2026 anaphylaxis action plan updates and what they mean for early childhood leaders

Severe allergic reactions, including anaphylaxis, remain one of the most critical emergency health risks in early childhood settings. Recent clinical guidance and therapeutic changes underscore why educators and service leaders must stay informed, confident and compliant.

Australia’s peak clinical authority, the Australasian Society of Clinical Immunology and Allergy, has released updated 2026 versions of its ASCIA Action Plans for Anaphylaxis and First Aid Plans designed to enhance clarity and safety in emergency responses. These updates arrive alongside the recent TGA approval of a new adrenaline nasal spray device, expanding treatment options beyond traditional injectors. 

The updated ASCIA plans now include:

• Five versions of the red ASCIA Action Plan for Anaphylaxis, with a general version and four device-specific versions tailored to recognised adrenaline delivery devices, now including nasal spray option.
• A refreshed Orange First Aid Plan for Anaphylaxis;
• Updated travel and allergic reaction plans to support safer mobility and recognition of non-anaphylactic allergic responses. 

Key refinements for 2026 include:

• Expanded language for prescribing authorities,  “prescribers” now replaces earlier terminology, acknowledging workforce and scope-of-practice changes including authorised nurses. 
• Addition of an explicit field for “Adrenaline device/s prescribed” in general ASCIA action plans to reflect the growing range of emergency devices. 

These documents remain medical records completed and signed by a treating practitioner and must be provided to services for every child at risk. 

In parallel with the updated action plans, a new adrenaline (epinephrine) nasal spray device delivered without needles, has been approved in Australia for emergency anaphylaxis treatment for children from around 15 kg or 4 years, and adults. 

This innovation represents a significant shift in emergency care:

• It offers a needle-free alternative to traditional autoinjectors (like EpiPen and Jext), potentially reducing barriers to timely administration in emergencies. 
• Neffy® and similar devices are increasingly being recognised in clinical guidelines and will be reflected in updated clinical action plan versions to ensure accuracy in service documentation. 
• Services should anticipate corresponding updates to their medical condition policies and anaphylaxis procedures to incorporate alternative device types safely and confidently.

Approved providers and nominated supervisors must check action plan device versions, ensuring that the version held for each child matches the type of adrenaline device prescribed. 

For leaders in early childhood education and care, these updates are not peripheral. They have direct implications for:

Under Regulation 92 of the Education and Care Services National Regulations 2011, services must have a documented anaphylaxis policy that reflects current evidence, training and devices. With updated clinical action plans and new treatment devices,  it’s time to review, update and communicate changes.

Approved providers must ensure policies are:

• aligned with the latest ASCIA plans
• integrated into daily practice
• accessible and understood by all educators.

Anaphylaxis procedures must be practised, not assumed. Training should include:

• recognising early signs and symptoms;
• correctly administering each type of adrenaline device included in children’s plans (injector and nasal spray where prescribed);
• clear documentation of medication location, expiry and access protocols.

Remember: the most effective response is the one that is well rehearsed.

ASCIA plans are owned by families and health practitioners. Services must have systems to:

• collect and hold signed, up-to-date ASCIA action plans;
• verify that the adrenaline device prescribed matches the action plan version;
• communicate any changes to families promptly;
• ensure consent and authorisation forms reflect current devices.

This is critical for safe arrivals, transitions and medication administration.

What leaders can do now

1. Audit and update policies
Check your anaphylaxis policy, ASCIA plan versions held and medication authorisations for every enrolled child with allergies. Ensure each plan reflects the device prescribed — including nasal spray options.

2. Refresh team capability
Plan and record structured training on each device type documented in action plans. Practical drills build muscle memory and confidence.

3. Communicate changes with families
Inform families about policy updates, device requirements and documentation expectations. Early, clear communication reduces risk and builds trust.

4. Embed practice checks
Routine checks of device location, expiry dates, correct plan version and staff familiarity help embed compliance in daily practice.

Anaphylaxis remains an unpredictable and potentially life-threatening condition. Updated clinical guidance and new emergency devices amplify the importance of:

• understanding regulatory obligations;
• embedding up-to-date practices;
• ensuring educator readiness;
• partnering with families and health practitioners.

With the 2026 ASCIA updates and new treatment options now part of clinical practice, early childhood leaders have the opportunity to strengthen anaphylaxis safety standards,  translating compliance into care that protects every child.