Allergy Immunotherapy Procedure

Getting allergy immunotherapy at the Health Center

Allergy immunotherapy is used to alter the immunologic response in allergic patients. The extracts used are individually prepared serums supplied by allergists not privileged at the Indiana University Health Center (IUHC). It is the intent of IUHC to provide to patients the service of administrating these extracts under the orders provided by outside allergists.

Required forms

Patients requesting administration of immunotherapy extracts will complete the Student Request to Receive Allergy Immunotherapy form. This is to be given to the nurse at the first appointment.

The patient’s allergist will complete these forms and fax them to the IUHC allergy clinic:

Once these forms are received, they will be reviewed by both of our immunization nurses. The allergist’s office will be contacted for any order clarifications.

Allergy serum administration

The allergist will provide allergy serum in vials that are adequately labeled with patient name, antigen(s) name, dilution, and expiration date. The serum can be mailed to the IUHC or delivered by the patient.

Administration of allergy serum will be performed by a licensed IUHC registered nurse.

Allergy immunotherapy will not be administered unless an IUHC attending physician is present and readily accessible in the building.

The IUHC will provide the service of storing allergy serum for patients between injections. The IUHC is not liable for a compromise in the integrity of allergy serum due to handling before the IUHC receives the medication or for loss or compromise of integrity due to power outage, storage equipment failure, or catastrophic event. See storage criteria.

Consents and referral agreements expire at the end of each academic year (August 15th).

No allergy injections will be given if the patient is ill, febrile, has symptomatic asthma, or has sunburn or irritation at the injection site. No allergy injection will be given if the patient does not have an EpiPen with them. The allergy nurse may give a prescription for an Epinephrine Auto Injector device if the patient’s allergist has not done so. RX: Epinephrine Injection USP 2-pak, Epinephrine Auto-Injectors 0.3mg.

Patients taking beta-blockers will not receive allergy injections.

The patient is required to wait for 30 minutes after receiving an allergy injection.

Documentation

All documentation for allergy injections will be written on the Patient Dosage Sheet and kept with the patient’s allergy serum. Current copies of the Allergy Patient Dosage Recording Sheet will be sent with all allergist correspondence. A copy of completed Allergy Patient Dosage Recording Sheets will be sent to the IUHC medical records department.

Storage of allergy extract

Allergy extract and the completed Allergist Order Sheet and Allergy Patient Dosage Recording Sheet are stored in containers clearly labeled with the patient’s name and university ID number.

The extract will be stored in a monitored refrigerator and kept between 36 degrees F and 46 degrees F.

Systemic Reactions

MAY BE FATAL. This includes all other reactions such as, but not limited to rash/hives, dyspnea, wheezing, trouble breathing, cough, swelling or itching in throat or other parts of body, chest tightness, trouble swallowing, nausea, vomiting, diarrhea, stomach cramping.

Patient MUST be evaluated by a provider.

If patient is in no acute distress:

  1. Draw up and give Epinephrine 1:1000 0.5cc in vastus lateralis
  2. Activate alarm
  3. Call Acute Care and tell RN you need the Acute Care provider stat. (A.C. RN will contact A.C. provider and have the provider go to Immunization)

If patient is in respiratory distress or has rapidly progressing symptoms:

  1. Draw up and give 0.5cc epinephrine in vastus lateralis
  2. Activate alarm
  3. Call 911 for EMS STAT
  4. Call Code 99 for cardiac or respiratory arrest and be ready to begin basic live support CPR
  5. Maintain airway, monitor BP and administer oxygen
  6. Draw up Epinephrine 1:1000 0.5 cc and give IM Vastus Lateralis every 3-5 minutes as needed
  7. Give report to EMS prior to transport