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

ONGOING COMPETENCY ASSESSMENT OF UNIT SPECIFIC SKILLS & PROCEDURES: Allergy and Immunology
CRITICAL BEHAVIOR
(SOURCE OF PERFORMANCE STANDARD)
*Self
Assess
+Eval
Method
Validator’s Signature Day/Month/Year Comments
S. Explains some post injection comfort measures and instructs
the patient to wait in the clinic lobby for 30 minutes for JEV and
immunotherapy injections, and 15 minutes for all other vaccines.
T. Advises the patient to contact any nurse, technician, or doctor
in the clinic if they began to feel “different” than prior to shot.
U. Documents local reaction at site of injection prior to departing
the clinic and any delayed reaction prior to administering next
shot.
CRITICAL
ADVERSE REACTIONS
THINKING: Understands the purpose of the medication and its intended effect. Recognizes systemic
reactions to vaccines. (Anaphylaxis vs vasovagal)
A. Recognizes adverse systemic reactions CRITICAL THINKING: Patients with post-shot vasovagal reactions tend to be lightheaded, pale, and have slower
pulses, while patients suffering post-shot allergic anaphylaxis tend to be flushed and tachycardic, and may have hives,
shortness of breath, cough, wheeze, and/or GI cramping.
B. Calls for Help
C. Positions patient (supine, Trendelenburg)
D. Administers age-appropriate dose of epinephrine IM
(1) Less than 60 pounds = 0.15 cc of 1:1,000 Epinephrine
(2) Greater than 60 pounds = 0.30 cc of 1:1,000 Epinephrine
E. Assesses ABC’s and continually monitors vital signs
F. Administers Oxygen
G. Appropriately annotates medical record
H. Arranges follow up appointment with Allergist.
I. Provides patient with epinephrine autoinjector
(1) Instructs patient/parent in indication(s) for use
(2) Instructs patient/parent in correct technique for use
(3) Monitors for compliance
Name: ____________________________________
4
*Self Assessment: E = Experienced NP = Needs Practice ND = Never Done NA = Not Applicable (Based on Scope of Practice)
+Evaluation Method: V = Verbal D = Demonstrated PE = Practical Exercise L = Lecture or Video