Celiac Disease Emergency Action Plan

Personal Information

• Name: ________________
• Date of Birth: ________________
• Emergency Contact: ________________
• Phone: ________________
• Physician: ________________
• Phone: ________________

Medical Alert

I have CELIAC DISEASE, an autoimmune condition requiring a strict gluten-free diet.

Emergency Situations

Accidental Gluten Exposure

Symptoms may include:

• Severe abdominal pain
• Vomiting
• Diarrhea
• Headache
• Skin rash

Immediate Actions:

1. Stay hydrated with clear fluids
2. Take prescribed anti-nausea medication if available
3. Rest and monitor symptoms
4. Contact healthcare provider if symptoms are severe

Severe Reaction

Seek immediate medical attention if experiencing:

• Severe abdominal pain that doesn't improve
• Persistent vomiting
• Signs of dehydration
• Fever above 101.5°F (38.6°C)
• Mental confusion

Hospital/ER Instructions

• Alert medical staff about celiac disease diagnosis
• Request gluten-free medications
• Verify all food and supplements are gluten-free
• Bring own safe food if possible

Medications

Known Safe Medications:

Medications to Avoid:

Important Notes

• Keep a copy of this plan at home, work, and with emergency contacts
• Update regularly with current medications and contact information
• Wear medical alert bracelet if prescribed

_Last Updated: _________________