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Create an Allergy and Anaphylaxis Emergency Plan: AAP Report Explained

​ By: Michael Pistiner, MD, MMSc, FAAP

Severe allergic reactions are unpredictable—they can happen anywhere, anytime. Symptoms can even go away with treatment and come back later. Parents of children with severe allergies to certain foods, insect stings, latex, and medication know this all too well.

What's the Plan?

In an effort to appropriately treat anaphylaxis—a potentially life-threating, severe allergic reaction—the American Academy of Pediatrics (AAP) developed the clinical report, Guidance on Completing a Written Allergy and Anaphylaxis Emergency Plan. The report explains to pediatricians and other health care providers how to create and use the new AAP Allergy and Anaphylaxis Emergency Plan. This new emergency care plan (ECP) is based on the most up to date and appropriate treatment of anaphylaxis. It's also clearly written and easy to understand. See for yourself!

​Be Better Prepared for an Allergic Emergency

In situations when you are not with your child, these written plans will also arm nurses, teachers, coaches, parents, relatives, babysitters, etc. with the tools they need in the event of an emergency.

Download the AAP Allergy and Anaphylaxis Emergency Plan (PDF)

The AAP plan emphasizes the important role of epinephrine and de-emphasizes the role of antihistamines (e.g., Benadryl). It lists symptoms and clearly tells the caregiver or child when to use the epinephrine auto-injector. Allergy and anaphylaxis emergency plans are especially important to provide to schools and child care facilities.

Anaphylaxis emergency care plan overview:

  • Includes simple criteria to identify potential allergic emergencies for use by patients, families, school staff, and all caregivers

  • Is accessible and understandable to anyone caring for your child

  • Given to school, child care, after-school programs, or any place where others care for your child

  • Trains others using your child's specific ECP

When creating an ECP, it is also important to customize it to the specific needs of your child, allergies, family, and your state and local regulations. (Some may have their own forms already in place; you can encourage them to use this new one.)

If in Doubt, Give Epinephrine!

The AAP report also includes more evidence for why epinephrine is so important and safe and that delaying the use of epinephrine and relying on antihistamines is a bad idea!

Epinephrine is the first line treatment for anaphylaxis because it works quickly by delivering a dose of medicine directly into a child's muscle. The auto-injectors are specially designed for easy use in non-medical settings. Delays in giving epinephrine for anaphylaxis can increase the risk of death, long hospitalization, and a second anaphylactic reaction called a biphasic reaction.

Anyone caring for a child with an allergy that can be life-threatening must know how to recognize anaphylaxis and know when and how to give the lifesaving treatment for severe allergic reactions. The AAP Allergy and Anaphylaxis Emergency Plan and clinical report were designed to help with this—wherever your child is and whoever is caring for him or her.

​Things to know about epinephrine:

  • First-line treatment of choice

  • Acts where it is needed

  • Will make you feel better

  • Fast acting

  • Delays in administration increase risk of death

  • Err on the side of caution and give if any doubt

  • Safe medicine

Additional Information:

About Dr. Pistiner:

Michael Pistiner, MD, MMSc, FAAP is a Boston based pediatric allergist for Atrius Health. He is a member of the American Academy of Pediatrics Section on Allergy and Immunology Executive Committee and has a special interest in food allergy and anaphylaxis education and advocacy. Dr. Pistiner is also the father of a child with food allergy and co-founder and content creator of, a free food allergy, and anaphylaxis educational resource.

Last Updated
American Academy of Pediatrics (Copyright © 2017)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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