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Allergy Injection Treatment Procedures and Precautions

Allergy Injection Treatment Procedures and Precautions

Method of Administration

Allergy injections are given subcutaneously, half-way between the elbow and the shoulder along the outer aspect of the back of the upper arm, or the outside of the mid-thigh. They should not be given too shallowly in the skin, nor should they ever be given without first aspirating (drawing back on the syringe plunger after the needle is in the tissue). If blood is seen when aspirating, the needle should be withdrawn before injecting and another area should be used for the injection. If there are 2 vials (such as “LEFT” and “RIGHT”), there should be 2 injections each time shots are given unless the doctor instructs otherwise. Some injections will be given from individual numbered unit dose vials while other will be dispensed from a larger multi-dose vial according to instructions specific for an individual patient.

A disposable 1 cc allergy treatment syringe with the ½ or 5/8 inch, 25, 26 or 27 gauge, regular bevel needle should be used to give the injections.

Important Precautions

  • The injections should never be administered unless injectable epinephrine 1:1000 is immediately available and there is a reliable person other than the patient to inject it.
  • OAAC requires that allergy injections be administered by a medically competent person in a medical facility equipped to treat (possible severe) allergic reactions. This advice encompasses all patients – even doctors, nurses, and other health professionals who are allergy patients.
  • Administration of allergy shots outside of an OAAC shot treatment room (for example your physician’s office) must be cleared by your OAAC physician (not just from your primary care physician or other health care provider); please do not proceed without it.

Injection Reactions

Allergy injection treatment is intended to decrease a patient’s sensitivities so that in time he/she will feel better. Injections should not cause allergy symptoms. Whenever problems occur, please discuss it with your OAAC doctor or staff.

A local reaction to an allergy injection consists of redness, soreness, itching, and/or swelling at the injection site. Most allergic individuals can be expected to have some local reaction at times. Some will have moderate local reactions regularly, at least until they have been on treatment for many months.

Should there be an excessive (greater than a quarter or 25 cent piece in diameter and lasting more than 24 hours) local reaction after an injection, an antihistamine (like Benadryl, Claritin, Allegra, Zyrtec or Xyzal), cold compress, and topical steroid cream may be used for symptom relief. Your OAAC physician and staff must be notified of the dose number and of the name of the specific vial before more injections are given. A dosage reduction may be indicated.

Systemic (generalized) anaphylaxis reactions to allergy injections are rare (0.015 to 0.02% of injections administered at OAAC Clinics). However, if they occur, prompt treatment with Epinephrine and not just an antihistamine like Benadryl is vitally important. It could save your life. In the event of a systemic (generalized) reaction after an allergy injection, there may or may not be marked swelling at the injection site, plus a vague feeling of apprehension and itching of the palms followed by generalized hives, flushing, sneezing, nasal congestion, increased mucus production or throat clearing, difficulty breathing, coughing, or wheezing.

PATIENTS MUST WAIT 20-30 MINUTES AFTER AN INJECTION SO THAT THEY MAY BE OBSERVED FOR SIGNS OF A GENERALIZED REACTION.

This type of reaction requires treatment with Epinephrine and not just an antihistamine like Benadryl. Prompt medical attention is always needed. If the shot was given at a location other than an OAAC treatment room your clinic physician must be notified before further allergy injections are given because dosage reduction is mandatory. Your OAAC physician is always notified by staff of systemic reactions which occur at an OAAC treatment room.

Beta blocker drugs may make systemic reactions more difficult to treat and you must notify your OAAC physician if you are taking one.

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Asthma Facts and Figures

Asthma Facts and Figures from the Asthma and Allergy Foundation of America (aafa.org)

May is Allergy and Asthma Awareness Month

What Is Asthma?

  • Asthma is a long-term disease that causes inflammation and swelling of the airways. This results in narrowing of the airways that carry air from the nose and mouth to the lungs.
  • Asthma symptoms include trouble breathing (shortness of breath), wheezing, coughing, and tightness or pain in the chest.
  • Asthma symptoms can be triggered by different things for different people. Allergens, like dust or pet dander, are common triggers. Some people also develop asthma symptoms in response to certain foods or to exercise.

    Asthma can be deadly.

  • There is no cure for asthma, but appropriate treatment prevents asthma attacks and can help you have a better quality of life.
  • Asthma is one of the most common and costly diseases in the United States.

    How Common Is Asthma?

  •  Approximately 25 million people in the U.S. have asthma. This equals about 1 in 13 people.
  • About 20 million U.S. adults age 18 and older have asthma.
  • Asthma rates are highest in Black adults in the U.S.
  • Asthma is more common in female adults than male adults. Around 9.8% of female adults have asthma, compared to 6.1% of male adults.
  • It is a leading chronic disease in children.2 Currently, there are about 5.1 million children under the age of 18 with asthma.
  • Black children are nearly three times more likely to have asthma compared to white children.
  • Asthma is more common in male children than female children. Around 8.4% of male children have asthma, compared to 5.5% of female children.

What Are the Rates of Asthma Attacks in Children?

  • In 2019, 44.3% of children age 18 and younger who had asthma reported having one or more asthma attacks in the past year.
    • About 47.2% of children under the age of 5 with asthma had an attack. 1
  • According to the Centers for Disease Control and Prevention (CDC), asthma attacks in children have declined from 2001 through 2019.
  • Even though asthma is controllable, it is estimated that 50% of children with asthma have uncontrolled asthma.

What Are the Rates of Asthma Attacks in Adults?

  • In 2019, 40.4% of adults age 18 and older who had asthma reported having one or more asthma attacks in the past year.
    • Black adults have the highest rate of asthma attacks in the U.S.
  • According to the CDC, asthma attacks in adults have declined from 2001 through 2019.3 2

How Many People Seek Medical Care for Asthma?

  • In 2018, asthma accounted for 5.8 million doctors’ office visits.
  • In 2018, asthma accounted for 178,530 discharges from hospital inpatient care and 1.6 million emergency department visits.
  • Black people in the U.S. are nearly five times more likely than white people in the U.S. to visit the emergency department due to asthma.

How Many People Die From Asthma?

  • On average, 11 people in the U.S. die from asthma each day. In 2020, 4,145 people died from asthma. Nearly all of these deaths are avoidable with the right treatment and care. In 2020, deaths due to asthma rose for the first time in 20 years.
  • Adults are five times more likely to die from asthma than children.
  • Female adults are more likely to die from asthma than male adults, and male children are more likely than female children.
  • Black people in the U.S. are nearly three times more likely to die from asthma than white people in the U.S.
  • When sex is factored in, Black females have the highest rate of fatality due to asthma. In 2020, Black females were nearly four times more likely to die from asthma than white males.

What Are the Costs of Asthma?

  • From 2008-2013, the annual economic cost of asthma was more than $81.9 billion – including medical costs and loss of work and school days:9 o $3 billion in losses due to missed work and school days
    • $29 billion due to asthma-related mortality o $50.3 billion in medical costs
  • Medical costs for people with asthma are estimated to be $3,266 higher per year (in 2015 U.S. dollars) compared to medical costs for people without asthma.
  • Among children ages 5 to 17, asthma is one of the top causes of missed school days. In 2013, it accounted for more than 13.8 million missed school days.

Why Do Certain Racial or Ethnic Groups Have Higher Rates of Asthma,Asthma Attacks, or Asthma Deaths?

See AAFA’s groundbreaking research report on Asthma Disparities in America. Racial and ethnic differences in asthma frequency, illness, and death are caused by complex factors, including:

  • Structural determinants such as systemic racism, segregation, and discriminatory policies
  • Social determinants such as socioeconomic status, education, neighborhood and physical environment, employment, social support networks, and access to health care
  • Biological determinants such as genes and ancestry
  • Behavioral determinants such as tobacco use and adherence to medicines
  • Social determinants and structural inequities (systemic racism) largely drive disparities in asthma. Factors such as genetics and individual behaviors contribute less to asthma disparities.

Why Do Males and Females Have Different Rates of Asthma?

  • Male children are more likely to have asthma than female children. This trend reverses in adulthood, where female adults are more likely to have asthma than male adults.
  • Some studies suggest this trend reverses because of the effects of testosterone on lung cells. Testosterone, a male sex hormone, has been found to decrease the swelling of the airways in asthma.

The post Asthma Facts and Figures appeared first on Oklahoma Allergy and Asthma Clinic.

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