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Allergology / Epinephrine autoinjector / First aid / Respiratory diseases / Immune system / Food allergy / Autoinjector / Anaphylaxis / Epinephrine / Medicine / Health / Type 1 hypersensitivity


Anaphylaxis Emergency Plan: _____________________________________________ (name) This person has a potentially life-threatening allergy (anaphylaxis) to: (Check the appropriate boxes.)
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Document Date: 2011-06-22 15:22:54

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City

Napa / /

Company

Mylan Inc. / Dey L.P. / King Pharmaceuticals Canada Ltd. / /

Country

United States / /

/

IndustryTerm

food allergies / food / /

MedicalCondition

anaphylactic reaction / allergic reaction / chest pain / shortness of breath / hives / nausea / anaphylaxis / nasal congestion / itching / allergy / pain/cramps / vomiting / food allergies / anaphylactic reactions / cough / wheezing / asthma / /

MedicalTreatment

emergency treatment / Massage / /

Organization

Canadian Society of Allergy and Clinical Immunology Date How / /

/

Position

Patient/Parent/Guardian Signature Date Physician / physician / ER physician / /

Product

Epinephrine / Twinject / EpiPen / Egg Latex Milk Medication / /

ProvinceOrState

California / /

Technology

cellular telephone / /

URL

www.EpiPen.ca / /

SocialTag