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How to use or fill out PLAN OF CARE — ANAPHYLAXIS PLAN OF CARE - DSBN
- Click ‘Get Form’ to open it in the editor.
- Begin by filling out the 'STUDENT INFORMATION' section. Enter the school name, age, homeroom teacher, and student name. Optionally, you can add a student photo.
- In the 'EMERGENCY CONTACTS' section, list contacts in priority order along with their relationship to the student and phone numbers.
- Identify known life-threatening triggers by checking the appropriate boxes for insect stings, food allergies, or other triggers. Specify details as needed.
- Complete the 'DAILY/ROUTINE ANAPHYLAXIS MANAGEMENT' section by listing food allergens to avoid and safety measures for both food and insect stings.
- Follow with the 'EMERGENCY PROCEDURES' section detailing steps to take during an anaphylactic reaction. Ensure clarity on administering epinephrine and contacting emergency services.
- Optionally fill out the 'HEALTHCARE PROVIDER INFORMATION' if applicable, including provider details and any special instructions regarding medications.
- Finally, complete the 'AUTHORIZATION/PLAN REVIEW' section by obtaining necessary signatures from parents/guardians and school officials.
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