis on the red plan; give adrenaline now, do not treat it as asthma or anxiety
• The adolescent with peanut or tree-nut allergy and uncontrolled asthma who does not carry the autoinjector — the classic fatal-anaphylaxis triad; rebuild the prevention plan around device-carrying and asthma control
• A reaction that looked mild but involved more than one body system, or any airway, breathing or cardiovascular sign — escalate from the green plan to adrenaline; the single decision the plan exists to make
• A child who has been given adrenaline in the community — every single use mandates ambulance transfer and hospital observation for the biphasic window, even if the child has fully recovered
• The child who stands, sits up, or walks during anaphylaxis — sudden fatal empty-vena-cava cardiovascular collapse; lie the child flat and do not let them mobilise
• An expired or absent autoinjector at the moment of reaction — system failure is the preventable cause of paediatric anaphylaxis death

Life stages

Care settings

Clinical exam formats

Board mappings

• Allergy and Immunology: written anaphylaxis action plans and adrenaline autoinjector prescribing, weight-appropriate dosing and carer education
• General Paediatrics: prevention of recurrent anaphylaxis — trigger avoidance, school liaison and the biphasic observation pathway
• Allergy and Immunology (Renewed curriculum): longitudinal prevention package, weight-band transitions, adolescent transition and management of complex multi-allergy and high-risk asthma-plus-food-allergy children
• Community and population child health: school anaphylaxis readiness, rural and remote access to adrenaline and equity of autoinjector access
• General Paediatrics: a child with a first anaphylactic reaction — the prevention prescription, the action plan and family/school education
• Pharmacology and Therapeutics: adrenaline pharmacology, the intramuscular route rationale and autoinjector device technique
• Long Case and Structured discussion: the adolescent with peanut anaphylaxis and uncontrolled asthma — risk stratification, prevention package and transition planning
• Communication station: counselling a family and a school on the action plan, device technique and when to use adrenaline
• Level 2 and 3 — Allergy: anaphylaxis prevention, written action plans and adrenaline autoinjector prescribing and technique
• Public health and safeguarding: school readiness for anaphylaxis and the safety-net for the high-risk adolescent
• Applied Knowledge in Practice (AKP): adrenaline autoinjector weight bands, the biphasic reaction and management of anaphylaxis in the community
• Foundation of Practice (FOP): recognition of anaphylaxis and the written action plan framework
• Communication: explaining an ASCIA anaphylaxis action plan and demonstrating autoinjector technique to a parent and a teacher
• History-taking and management: the child with a first anaphylactic reaction — the prevention prescription and follow-up plan
• General Pediatrics Content Outline — Allergy and Immunology: prevention of anaphylaxis, epinephrine autoinjector selection and patient and caregiver education
• Emergency Care: community first-aid management of anaphylaxis, biphasic reactions and disposition
• Patient Care: prescribe and teach an age- and weight-appropriate adrenaline autoinjector and a written anaphylaxis action plan
• Systems-Based Practice: school and community readiness, spare-autoinjector access and rural access to adrenaline
• Medical Knowledge: adrenaline pharmacology, the intramuscular route, biphasic reactions and the fatal-risk profile of adolescence
• Medical Expert: anaphylaxis prevention, written action plans and adrenaline autoinjector prescribing and technique
• Health Advocate and Collaborator: school anaphylaxis policy, adolescent transition and equitable access to adrenaline
• Communicator: counselling the family, child and school on the action plan and device technique