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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 If blood is seen when aspirating, the needle should be withdrawn before injecting and another area should be used for the injection.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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Don’t Forget the Drinks if you have Food Allergies

Managing food allergies requires constant avoidance of allergens, emergency preparedness and effective communication. Going out to eat with food allergies can be challenging but is completely doable. When it comes to avoiding allergens while out to eat, the focus in the minds of patrons and eating establishments is often the food, but it is important to keep in mind that beverages can contain allergens as well. Outlined below are key points and tips to consider before you take your sips.

Avoid Cross Contact
Remember that allergens can remain in someone's saliva for several hours after eating and for some people even small amounts of an allergen can cause a severe allergic reaction. To prevent the chance of cross contact drink from your own cup and don't share with others around you. Also remember cross contact can occur with drink stirrers, shakers and other utensils used to mix drinks as with condiments like sprigs of mint or slices of fruit.

Be Aware of All Ingredients Added to the Beverage
This is especially true in the case of mixed drinks. For example if you are allergic to dairy and cream is added to your pina colada, then this can cause an allergic reaction. Some drinks contain raw egg whites - the white 'fuzz' of a Pisco sour, for example, is from beaten egg whites. Raw eggs are particularly dangerous in people with egg allergies.

Know What Ingredients Are in the Beverage
The drink itself may have an allergen in it (for example, wheat in beer). Things to consider here are that since alcohol is not regulated by the Food and Drug Administration (FDA), beverage companies that are bottling alcoholic products do not need to follow current labeling laws and do not need to disclose allergens. In fact, many alcoholic beverages do not list ingredients at all. This certainly becomes an issue for those allergic to wheat, rye, and barley as well as those with celiac disease who need to avoid wheat, rye and barley because of gluten. Similar concerns can arise with wine. If ingredients are unclear then consider calling the company for a list of ingredients. Distilled alcohol is a bit less of an issue but still worth discussing with your healthcare team.

Consider Sulfites
Also, keep in mind that sulfites can exacerbate asthma and in rare cases can cause allergic reactions. Sulfites are commonly found in many alcoholic beverages including wine, beer, ciders and drink mixes added to the alcohol.

Know Alcohol’s Effects
Another issue to take into consideration is the effect of the alcohol itself. Alcohol can decrease our ability to make good decisions and communicate effectively. Other things to consider are that alcohol can decrease the threshold level to trigger an allergic reaction, can decrease the time to develop an allergic reaction, and increase severity. However, alcohol itself is an unlikely allergen.

If you have been prescribed an epinephrine autoinjector, remember to carry this with you at all times, even if you're just going out for a drink.

This article is for educational purposes only. Talk to your healthcare provider before any change in food allergy management.

Find out more about food allergies.

The post Don’t Forget the Drinks if you have Food Allergies appeared first on Oklahoma Allergy and Asthma Clinic.

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