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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 If blood is seen when aspirating, the needle should be withdrawn before injecting and another area should be used for the injection.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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Facts and Figures about Allergies

May is allergy and asthma awareness month. This information is from the Asthma and Allergy Foundation of America. 

What Is an Allergy?

  • An allergy is when your immune system reacts to a foreign substance, called an allergen. It could be something you eat, inhale into your lungs, inject into your body, or touch.
  • An allergic reaction can cause coughing, sneezing, hives, rashes, itchy eyes, a runny nose, and a scratchy throat. In severe cases, it can cause low blood pressure, breathing trouble, asthma attacks, and even death if not treated promptly.
  • There is no cure for allergies. You can manage allergies with prevention and treatment.
  • Allergies are among the country’s most common, but overlooked, diseases.

How Common Are Allergies?

  • More than 50 million people in the U.S. experience various types of allergies each year.
  • Allergies are the sixth leading cause of chronic illness in the U.S.

How Many People Seek Medical Care for Allergies?

  • Allergic conditions are one of the most common health issues affecting children in the U.S.
  • Each year in the U.S., it is estimated that anaphylaxis (a severe allergic reaction) to food results in 90,000 emergency room visits.

How Many People Die From Allergies?

  • The most common triggers for anaphylaxis are medicines, food, and insect stings. Medicines cause the most allergy-related deaths.
  • Black people and older adults in the U.S. have the highest rates of death due to allergic reactions to medicines, food, or unknown allergens.

What Are the Costs of Allergies?

  • The cost of nasal allergies is between $3 billion and $4 billion each year.
  • Food allergies cost about $25 billion each year.

What Are Indoor and Outdoor Allergies?

  • Indoor and outdoor allergies can lead to sinus swelling/pain, itchy/watery eyes, nasal congestion, and sneezing. Airborne allergens can cause seasonal (sometimes called “hay fever” or “rose fever”) or constant (called “persistent”) allergies.
  • Many people with allergies often have more than one type of allergy. The most common indoor/outdoor allergy triggers are: tree pollen, grass pollen, weed pollen, mold spores, dust mites, cockroaches, cat and dog dander, and rodent urine.

How Common Are Seasonal Allergies?

  • In 2018, approximately 24 million people in the U.S. were diagnosed with seasonal allergic rhinitis (hay fever). This equals around 8% (19.2 million) of adults and 7% (5.2 million) of children.
  • Seasonal allergic rhinitis is an allergic reaction to pollen from trees, grasses, and weeds. This type of rhinitis occurs mainly in the spring and fall when pollen from trees, grasses, and weeds are in the air.
  • In 2018, white children were more likely to have hay fever than Black children.
  • The same triggers for indoor/outdoor allergies also often cause eye allergies.

How Common Are Skin Allergies?

Skin allergies include skin inflammation, eczema, hives, chronic hives, and contact allergies. Plants like poison ivy, poison oak, and poison sumac are the most common skin contact allergy triggers and cause symptoms days after the exposure. But skin contact with cockroaches and dust mites, certain foods, or latex may also cause skin allergy symptoms.

  • In 2018, 9.2 million children had skin allergies.
  • Children birth to age 4 are most likely to have skin allergies.
  • In 2018, Black children in the U.S. were more likely to have skin allergies than white children.

How Common Are Food Allergies?

Nine foods cause most food allergy reactions. They are milk, soy, eggs, wheat, peanuts, tree nuts, sesame, fish, and shellfish.

  • About 32 million people have food allergies in the U.S.8,9 o About 26 million (10.8%) U.S. adults have food allergies.8 o About 5.6 million (7.6%) U.S. children have food allergies.
  • In 2018, 4.8 million (6.5%) children under 18 years of age had food allergies over the previous 12 months.
  • In 2018, 6% of Black and Hispanic children had food allergies over the previous 12 months, compared to 6.6% of white children.7 o Food allergy has increased among U.S. children over the past 20 years, with the greatest increase in Black children.
  • Milk is the most common allergen for children, followed by egg and peanut.
  • Shellfish is the most common allergen for adults, followed by peanut and tree nut.
  • Sesame is a rising food allergy. It impacts an estimated 1 million people in the United States. It was declared a major allergen in the United States in 2021.

How Common Are Drug Allergies?

  • Severe drug reactions account for 3% to 6% of all hospital admissions worldwide. Drug allergy accounts for less than 10% of these severe drug reactions.
  • The most commonly reported drug allergy is to penicillin, with up to 10% of people saying they are allergic to these drugs. However, less than 10% of these people (or less than 1% of 3 the total population) are actually allergic to penicillin drugs when evaluated for these allergies.

How Common Is Latex Allergy?

  • About 4.3% of the general population has a latex allergy.
  • Latex allergy is more common in certain occupations. Approximately 9.7% of health care workers have a latex allergy.

How Common Is Insect Allergy?

People who have insect allergies are often allergic to bee, wasp, and ant stings. Cockroaches and dust mites may also cause nasal or skin allergy symptoms.

  • Insect sting allergies affect 5% of the population.
  • As many as 100 deaths occur each year in the United States due to insect sting anaphylaxis.

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

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