Pharmacists are ideally positioned to advise patients, their family or carers on how to avoid an anaphylactic reaction, recognise the early symptoms of a reaction and also how to use their AAI.

Counselling could take place when supplying an AAI, during an advanced service such as an MUR or opportunistically within the pharmacy.

Suitable advice to provide would include:

• Recognise what triggers a reaction and avoid the triggers
• Where food is the identified trigger factor:
  • Be vigilant and check food labels.
  • Ask questions about what is in foods when eating out or having a takeaway.
  • Avoid food where you are unsure of the ingredients.
  • Be especially careful during festive occasions such as weddings or parties.
• Ensure you can recognise the early symptoms of a reaction.
• Use the AAI at the first sign of a reaction. If in doubt whether your reaction is severe use your AAI.
• Practice using your AAI using a suitable placebo device, and encourage family and friends to practice too.
• Ensure your family and friends can recognise the symptoms of an episode and are able to administer your AAI.
•  Ensure you always carry two AAI, this is especially important for patients with allergic asthma as they have an increased risk of severe anaphylactic reaction.
• AAIs are designed for administration through clothing.
• When administering an AAI try to avoid zips, buttons, buckles, seams and pocket contents.
• Only use each device once.
•  Always call 999 and state €anaphylaxis€ if you have a reaction.
• Check the expiry dates of your AAI regularly, and obtain a replacement before they expire.
• Register for the expiry date alert service relevant for your AAI.
• Consider wearing a form of alert or identification device e.g. medic alert bracelet or chain that provides information on the type of anaphylactic reaction and identified triggers.

 Advise patients travelling abroad to:

• Check with the airline whether the AAI can be carried on the plane.
• Carry the AAI in hand luggage.
• Take a letter from their GP as this may be required for foreign travel.
• Take travel certificates which can be downloaded from most AAI manufacturer websites.
• Take translation cards which are available from the Anaphylaxis Campaign.
• Carry the translations for specific triggers when travelling abroad and also a translation of the phrase €anaphylaxis€.
• Keep AAIs out of direct sunlight, excessive heat or light because this will cause adrenaline to turn brown.
• Make sure they know how to contact the emergency services when abroad.
• Travel with comprehensive travel insurance.

Pharmacists can also signpost patients, family members or carers to suitable patient support groups e.g. www.anaphylaxis.org.uk or resources available on AAI manufacturer websites.