Administration of Allergy Injections

University of Rochester, University Health Services

Developed by Mary Madsen, RN, Manager UHS, River Campus Office, July 1997

ALLERGY INJECTION SERVICES

POLICY C.1.3: ADMINISTRATION OF ALLERGY INJECTIONS

• The University Health Service (UHS) will administer allergy injections safely per UHS protocol and per individual allergist's instructions.

PROCEDURES:

1. Call patient by name (first and last) to verify name on injection record.
   Have patient remove his/her own serum from the refrigerator.

2. Inquire about any reactions following previous injection.
   Review any early local reaction, current health status, and medications.
   Record any delayed reactions on treatment record. Adjust dose accordingly.

3. Check with UHS physician before giving allergy injection if
   • fever
   • Obvious wheezing or complaint of wheezing
   • Hives or other rash of undetermined etiology
   • Patient is on beta-blocker or MAO inhibitor medications.

4. Use disposable 26 or 27 gauge needles and disposable allergy syringes with 0.01 ml. graduation.

5. Carefully check for the proper patient identity, the current allergen vial, proper dose, and site:

   Check:

   Patient's identity
   Record's identity

   Check vial's:

   Identity
   Expiration date
   Allergen label
   Concentration
   Cap color code, if applicable.

   Record:

   The proper date, site, vial number, dose, provider initials, and time of injection on the treatment record.

   Administer:

   Rinse syringe with medication as ordered (e.g., epinephrine).
   Draw up proper dose.
   Alternate arms, unless otherwise instructed.
   Swab site with alcohol.
   Administer injection. (see #6-9).

6. Injection site is the outer aspect of the upper arm, midway between the shoulder and the elbow in the groove between the deltoid and the triceps muscle.

7. Injections should be given subcutaneously ONLY, unless otherwise noted.

8. Aspirate the syringe plunger before injections. If blood is aspirated, DO NOT inject. Withdraw immediately and discard. Draw up new dose and repeat the procedure.

9. Avoid rubbing the injected area to prevent rapid absorption.

10. Remind patient to:
    • Wait 20 minutes in the waiting room.
    • Have a UHS registered nurse, nurse practitioner, or physician check the site before leaving.
    • Call or return to UHS immediately if problems develop.
    • Avoid strenuous activity immediately (2hrs.) after injection.
    • Note when next injection is due and schedule appointment at time of visit if possible.
    • Schedule re-evaluation, if necessary.
      Order new serum if needed.

11. At the end of the waiting period (20 minutes), injection site will be checked by and available registered nurse, nurse practitioner, or physician. If a negative reaction, a check will be placed in the chart next to that date's recorded information. Any reactions will be documented on the treatment record.

REFERENCES: Treatment Record form

REVIEW HISTORY:
Date Initiated: July 1997
Developed by: Mary Madsen, RN, Manager, River Campus Office
Date(s) Reviewed/Revised: August 28, 1997

NOTES:___________________________________________________________ __________________________________________________________________ __________________________________________________________________

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