Emergency Action Plan for Severe Skin Allergies

Patient Information

Name: _________________________ Date: _________________________ Allergist/Dermatologist: _________________________ Emergency Contact: _________________________

Known Allergens

• List specific triggers: _________________________
• Previous reaction severity: _________________________

Signs of Severe Allergic Reaction

Immediate Action Required If:

• Large areas of hives or swelling
• Difficulty breathing
• Facial or throat swelling
• Dizziness or fainting
• Severe itching affecting daily activities

Emergency Steps

1. Mild to Moderate Reactions

• Take prescribed antihistamine: _________________ (dosage)
• Apply prescribed topical medication: ________________
• Apply cool compress to affected areas
• Document time and symptoms
• Monitor for worsening

2. Severe Reactions

1. Use epinephrine auto-injector if prescribed
2. Call emergency services (911)
3. Take prescribed antihistamine
4. Keep calm and lie down
5. Contact your healthcare provider

Prevention Plan

• Avoid identified triggers
• Wear medical alert bracelet
• Keep medications readily available
• Regular follow-up with healthcare provider

Emergency Contacts

Primary Care: _________________________ Dermatologist: _________________________ Nearest ER: _________________________

Additional Instructions

Keep this plan readily available and share with family members/caregivers