What Are the Five Steps in the Allergen Action Plan?

More than 1 in 4 people in the UK are thought to be affected by allergies at some point in their lives. Whilst most of these cases are likely to only be mild, some people will have severe reactions to certain allergens which mean they have to be very careful around particular ingredients and know what to do if they come into contact with the substance they are allergic to.

If you work in an environment where allergens are present or spend time with people who suffer from serious allergies, knowing what to do in the event of an allergic reaction is very important. An allergen action plan may be consulted if someone is having an allergic reaction, and this article explains the five steps that will be outlined in this plan and what you should do to follow them.

What is an Allergen Action Plan?

In the context of dealing with individuals with allergies, an allergen action plan is a document that recommends a course of treatment if an individual has an allergic reaction. These will be unique to every individual and are recommended by healthcare providers as a way of outlining a clear process to follow in an emergency.

Allergen action plans are very common for children who have allergies, as they are potentially more at risk of harm from an allergic reaction as they may not recognise their symptoms or know what to do in an emergency. Schools and children's activity providers may require any child with an allergy to provide an allergen action plan to be kept with official records so that staff know what to do in the event of an allergic reaction.

Different levels of allergies require different kinds of action plans; an individual who only suffers from mild reactions will require a different response from someone who needs an EpiPen, for example.

There is no official structure to an allergen action plan, and different advisors may have different templates or resources that they offer to help allergy sufferers create their own plans. In general, the actions outlined in the plan can be broken down into around five stages, which we will describe in more detail below.

The Five Steps in the Allergen Action Plan

In most cases, an allergen action plan will be divided into two sections; what to do in the event of a mild reaction, and what to do if the individual goes into anaphylactic shock. Anaphylaxis is a life-threatening allergic reaction, and acting quickly by following someone’s allergen action plan is essential to minimising harm.

Mild to Moderate Allergic Reaction

The first of the allergen action plan steps should be followed if an individual has a mild to moderate reaction to an allergen. 

Symptoms

Different people have different reactions to allergens, which is why it is important to fill out a new action plan for every person so that their specific symptoms can be noted down. However, some common signs indicate that someone is having a mild allergic reaction, which may appear together or happen as isolated symptoms.

These are:

• Hives on the body, which will look like red bumps or patches of raised skin that are irregularly shaped and feel warm to the touch
• Other itchy skin rashes, particularly on the arms, face and neck
• Swelling on the face, particularly around the lips or the eyes
• An itchy or tingly feeling in or around the mouth
• Abdominal pain after consuming something
• Feeling or being sick after consuming something
• A sudden change in behaviour

If an individual is showing any of these signs, you should take action.

Step 1

The first and most important action to take is to stay with the person who is having an allergic reaction. Their condition could worsen rapidly, and if you leave them on their own they risk becoming seriously or critically unwell.

If you are on your own with a person having an allergic reaction, it is a good idea to get someone else to come and help you. If other people are nearby, call for help. If this doesn’t work, try and contact someone nearby using a phone.

Whilst trying to get help, stay with the individual.

If the person having an allergic reaction is a child, their allergen action plan may have their parent or guardian’s contact details on it. In most cases, you are advised to get in touch with the child’s caregiver to let them know that they have had an allergic reaction, even if the child makes a full recovery.

Step 2

The next step if someone is having a mild allergic reaction is usually to give them antihistamine medication, if specified in their action plan. This will usually treat the symptoms of a mild allergic reaction in around half an hour, in which case no action needs to be taken.

Only let an individual take antihistamine if it is safe to do so and specified on their allergen action plan. If they vomit soon after taking the medication, give them another dose so that it has the chance to take effect.

At this stage of an allergic reaction, you should also locate someone’s adrenaline autoinjector (EpiPen). If their symptoms worsen then you may need to act quickly, so having their emergency medication on hand will make doing this much easier. 

Anaphylaxis Reaction

In serious cases of allergic reactions, an individual’s symptoms may worsen and they may experience a life-threatening reaction known as anaphylaxis. It’s very important to know the symptoms of this kind of reaction and follow the steps on an action plan as quickly as possible to ensure that the individual recovers and receives the medical help that they need.

Symptoms

The symptoms of anaphylaxis can be broken down into three key categories:

Airways:

• The individual has a persistent cough
• Their voice sounds horse or strained
• They have difficulty swallowing
• Their tongue becomes swollen and sounds difficult or laboured

Breathing:

• An individual’s breathing becomes noisy 

• They are wheezing or have developed a persistent cough

Consciousness:

• The individual is experiencing persistent dizziness
• They appear pale
• Their limbs are floppy and lifeless
• They suddenly become very sleepy and unresponsive
• They collapse and/or become unconscious

Not all of the symptoms in anaphylaxis always appear when someone is having a life-threatening reaction. As a general rule, if someone with a known food allergy is experiencing difficulty breathing after eating something, you should take action to prevent anaphylactic shock.

Step 1

If you believe someone to be suffering from anaphylaxis, the first thing you should do is to make them lie down with their legs raised. Ideally, they will be on their back on the floor with their legs propped up on something, but if the individual is struggling to breathe, they should remain sitting and raise their legs in this position instead.

Make sure that the individual having the reaction does not remain standing up, or try to stand up after you have helped them down. Staying on the ground with their legs raised will help to delay the worsening of their reaction, and they should remain in this position until help arrives.

Step 2

The next of the five steps in the allergen action plan is to administer adrenaline with an allergic reaction EpiPen. This won’t cure the person with anaphylaxis, but it will keep their condition stable unless professional medical help arrives.

There are numerous allergies that require an EpiPen, but not all allergy sufferers will have one. Make sure to check their allergen action plan to confirm whether adrenaline should be administered.

To use an EpiPen for allergies, hold it in your fist with the blue end pointing upwards and the orange end pointing down at the person you will administer it to. You can use the phrase ‘blue to the sky, orange to the thigh’ to remember this. 

Pull off the blue safety cap and place the orange end of the pen against the outside of the individual’s leg. You can do this through clothing or directly onto their skin. It can help to hold their leg still, and if you’re unsure of where to administer the EpiPen, aim for where the outer seam of a pair of trousers would lie.

Push the EpiPen firmly into the person’s leg until you hear or feel a click. Wait for at least three seconds, then remove the EpiPen.

Step 3

The final stage listed in all allergen action plans is to call 999 and ask for an ambulance. Tell the operator that you are with someone with anaphylaxis and explain the situation, including the severity of the person’s symptoms.

Whilst you are waiting for medical help to arrive, do not leave the person who has just been given adrenaline. If you are still on your own with them, call for help if possible.

If the person with allergies is a child, you should call their parent or guardian at this stage and inform them of what has happened and what will happen next.

In very serious cases, the person with anaphylaxis may not get better after being given adrenaline. In these circumstances, if you have access to a second Adrenaline autoinjector then you should administer this five minutes after you gave the first dose.

Whilst it is unlikely, there may be cases where the allergic reaction is so severe that the sufferer may fall unconscious and stop breathing. You are advised to commence CPR at this point until medical help arrives, but only if you know the correct technique to use and feel confident delivering chest compressions and/or mouth to mouth.

Once an ambulance arrives, tell the paramedics what has happened and how you have handled the situation, and they will be able to take care of the person with anaphylaxis from here. Even if they have recovered after being given an EpiPen, they will still need to stay under medical observation for a few hours after their allergic reaction.

FAQs

What is a food allergen?

A food allergen is a substance or ingredient present in a food product that is usually harmless, but can cause harm and/or an allergic reaction in a susceptible individual. The majority of food allergens are proteins, but some additives found in food are also known for causing allergic reactions.

What is allergen management?

Allergen management is the system that identifies and controls allergens that may be present in an environment. It is most important in kitchens and workplaces where food preparation takes place, but also may be implemented in environments such as schools, where children with allergies run the risk of being exposed to ingredients that they might react to.

Who should receive training in allergen awareness?

Anyone who works in a food business should receive allergy awareness training, whether they prepare food products or meals, package them or just serve customers. Many healthcare professionals, teaching staff and individuals who interact with people as part of their job may also receive allergen training, especially if they are likely to come into contact with people with allergies and work in an environment where allergens may be present.

Summary

Serious reactions to allergens are quite rare, and most people will probably go their whole lives without having to act in an emergency to help someone having a severe reaction. However, acting quickly is essential in these situations to ensure that help is given as soon as possible and the allergic sufferer is unharmed, which is why being confident with the five allergen action plan steps is so useful.

If you work in an environment where allergens are present, or would just like to learn more about food allergies and how to help those who suffer from them, we offer an online ‘Food Allergy Awareness Training’ course that covers all of this information and more.