Immunotherapy Safety for the Primary Care ... - U.S. Coast Guard

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Differential Diagnosis • Pulmonary – Epiglottis, PE, foreign body aspiration, hyperventilation, asphyxiation • Cardiovascular – MI, arrhythmia, cardiac arrest, hypovolemic shock • CNS – Vasovagal rxn, CVA, seizures, drug overdose • Endocrine – Carcinoid, pheochromocytoma, hypoglycemia • Other – Mastocytosis, H/AAE, idiopathic urticaria, serum sickness, scombroid poisoning, VCD, panic attack Montanaro A and Bardana EJ Jr. J Investig Allergol Clin Immunol 2002;12:2-11
Anaphylaxis Grading Scale I • Severe Anaphylaxis (likely to progress to hypotension/hypoxia) – Confusion, fainting, unconsciousness, incontinence • Moderate Anaphylaxis (weakly associated with hypotension/hypoxia) – Diaphoresis, vomiting, lightheadedness, dyspnea, stridor, wheezing, throat/chest tightness, nausea, abdominal pain • Mild Anaphylaxis (not associated with hypotension/hypoxia) – Flushing, urticaria, erythema, angioedema (reactions limited to the skin alone)
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Immunotherapy Safety for the Primar
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Welcome to “Immunotherapy Safety
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Click the ⌧ next to the topic to
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Immunotherapy at Remote Sites Stand
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What Immunotherapy Is Not • Not p
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How Does Immunotherapy Work? • De
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Who Benefits? •Those with… - Al
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Immunotherapy Efficacy • Effectiv
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Not Efficacious For… • Atopic d
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The Extracts/Vaccines • Bioequiva
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Lots of Numbers! Vial v/v W/V (exam
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Immunotherapy Phases • Maintenanc
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Reaction Prevention - Avoidance •
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Reaction Therapy - BLS+ Level • T
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Treatment Guidelines • Treatment
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Frequency of Systemic Reactions •
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Immunotherapy Safety • To lessen
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Immunotherapy Safety • To lessen
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Immunotherapy Safety • After Inje
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Immunotherapy Safety • Equipment:
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What To Expect (Demand) from the Al
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Summary • Risk factors for advers
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End of Selection Go to Bookmarks &
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• Allergen immunotherapy (allergy
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BEFORE EACH SHOT!!! • Screen pati
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instruct patient to report any abno
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• Negative (swelling up to 15mm;
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Epi-Pen Adult Epi-Pen JR TwinJect
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How to dilute from available vials:
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Vial v/v W/V AU/ML BAU/ML 5 Red 4 G
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Summary • Pull the patient's alle
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a. Medical conditions that reduce t
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Allergen immunotherapy should be gi
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patient’s peak expiratory flow ra
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7. Neilson L, Johnsen C, Mosbech H,
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Click the ⌧ next to the heading t
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a common practice to alternate the
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ALLERGY IMMUNOTHERAPY (AIT) PROBLEM
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10. Those patients having their dos
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SPECIFIC INSTRUCTIONS A. PHYSICIAN
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ALLERGY IMMUNOTHERAPY RECORD NNMC,
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Immunotherapy Pre-Injection Questio
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Aeroallergen Dose Adjustment Schedu
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NATIONAL NAVAL MEDICAL CENTER: Alle
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ONGOING COMPETENCY ASSESSMENT OF UN
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eflecting current robust documentat
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Allergen immunotherapy: A practice
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J ALLERGY CLIN IMMUNOL VOLUME 120,
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Page 140 and 141: J ALLERGY CLIN IMMUNOL VOLUME 120,
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Page 168 and 169: Site Under Construction
Page 170 and 171: Introduction • “Anaphylaxis”
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Page 174 and 175: Anaphylaxis* Is Not Rare Estimated
Page 176 and 177: Pathophysiology
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Page 180 and 181: Pathophysiology • Histamine acts
Page 182 and 183: IgE Mediated Reactions • Most Ant
Page 184 and 185: Complement-mediated • C5a, C3a, C
Page 186 and 187: Unknown Mechanisms • Exercise-ind
Page 188 and 189: Anaphylaxis Summary of Signs & Symp
Page 192 and 193: Anaphylaxis Grading Scale II • An
Page 194 and 195: Laboratory Studies • IgE antibodi
Page 196 and 197: Guidelines for Treatment • Treatm
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Page 200 and 201: How the Allergist/Immunologist Can
Page 202 and 203: Summary • Anaphylaxis: release of
Page 204 and 205: ANAPHYLAXIS • First reported case
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Page 212 and 213: Antihistamines H1 antihistamines (B
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c. The patient will be counseled co
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skin testing typically is performed
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TABLE 3 Required Information on Vac
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TABLE 6 Checklist for Safe Vaccine
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Strength of Recommendations Key cli
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Original articles Evaluation of nea
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Allergy Treatment Record Review Cha
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References Acknowledgment: Linda Co
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Immunotherapy Safety for the Primary Care ... - U.S. Coast Guard

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