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 If blood is seen when aspirating, the needle should be withdrawn before injecting and another area should be used for the injection.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

Recent News

Oklahoma City Ranks Ninth for Most Challenging Cities for Allergies
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Oklahoma City Ranks Ninth for Most Challenging Cities for Allergies

The Asthma and Allergy Foundation of America (AAFA) released Feb. 23 its annual Allergy Capitals™ report for 2021 which identifies the most challenging cities for spring and fall allergies in the top 100 metropolitan areas in the United States. Oklahoma City was ranked ninth. Scranton, Pennsylvania took the top spot for 2021.

Cities are ranked based on three factors: spring and fall pollen scores, over-the-counter medicine use, and availability of board-certified allergists. Richmond, Virginia held the #1 title in 2020. The top 20 Allergy Capitals™ for 2021 are: 1. Scranton, Pennsylvania; 2. Richmond, Virginia; 3. Wichita, Kansas; 4. McAllen, Texas; 5. Pittsburgh, Pennsylvania; 6. Hartford, Connecticut; 7. Springfield, Massachusetts; 8. New Haven, Connecticut; 9. Oklahoma City, Oklahoma; 10. Bridgeport, Connecticut; 11. Albany, New York; 12. Virginia Beach, Virginia; 13. Buffalo, New York; 14. San Antonio, Texas; 15. Dayton, Ohio; 16. Riverside, California; 17. Las Vegas, Nevada; 18. Memphis, Tennessee; 19. Dallas, Texas; and 20. Louisville, Kentucky. Tulsa, Oklahoma was ranked 21.

“Allergies are a serious public health concern. More than 24 million people in the U.S. have seasonal allergic rhinitis, more commonly referred to as hay fever. Pollen allergies are a major cause. AAFA’s Allergy Capitals™ report helps more Americans make sense of the impact on individual and community health,” says Kenneth Mendez, CEO and president of AAFA. “Two notable parts of our 2021 report include the effect of COVID-19 and climate change on seasonal allergies. In 2020, fewer people felt the impact of pollen allergies. This is likely due to COVID-19 restrictions with more people staying indoors. But climate change continues to cause longer and more severe allergy seasons. If we don’t slow down the cycle, pollen production will only intensify. This means symptoms could worsen as climate change continues to evolve.”

Seasonal pollen allergies cause nasal, sinus, and other symptoms each spring through fall. Pollen can also trigger asthma attacks. Tree pollen season starts as early as January in some parts of the U.S. and continues through summer. In the fall, weed pollen including ragweed, causes symptoms. But relief is possible with the right treatment and by managing contact with pollen. Oklahoma City just had several allergy alert days in March for cedar and elm tree pollen which is always problematic in the winter months.

“It’s important people with seasonal allergies prepare. They should try their best to reduce exposure to pollen,” says Dr. Mitchell Grayson, chair of AAFA’s Medical Scientific Council and Director of the Division of Allergy and Immunology at Nationwide Children’s Hospital and The Ohio State University. “Schedule an appointment with your allergist to work on a treatment plan together to help reduce allergy symptoms when prevention is not enough.”

Treatment options include over-the-counter or prescription allergy medicines. Medications are most effective when started before allergy season begins.

“If medicines are not helping, it is important to establish care with an allergist to discuss what treatment options are best to reduce your allergy symptoms and attacks,” said Oklahoma Allergy & Asthma Board Certified Allergist (OAAC) Dr. Laura Chong.

The Allergy Capitals™ ranking is an annual research and educational project of AAFA, designed to help patients recognize, prevent and safely treat allergy symptoms. Through this ranking, AAFA raises awareness about the impact of seasonal allergies and provides helpful information designed to improve the quality of life for people who experience them. The ranking is based on local spring and fall pollen levels, use of allergy medication and the number of board-certified allergists in each metro area. Visit allergycapitals.com to see the full list, study methodology and learn more about allergy diagnosis, prevention and treatment.

To see the complete, 100-city list go to allergycapitals.com. The report lists overall annual rankings and breaks down a seasonal ranking for spring and fall.

The post Oklahoma City Ranks Ninth for Most Challenging Cities for Allergies appeared first on Oklahoma Allergy and Asthma Clinic.

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