Updated September 2024
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An admission to hospital can be a confusing and frightening experience. Preparing for any future hospital stay can be useful if you have a food allergy.
Reason for hospital admission
There are two types of hospital admission: emergency or elective.
Emergency admission
Emergency admission occurs through the Emergency Department of a hospital. You may arrive in an ambulance, or you may attend as a result of an ‘emergency’ situation (for example an injury or sudden serious illness). Your visit may be because of an allergic reaction or unrelated. Either way, this can often involve several hours in hospital, waiting and being treated. It is likely at some point you will need to eat or drink.
An emergency admission does not necessarily allow for planning or preparation at the time, but you can plan ahead ‘just in case’ (for example, have a list of packaged food that is appropriate, have a trusted family member bring food in if needed).
Elective admission
An elective admission or direct admission is planned ahead of time and will occur through an admissions department rather than though an emergency department.
Elective admissions usually occur at a more convenient time and often allow for a planned/prepared approach. It may involve just a day procedure or could involve a longer stay, so you should make time to think ahead and plan how to manage your needs, including your food allergy, during your stay.
Awareness of allergy resources for hospitals
Even though there are resources available to hospitals such as the:
- Acute Anaphylaxis Clinical Care Standard (2021), and
- National Allergy Council free online food allergen training for hospital staff,
don’t assume that hospital staff know about food allergies or these resources.
Food allergies in hospitals and healthcare setting
Managing food allergies can be difficult in hospital, especially when a person has multiple food allergies or allergies to a whole food group such as milk (dairy) or other common everyday foods such as wheat and egg. Don’t assume that hospitals are any better at catering for food allergies than any other restaurant or cafe. Despite the increase in food allergies, many hospitals may not have good processes in place for providing appropriate foods to patients with food allergy.
Just as you would plan for a holiday or your regular day at school or work, it is important to plan for a possible trip to hospital. Food allergy management can be challenging, and it is important to prepare as you would for any other eating out experience.
PLEASE NOTE: If you are a parent or carer of a child with a food allergy, you or your refers to the person with the food allergy.
Remember:
- Always tell doctors and nursing staff about your food allergies (even if they don’t ask or only ask about medication/drug allergies).
- If you are having a planned hospital visit, contact the hospital ahead of time explaining your food allergy and ask how they will manage it. Depending on the health service and type of admission, you could ask to talk with the admissions department, dietetics and nutrition department, ward coordinator, or kitchen.
- If you have a medical condition that may lead to your admission to hospital when you are not able to communicate with staff, consider wearing a medical identification bracelet or necklace.
- It is very important to check that your food allergy is included in your medical notes and medication chart on every hospital visit.
- On admission, you may have an allergy wristband (usually red) put around your wrist or ankle. However, not all hospitals put coloured wristbands on people with a food or medication allergy.
- Be aware that even if your food and medication allergies are in your medical notes and on your medication chart, medical staff often still ask you what you are allergic to, especially before giving any medication and before having an operation. The checking of allergies many times when in hospital and healthcare settings helps to keep you safe.
- Tell those caring for you about your food allergies at EVERY meal and snack time, as well as when you move to another hospital area such as the emergency department, the ward, and other departments where you need to have a blood test, an X-ray, scan, or other medical test.
- Do not rely on hospital staff checking your medical notes to see if you have a food allergy. Tell them, even if they do not ask.
Food
- Meals provided by the hospital: Legally, hospitals have the same responsibilities as any food service such as a restaurant or cafe. If you have told the hospital about your food allergies, they must provide you with a meal that does not contain the food you are allergic to. It does not matter what food you are allergic to, whether it is a common or uncommon food allergen, if you have told them about your food allergy, the meals you receive should not have the food you are allergic to in them.
- Ask about ingredients of every meal or snack where you cannot read food labels for yourself. If the staff you are speaking to cannot give you answers about your food then ask to speak with someone who can give you trusted information. This may be the ward dietitian, nutrition services or catering manager.
- It is not recommended that hospitals ban any type of food, for example, peanuts or sesame. Hospital patients have a range of medical and nutritional needs. They also cannot enforce what foods patients and families bring into the hospital.
- For children with food allergies, make sure your child’s meal and snack times are ALWAYS supervised by a parent/carer or nurse who is aware of and understands your child’s food allergy.
- You may wish to provide your own food if you are worried about the hospital providing safe food. Speak to staff about storing and reheating food that you bring in or is brought in for you.
- If you can, wash your hands before you eat.
Adrenaline injectors and ASCIA Action Plans in hospital
- Have your adrenaline (epinephrine) injector/s (Anapen®, EpiPen®) with you and ask that the adrenaline injector is written up on your medication chart by the doctor when you are admitted.
- If you are told that the staff will keep your adrenaline injector with your other medications and not with you, tell the healthcare worker to look at information in the Acute Anaphylaxis Clinical Care Standard 2021. It says: “it is important for the patient (or their carer) to be able to immediately administer their own adrenaline injector, regardless of the setting”
- However, there may be settings where other safety factors need to be considered, such as a mental health ward or sometimes a children’s ward when the parent is not able to stay with the child. Work with staff to find a solution for appropriate storage that ensures the adrenaline injector is easily accessible and not locked in a room or a cupboard.
- Having your adrenaline injector with you will help you give the adrenaline quickly if you show signs of a severe allergic reaction. You can give yourself your adrenaline injector when you are a patient in the hospital, you do not need to wait for medical staff to give it.
- Keep an ASCIA Action Plan with your adrenaline injector. If you can, take an extra copy for staff to include in your medical notes.
If you have any symptoms of an allergic reaction while in hospital
- Have your adrenaline injector close by
- Follow instructions on your ASCIA Action Plan
- Use your call bell or call for help so that staff know and come to you. Do not stand and walk to look for a nurse or doctor.
If you have any symptoms of anaphylaxis while in hospital
- If not already done, call out for help or press the ASSIST/EMERGENCY button. If you cannot easily reach your call bell or adrenaline injector, do not stand or walk – ask others in the room to help, shout for help or make a noise to attract attention.
- Lay in your bed or on the floor and give your adrenaline injector.
- Tell hospital staff that you are having anaphylaxis and whether you have given yourself your adrenaline injector.
- DO NOT stand or walk while you are having a severe allergic reaction or after having adrenaline, even if you feel better. Say “no” if you are asked to stand and walk to another area such as a treatment room or back to your bed. Ask for staff to arrange for you to be moved in a way that keeps you in the lying position, as written on the ASCIA Action Plan. If you stand up, there is a risk your blood pressure will become very low, very quickly, and you could collapse.
- Parents or carers of babies and small children should carry them in a lying position, not held upright.
- Just remember that if you are having trouble breathing you may sit up with your legs stretched out straight in front of you.
Things to think about
Hospitals are busy, and nursing staff are often responsible for managing many patients, including those less able to care for themselves, such as children or people with disabilities. These people are sometimes called vulnerable patients. When a person is less able to care for themselves, a family member needs to talk with nursing staff about food allergy management while in hospital. Those with an altered mental state (such as people with head injuries or dementia and those on strong medication to help decrease their pain) during their hospital stay also need family support to make sure the right food is served to the patient. Talk with nurses about a plan to make sure the right food is given to the patient with food allergy.
Consider:
- Educate your child or vulnerable person with food allergy on how to increase food safety and reduce risk in a way they can understand.
- If you are in a shared room, tell other parents/carers/patients in the room that your child or vulnerable person has food allergy and not to offer them any food.
- If children are encouraged to eat at a table with other children, be aware of what other children are eating, remind children not to share food, supervise your child closely and if possible encourage hand washing before and after eating.
- Everyone, including teens and adults with food allergy needs extra care while they are in hospital.
- People may be too embarrassed or feel awkward about asking busy staff questions about ingredients in hospital food they are served. Encourage them to talk with staff and reassure them that they are not doing it to be awkward but must ask to reduce risk.
- If the patient has had surgery or is on medication, they may not be thinking clearly. Ensure hospital staff check the food is appropriate.
Things to take with you to the hospital (if you can):
- Adrenaline injectors
- Copy of your ASCIA Action Plan
- Own food/snacks
- Mobile phone and charger
- Any other medication the person takes regularly
- Medicare card
- Private health fund information