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

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Immunotherapy Safety • Patient instructions: – Must remain in clinic 30 minutes after injection. – Have staff inspect site(s) for swelling before leaving. – Report any abnormal signs or symptoms to staff immediately. – Don’t exercise for 2 hrs after receiving AIT. – Notify staff prior to next shot of any delayed reaction. – Keep to their AIT/VIT schedule.
Immunotherapy Safety • Equipment: • Aeroallergen & venom extract storage (4º C refrigerator with alarm) • 1 ml (for AIT) & 3ml (for VIT) disposable (safety) syringes with 27gauge 5/8 inch needles • Epi-pen Auto-injectors 0.3mg for adults & 0.15mg for children • Alcohol pads • 2x2 gauze pads • Gloves • Sharps container • Crash cart – BLS+ level – Vital signs monitor, SO 2 – Equipment to establish an oral airway – AMBU bag & oxygen equipment – Intravenous access/fluids – Injectable epinephrine – Injectable antihistamine – Injectable steroids • Phone (911)
Page 1 and 2: Immunotherapy Safety for the Primar
Page 3 and 4: Welcome to “Immunotherapy Safety
Page 5 and 6: Click the ⌧ next to the topic to
Page 7 and 8: Immunotherapy at Remote Sites Stand
Page 9 and 10: What Immunotherapy Is Not • Not p
Page 11 and 12: How Does Immunotherapy Work? • De
Page 13 and 14: Who Benefits? •Those with… - Al
Page 15 and 16: Immunotherapy Efficacy • Effectiv
Page 17 and 18: Not Efficacious For… • Atopic d
Page 19 and 20: The Extracts/Vaccines • Bioequiva
Page 21 and 22: Lots of Numbers! Vial v/v W/V (exam
Page 23 and 24: Immunotherapy Phases • Maintenanc
Page 25 and 26: Reaction Prevention - Avoidance •
Page 27 and 28: Reaction Therapy - BLS+ Level • T
Page 29 and 30: Treatment Guidelines • Treatment
Page 31 and 32: Frequency of Systemic Reactions •
Page 33 and 34: Immunotherapy Safety • To lessen
Page 35 and 36: Immunotherapy Safety • To lessen
Page 37: Immunotherapy Safety • After Inje
Page 41 and 42: What To Expect (Demand) from the Al
Page 43 and 44: Summary • Risk factors for advers
Page 45: End of Selection Go to Bookmarks &
Page 48 and 49: • Allergen immunotherapy (allergy
Page 50 and 51: BEFORE EACH SHOT!!! • Screen pati
Page 52 and 53: instruct patient to report any abno
Page 54 and 55: • Negative (swelling up to 15mm;
Page 56 and 57: Epi-Pen Adult Epi-Pen JR TwinJect
Page 58 and 59: How to dilute from available vials:
Page 60 and 61: Vial v/v W/V AU/ML BAU/ML 5 Red 4 G
Page 62 and 63: Summary • Pull the patient's alle
Page 64 and 65: End of Selection Go to Bookmarks &
Page 66 and 67: a. Medical conditions that reduce t
Page 68 and 69: Allergen immunotherapy should be gi
Page 70 and 71: patient’s peak expiratory flow ra
Page 72 and 73: 7. Neilson L, Johnsen C, Mosbech H,
Page 74 and 75: Click the ⌧ next to the heading t
Page 76 and 77: a common practice to alternate the
Page 78 and 79: ALLERGY IMMUNOTHERAPY (AIT) PROBLEM
Page 80 and 81: End of Selection Go to Bookmarks &
Page 82 and 83: 10. Those patients having their dos
Page 84 and 85: SPECIFIC INSTRUCTIONS A. PHYSICIAN
Page 86 and 87: 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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End of Selection Go to Bookmarks &
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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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Immunotherapy Safety for the Primar
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15. A 12 yo male presents for his a
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Immunotherapy Safety for the Primar
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Site Under Construction
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Introduction • “Anaphylaxis”
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Revised Nomenclature For Anaphylaxi
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Anaphylaxis* Is Not Rare Estimated
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Pathophysiology
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Pathophysiology
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Pathophysiology • Histamine acts
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IgE Mediated Reactions • Most Ant
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Complement-mediated • C5a, C3a, C
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Unknown Mechanisms • Exercise-ind
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Anaphylaxis Summary of Signs & Symp
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Differential Diagnosis • Pulmonar
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Anaphylaxis Grading Scale II • An
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Laboratory Studies • IgE antibodi
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Guidelines for Treatment • Treatm
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Guidelines for Treatment • Treatm
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How the Allergist/Immunologist Can
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Summary • Anaphylaxis: release of
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ANAPHYLAXIS • First reported case
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4) Hymenoptera stings Although almo
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• Sulfites are added to all the b
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mastocytosis on bone marrow biopsy.
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Antihistamines H1 antihistamines (B
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The diagnosis and management of ana
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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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