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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 If blood is seen when aspirating, the needle should be withdrawn before injecting and another area should be used for the injection.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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Making Halloween Fun for Everyone

When a child has a food allergy, holidays can be especially tough for both the child and the child’s family, says Oklahoma Asthma & Allergy Clinic’s Board-Certified Allergist Dr. Maya Gharfeh.

“Holidays are such an important and fun part of childhood,” said Gharfeh. “One of the most important things of raising a child with a food allergy is to not let him or her feel different or isolated because of the food allergy. Instead, we adapt and still let the holiday be as fun as possible.”

The Teal Pumpkin project is an initiative created by the Food Allergy Research and Education (FARE) network to promote a safe Halloween for all including those with a food allergy. It encourages families to place a teal pumpkin on their doorstep to let families know they have non-food treats available for kids with food allergies. Those who wish to participate can register their home address on the FARE website so families can pre-plan their trick or treating.

Any food allergy is potentially life threatening. An accidental exposure through ingestion of a food allergen may quickly lead to a life-threatening situation where a child would need emergency medication – like epinephrine – for survival.

As the mother of a child with a food allergy, Gharfeh has first-hand knowledge. She suggested ideas they’ve done to make a happier Halloween for their daughter.

“We have a rule of no eating or snacking on candy while trick or treating. We go house to house and collect treats as normal. Once we get home, we dump them out and I sort the candies into safe and non-safe, specific for my daughter,” Gharfeh said.

She always keeps safe treats at home for a swap out for those unsafe ones.

“No one wants a half-full Halloween basket,” she said.

Non-food items for those swap outs could include stickers, glow in the dark bracelets and necklaces, Halloween pencils, spider rings, etc.

“Since my daughter has a nut allergy, we try to stay away from most of the chocolate candies and stick with sugar candies such as Skittles or Jolly Ranchers,” Gharfeh added. “We always carry our emergency epinephrine device with us while trick or treating to be ready for an emergency.”

Other ideas for making Halloween safer, Gharfeh says, includes hosting your own Halloween party with allergy safe food treats and non-food items as treats. She encourages families to educate their neighbors and friends about the Teal Pumpkin project. Volunteer for school positions to allow more involvement in choosing snacks/treats for holidays such as Halloween.

“Kids love painting pumpkins,” Gharfeh said. “By inviting your neighbors to participate, you have provided an opportunity to ensure some safe stops for your food allergic littles in your neighborhood.”

FARE recommends has these ideas to celebrate the teal pumpkin project:

  • Decorate your front door. Grab some teal plastic pumpkins (available at local retailers), festive decorations and transform your door. Get your whole neighborhood involved.
  • Host a virtual Halloween party. Staying inside this year? Plan a virtual party so kids can dress up and show off their costumes. Make the party even more interactive by playing fun games online like bingo or trivia.
  • Set up a craft and activity station and let the kids loose! From coloring sheets to word matches, FARE has printable resources for getting kids excited about Halloween.
  • Halloween Scavenger Hunt – get your kids outside and moving. Take a walk or drive around to try and spot sooky sights. Bonus points for spotting teal pumpkins.
  • Stay in for a scary movie night. Invite your friends and neighbors over to watch your favorite Halloween movie.
  • For food allergy friendly recipes, check out the FARE website www.foodallergy.org

If families suspect their child might have a food allergy, Gharfeh says, “Come see a board-certified allergist. We want to help not only diagnose but also to help you, your child, and your family know what a food allergy means and the steps to ensure a safe, healthy and fun childhood, even with a diagnosis of a food allergy.”Teal Pumpkin Campaign

 

The post Making Halloween Fun for Everyone appeared first on Oklahoma Allergy and Asthma Clinic.

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