Medical conditions: Anaphylaxis and allergies policy and procedure

Early Learning Victoria is committed to the safety, health and wellbeing of children in its care, including children with allergies and anaphylaxis. We are committed to providing all staff with the information, training and skills they need to support children with anaphylaxis and allergies and respond effectively in an emergency.

1. Scope

This policy applies to children, families, staff, management and visitors of Early Learning Victoria centres. This includes volunteers, students on placement and contractors or labour hire employees of Early Learning Victoria.

2. Policy statement

This policy describes procedures to be implemented at Early Learning Victoria centres to:

minimise the risk of allergic reaction, including anaphylaxis
ensure that staff respond appropriately to allergic reactions, including anaphylaxis, by following the child’s Australasian Society of Clinical Immunology and Allergy (ASCIA) Action Plan for Anaphylaxis and ASCIA Action Plan for Allergic Reactions
raise awareness of allergies and anaphylaxis and appropriate management among all staff through education and policy implementation
work with families of children with allergies and anaphylaxis to understand risks, and to develop and implement an individualised anaphylaxis care plan, Risk Minimisation Plan and Communication Plan to support the child and reduce their risk of an allergic reaction.

This policy should be read in conjunction with:

Administering medication policy and procedure
Administration of first aid policy and procedure
Management of medical conditions policy and procedure
Incident, injury, trauma and illness policy

2.1 Requirements

Under the Education and Care Services National Law Act 2010 and Education and Care Services National Regulations 2011, Early Learning Victoria must ensure:

that this policy is displayed at the service, its procedures are adhered to and it is reviewed annually (or sooner if required)
that all staff, families, contractors, volunteers and students on placement are provided with a copy of this policy and have read and understood it
families are aware of expectations for their role in acquiring an ASCIA Action Plan for Anaphylaxis or ASCIA Action Plan for Allergic Reactions, completed by the child’s doctor or nurse practitioner (see links).

2.2 Background and information

Anaphylaxis is a severe and life-threatening allergic reaction. Allergies, particularly food allergies, are common in children. The most common causes of allergic reactions in young children are foods, bee or other insect stings, and some medications. An allergic reaction can develop within minutes of exposure to an allergen and young children may not be able to identify or communicate the symptoms of anaphylaxis.

With planning and training, many reactions can be prevented. However, when a reaction occurs, good planning, training and communication can ensure the reaction is treated appropriately, including if needed by using an adrenaline injector (EpiPen® or Anapen®).

This policy is informed by the National Allergy Council’s Best Practice Guidelines for the Prevention and Management of Anaphylaxis in Children’s Education and Care and by the Australasian Society of Clinical Immunology and Allergy (ASCIA), the peak professional body of clinical immunology and allergy in Australia and New Zealand (see links).

3. Actions and procedures

3.1 Responsibilities of families

Families are responsible for:

informing staff, either on enrolment or on initial diagnosis, of their child’s allergies
providing a completed enrolment form for their child that includes medical information and written authorisations for medical treatment and ambulance transportation
providing Early Learning Victoria with an ASCIA Action Plan for Anaphylaxis or an ASCIA Action Plan for Allergic Reactions (see links), signed by a registered medical practitioner or nurse practitioner, and written consent to use medication prescribed in line with the action plan
working with the nominated supervisor to develop an individualised anaphylaxis care plan for their child before they begin orientation (or before they return to the centre after diagnosis) and providing authorisation required for administration of any medical treatment and medication
if an adrenaline injector has been prescribed, providing an unused, in-date adrenaline injector at all times their child is attending the Early Learning Victoria centre. The child will be unable to attend the centre if this has not been provided
meeting with the food service staff to discuss plans for managing meals, snacks and drinks while the child is attending the Early Learning Victoria centre. If the child consumes a special infant formula, parents should supply a tin of infant formula for their child for use while the child is attending the centre.

3.2 Responsibilities of staff

Individualised anaphylaxis care plans

For children with known allergies and anaphylaxis, individualised anaphylaxis care plans (see definitions and Attachment 1) must be completed by the nominated supervisor to document a child’s allergies and the strategies that will be used to reduce the risk of an allergic reaction before a child starts orientation, or when the centre is informed about the child’s allergies.

The individualised anaphylaxis care plan must include a copy of the child’s current ASCIA Action Plan. The individualised anaphylaxis care plan must include appropriate risk minimisation strategies that will be implemented to manage the child’s allergies both onsite and offsite during excursions. The individualised anaphylaxis care plan must be agreed to and signed by the child’s parent or carer and must be reviewed if the child’s allergies change or they have a reaction while in the care of Early Learning Victoria.

Risk management plan

It is important to consult with families to determine which strategies are appropriate for reducing the risk of exposure to known allergens. This should be done as part of developing the child’s individualised anaphylaxis care plan. Attachment 2 provides examples of strategies to help reduce the risk of exposure to known allergens and should be used during consultations with families and completion of the individual anaphylaxis care plan.

The nominated supervisor, in partnership with the parent or guardian, must develop an anaphylaxis risk management plan using Attachment 3. Anaphylaxis risk management plans should be developed for day-to-day allergy management at the centre and for excursions, as the risks are different.

Communication Plan

The nominated supervisor is responsible for ensuring that a Communication Plan is developed to provide information to all centre staff, volunteers, students and families about anaphylaxis and this policy. The Communication Plan must include strategies for advising staff, volunteers, students and families about how to respond to children experiencing an allergic reaction, including anaphylactic reaction in children in various environments, including during excursions. The Communication Plan must include arrangements for staff to be briefed at least twice a year by a team member who has completed recent anaphylaxis management training.

Emergency response

Signs and symptoms of an allergic reaction to food usually occur within minutes and up to 2 hours after eating the food allergen. Severe allergic reactions to insects usually happen within minutes of the insect sting or bite. Where it is known that a child has been exposed to their allergen, but has not developed symptoms, the child should be monitored, and the child’s family must be contacted and asked to collect their child. If any child is showing signs and symptoms of an allergic reaction (see definitions), staff should immediately follow the child’s ASCIA Action Plan if they are known to have allergies, or the ASCIA First Aid Plan for Anaphylaxis for all other children (see links).

Adrenaline is the first line treatment for anaphylaxis. If in doubt about whether a child is experiencing anaphylaxis or not, staff should immediately administer the child’s adrenaline injector if they have one. See signs and symptoms of anaphylaxis in definitions. For children with asthma and food allergies, administer the adrenaline injector before the asthma reliever, as per the ASCIA Action Plan.

For children not previously identified as being at risk of anaphylaxis, staff should immediately administer the centre’s general-use adrenaline injector and follow the ASCIA First Aid Plan for Anaphylaxis. After an adrenaline injector has been administered, the child should stay in position as per the ASCIA Action Plan and an ambulance called to transport the child to hospital for medical monitoring.

Incident reporting

If a child is exposed to a known allergen, Early Learning Victoria centre staff will complete an incident report (see the Incident, injury, trauma and illness policy). The nominated supervisor will work with Early Learning Victoria central office to:

notify the Regulatory Authority of serious incidents online through the NQA IT System, if required
record the incident appropriately (using, for example, the Incident, Injury, Trauma and Illness Record or EduSafe Plus for staff-related incidents).

If a child has had an allergic reaction to a packaged food or to a meal provided by Early Learning Victoria, it must be reported to the local food authority for investigation.

Staff will be offered a debrief after each incident. An emergency can cause distress not only for the child, but for staff and other children, especially if the event was life-threatening.

Review

After an incident or emergency response, the child’s individualised anaphylaxis care plan will be reviewed to identify if further risk minimisation strategies are needed, or if some strategies need to be adapted. It is important to understand what could have been improved, to learn from each incident and to put plans in place to help prevent the same incident from happening again. The adrenaline injector must be replaced by the parent or guardian as soon as possible.

Educators are responsible for:
- meeting requirements in relation to anaphylaxis and allergen training and first aid management of anaphylaxis (see links)
- adhering to the individualised anaphylaxis care plan and ASCIA Action Plan for each child diagnosed as at risk of anaphylaxis
- ensuring they are aware of and can readily identify each child diagnosed with an allergy or at risk of anaphylaxis
- adhering to the risk minimisation plan developed in consultation with the child’s parents or guardians
- ensuring that children with allergies, including those at risk of anaphylaxis, are not discriminated against for their medical conditions and may engage fully in the centre program
- storing allergy and anaphylaxis medication out of reach of children. This medication must be stored (unlocked) somewhere accessible to staff, but out of reach of children
- checking the expiry dates of the prescribed adrenaline injectors for individual children and the centre’s general-use adrenaline injector quarterly (see definitions). Please refer to the Infection control and immunisation policy for procedures for the safe disposal of sharps
- ensuring families have provided written authorisation before children attend excursions (see Excursions, incursions and regular outings policy and procedure)
- ensuring the medication and the individualised anaphylaxis care plan and ASCIA Action Plan are kept together in a kit and are accessible to staff when children are inside, outside or on excursions
- ensuring that a risk assessment (see links) is completed to identify areas of risk and possible solutions to reduce the risk.
Cooks and food handlers are responsible for:
- keeping up to date with relevant professional training (see links)
- being familiar with the food allergies of children at the Early Learning Victoria centre and preparing food and drinks suitable for these allergies
- adhering to practices and procedures in relation to the safe handling, preparation, consumption and serving of food, in accordance with the centre’s Food Safety Program (see the Eating and drinking: Health, nutrition and food safety policy and procedure)
- immediately implementing any changes or requirements to menu preparation in response to a child’s allergies or individualised anaphylaxis care plan or Risk Minimisation Plan
- adhering to food safety procedures and cleaning and sanitation requirements, in accordance with the centre’s Food Safety Program and checklists (see Eating and drinking: Health, nutrition and food safety policy and procedure)
- undertaking the National Allergy Council’s All about Allergens for Children’s Education and Care free online training for food allergen management and food service at least every 2 years.
The nominated supervisor is responsible for:
- ensuring a current ASCIA Action Plan (see links) for the child, prepared and signed by the child’s medical practitioner or nurse practitioner, is provided as part of the child’s health information during enrolment and is recorded in the enrolment record for that child
- ensuring that individualised anaphylaxis care plans are developed in consultation with the child’s parents or guardians and is co-signed. The plan will include written permission to display the child’s ASCIA Action Plan on the wall in appropriate places and share the information in the plan with Early Learning Victoria staff
- ensuring an individualised anaphylaxis care plan is reviewed at the start of each year in consultation with the child’s parents or guardians, so information is up to date and strategies to reduce risk remain age-appropriate
- ensuring that a risk minimisation plan is developed in consultation with the child’s parents or guardians
- ensuring that all staff members are aware of, and able to identify, each child diagnosed at risk of an allergy or anaphylaxis
- ensuring all staff members are aware of the individual anaphylaxis care plans for each child diagnosed as at risk of anaphylaxis
- advising all parents of enrolled children if Early Learning Victoria is caring for and educating a child at risk of anaphylaxis
- ensuring a notice is displayed stating that a child who has been diagnosed as at risk of anaphylaxis is being cared for or educated at the service
- ensuring staff are informed of the location/s of the prescribed adrenaline injectors for individual children and the location of the centre’s general-use adrenaline injector (see definitions)
- ensuring that the expiry dates of the centre’s general-use adrenaline injector are checked quarterly, and that the injector is disposed of and replenished if needed. See the Infection control and immunisation policy for procedures regarding the safe disposal of sharps
- ensuring that whenever a child at risk of anaphylaxis is enrolled at Early Learning Victoria or newly diagnosed as being at risk of an allergy or anaphylaxis, all staff will be told:
  - the child’s name and room
  - where the child’s adrenaline injector and ASCIA Action Plan for Anaphylaxis is kept (if the child has a prescribed adrenaline injector)
  - where the child’s ASCIA Action Plan for Allergic Reactions is kept (if the child does not have a prescribed adrenaline injector)
- ensuring a process is in place to routinely check (quarterly) that children’s prescribed adrenaline injectors have not expired and do not need to be replaced. Early Learning Victoria will inform the parents or carers if the adrenaline injector needs to be replaced if about to expire
- ensuring all adrenaline injectors (and any other medication) are labelled with the name of the child and kept somewhere unlocked and easily available to staff, but not accessible to children. The adrenaline injector must be stored at room temperature (not in the fridge) and away from direct heat and sunlight
- ensuring adrenaline injectors and/or other prescribed medications (antihistamine) and ASCIA Action Plans are taken whenever the child goes to offsite activities in accordance with the excursion or regular outings plan, and that a Risk Management Plan is completed (see the Excursions, incursions and regular outings policy and procedure)
- following appropriate reporting procedures set out in the Incident, injury, trauma and illness policy if a child is ill or is involved in a medical emergency or an incident at the service that results in injury or trauma
- ensuring a poster with details of each child’s anaphylaxis risks and allergic conditions, alongside a photo, is displayed in the staff room or a suitably private location.
The approved provider is responsible for:
- establishing robust induction procedures that include the provision of information for implementing practices outlined in this policy
- ensuring educators undertake ASCIA anaphylaxis refresher e-training twice yearly
- ensuring all educators involved in serving and supervising meals undertake the National Allergy Council’s All about Allergens for Children’s Education and Care training for food service at least every 2 years
- ensuring that all staff responsible for caring or educating a child diagnosed with an allergy or anaphylaxis have undertaken approved anaphylaxis management training
- working with the nominated supervisor to notify the Regulatory Authority of a serious incident using the NQA IT System (see the Incident, injury, trauma and illness policy).

4. Resources

Legislation and standards

Education and Care Services National Law Act 2010
Education and Care Services National Regulations 2011
Equal Opportunity Act 2010
Disability Discrimination Act 1992
Health Records Act 2001
National Quality Standard, Quality area 2: Children’s health and safety
Occupational Health and Safety Act 2004
Occupational Health and Safety Regulations 2017
Privacy and Data Protection Act 2014
Privacy Act 1988
Public Health and Wellbeing Act 2008
Public Health and Wellbeing Regulations 2019

Administering medication policy and procedure
Administration of first aid policy and procedure
Anti-bias approach policy
Duty of care policy
Incident, injury, trauma and illness policy
Infection control and immunisation policy
Management of medical conditions policy and procedure
Eating and drinking: Health, nutrition and food safety policy and procedure
Staffing overview policy

Links

Download ASCIA action plans and checklists including:
- Action Plans for Anaphylaxis
- Action Plan for Allergic Reactions
- Action Plan for Drug Allergy
- First Aid Plan for Anaphylaxis
- Travel Plan for People at Risk of Anaphylaxis
- Action Plan for FPIES (food protein-induced enterocolitis syndrome)
- Action Plan for Eosinophilic Oesophagitis (EoE)
Download and print the ASCIA First Aid Plan poster for display where the centre’s general-use adrenaline injectors are stored.
Download the National Allergy Council’s Best Practice Guidelines for the Prevention and Management of Anaphylaxis in Children’s Education and Care.
The National Allergy Council’s Allergy Aware website is a resource hub that includes links to evidence-based resources and training for education and care services to help manage anaphylaxis.
The National Allergy Council’s Food Allergy Aware website is a resource hub with information and practical resources to manage food allergies. It provides additional information for people working in food services.
Also see the Victorian Government Department of Health’s Food Safety website.

Training

ACECQA-approved first aid, emergency asthma management and anaphylaxis qualification and training courses can be found on the NQF-approved qualifications list.
ASCIA anaphylaxis e-training (to support children in schools and education and care services): free training that is accessible, evidence-based and developed according to best practices.
The National Allergy Council’s All about Allergens free online training for food service in early childhood settings is recommended for all staff preparing and serving food to children with food allergy.

Attachments

ASCIA plans and templates

Definitions

Adrenaline injector: An intramuscular injection device containing a single dose of adrenaline, designed to be administered by people who are not medically trained. Two brands of adrenaline injectors are currently available in Australia – EpiPen® and Anapen®. As EpiPen® and Anapen® products have different administration techniques, only one brand should be prescribed per individual and their ASCIA Action Plan for Anaphylaxis (see links) must be specific for the brand they have been prescribed. Staff should know how to administer both brands of adrenaline injectors, as per their accredited training (see Training). Adrenaline injectors that have been used in an emergency response should be placed in a hard plastic container or similar and given to the paramedics.

Adrenaline injector kit: An insulated container with an unused, in-date adrenaline injector, a copy of the child’s ASCIA Action Plan for Anaphylaxis or ASCIA Action Plan for Allergies, and telephone contact details for the child’s family, doctor/medical personnel and the person to be notified in the event of a reaction (if the family cannot be contacted). If prescribed, an antihistamine should also be included in the kit, which must be in the original packaging with a visible expiry date. Adrenaline injectors must be stored away from direct heat and cold.

Allergen: A substance that can cause an allergic reaction.

Allergy: An immune system response to something in the environment; for example, food, pollen or dust mites. These can be ingested, inhaled, injected or absorbed. Almost always, food needs to be ingested to cause a severe allergic reaction (anaphylaxis). However, measures should be in place for children to avoid touching food they are allergic to.

Allergic reaction: A reaction to an allergen. Common signs and symptoms as per the ASCIA Action Plan include one or more of the following:

mild to moderate signs and symptoms:
- hives or welts
- tingling mouth
- swelling of the face, lips and eyes
- abdominal pain, vomiting or diarrhoea are mild to moderate symptoms; however, these are severe reactions to insects.
anaphylaxis (severe allergic reaction) signs and symptoms:
- difficult or noisy breathing
- swelling of the tongue
- swelling or tightness in the throat
- difficulty talking or hoarse voice
- wheeze or persistent cough
- persistent dizziness or collapse
- pale or floppy child (young children)
- abdominal pain or vomiting are signs of severe allergic reaction to insects

Anapen®: A type of adrenaline injector (see definitions) containing a single fixed dose of adrenaline. The administration technique in an Anapen® is different to that of the EpiPen®. Three strengths are available – Anapen® 250, Anapen® 300 and Anapen® 500 – and each is prescribed according to a child’s weight. The Anapen® 150 is recommended for a child weighing 7.5–20kg. An Anapen® 300 is recommended for use when a child weighs more than 20kg and Anapen® 500 may be prescribed for teens and young adults over 50kg. The child’s ASCIA Action Plan for Anaphylaxis (see definitions) must be specific for the brand they have been prescribed (that is, Anapen® or EpiPen®).

Anaphylaxis: A severe, rapid and potentially life-threatening allergic reaction that affects normal functioning of the major body systems, particularly the respiratory or circulatory systems.

Anaphylaxis management training: Training that includes recognition of allergic reactions, strategies for risk minimisation and risk management, procedures for emergency treatment and practising administration of treatment using an adrenaline autoinjector (see definitions). Approved training is listed on the ACECQA website (see links).

ASCIA: Australasian Society of Clinical Immunology and Allergy, the peak professional body of clinical immunology and allergy in Australia and New Zealand.

ASCIA Action Plan for Anaphylaxis/Allergic Reactions: This plan is a nationally recognised action plan for anaphylaxis or allergy developed by ASCIA. These plans are device-specific; that is, they list the child’s prescribed adrenaline autoinjector (EpiPen, EpiPen Jr, Anapen 500, Anapen 300, or Anapen Jr) and/or prescribed antihistamine. The plan must be completed by the child’s medical practitioner or a nurse practitioner. The plan provides the child’s name and confirmed allergens, a photograph of the child, a description of their prescribed anaphylaxis/allergy medication and clear instructions on treating an anaphylactic episode. The plan must be specific for the brand of adrenaline injector prescribed for each child. Examples of plans specific to different adrenaline injector brands are available for download on the ASCIA website (see links).

At-risk child: A child whose allergies have been medically diagnosed and who has either an ASCIA Action Plan for Anaphylaxis or an ASCIA Action Plan for Allergic Reactions is deemed to be at risk of anaphylaxis.

Communication Plan: A plan developed by the Early Learning Victoria centre that provides information to all staff, families and children about anaphylaxis and the centre’s anaphylaxis management policy.

EpiPen®: A type of adrenaline injector (refer to definitions) containing a single fixed dose of adrenaline that is delivered via a spring-activated needle that is concealed until administration is required. Two strengths are available – EpiPen® and EpiPen Jr® – and each is prescribed according to a child’s weight. The Epipen Jr® is recommended for a child weighing 10–20kg. An EpiPen® is recommended for use when a child weighs more than 20kg. The child’s ASCIA Action Plan for anaphylaxis (refer to definitions) must be specific for the brand they have been prescribed.

First aid management of anaphylaxis course: Accredited training in first aid management of anaphylaxis, including competency in the use of an adrenaline autoinjector.

Food allergen management training: Training that includes information about how to order, store, prepare and serve food safely for people with food allergies.

General-use adrenaline injector: A 'back up' or 'unassigned' adrenaline autoinjector purchased by Early Learning Victoria.

Individualised anaphylaxis care plan: A plan that documents the child’s allergies, treatment to be administered in the event of an allergic reaction including anaphylaxis, and the risk minimisation strategies that will be put into place to prevent exposure to known allergens.

Intolerance: Often confused with allergy, intolerance is an adverse reaction to ingested foods or chemicals, experienced by the body but not involving the immune system.

‘No food sharing’: A rule or practice in which a child at risk of anaphylaxis only eats food that is supplied or permitted by their parent or guardian and does not share food with, or accept food from, any other person.

Risk Management Plan: An anaphylaxis Risk Management Plan helps to identify areas of potential risk and possible strategies to reduce the risk.

Education

Updated 3 June 2025