Allergy Newsletter Spring 2013 : Cover

(continued from front) EMLA cream, is applied to the testing area. EMLA cream is a mixture of lidocaine and prilocaine. It can take up to 45 minutes to numb the skin, so make sure to come to the appointment about an hour before your scheduled time. Once the area is numb, small amounts of suspect and allergy triggers are introduced through the skin on the arm or back by pricking the skin using a plastic device. After the allergy triggers are on the skin for 20 minutes, an allergy nurse will read the results of the test. If your child is allergic to a substance, you will see a raised, red itchy bump, called a wheal. The wheals must be a certain size to be considered positive. The bigger the wheal, the more sensitive your child is to that particular substance. The allergy nurse will then review the results with you and your child. Your provider might also want to discuss these results with you at your next appointment. Sometimes a skin-prick test is not appropriate for a child. If the child is too young to sit still for the test, has a widespread skin rash, or has the potential for sudden and severe allergic responses, a blood test may be performed instead. Blood tests use radioactive or enzyme markers to detect allergy antibodies in the blood. These tests can usually be done in a local laboratory on the same day the decision is made to test the child. It can take up to a couple of weeks to get the blood work results. You will be contacted by your health care provider or nurse when the results are ready for review. diagnose sensitivity to specific allergens. Both tests are considered to be about 90 percent accurate. Skin-prick tests are the most common tests for allergy. If a skin-prick test is ordered for your child, a special numbing cream, called MIXING ALLERGY MEDICATION When your provider recommends that you take immunotherapy (shots or sublingual drops) for allergy relief, they initiate an order for vials to be mixed for you. Below is the process that ENT and Allergy Center of Missouri staff members follow to provide you with the immunotherapy method that’s right for you. The mixing room Allergy vials are mixed in a separate room that is specifically designed for creating allergy vials. The room is separate from the rest of the clinic activity, and only employees mixing vials work in the room. It is equipped with Laminar Flow Hoods containing a filter pad, a fan and a HEPA (high efficiency particulates air) filter. The fan pulls the air though both the filter pad and the HEPA filter trapping dirt, dust and bacteria to provide sterile air into the room. Staff credentials Our staff members follow rigorous training on sanitary and safe mixing practices developed by the Pharmacy Department at University of Missouri Health Care. Employees are trained on aseptic techniques, hand hygiene, proper attire, how to clean and disinfect the work area, and the principles for operating specific equipment. Upon completion of the training, employees must pass a written test, then a fill test using a sample vial to ensure bacteria isn’t present and the vial is sterile. Finally, the staff must demonstrate their actual mixing process in front of a registered pharmacist before getting approval for mixing vials. Creating allergy vials By following these procedures, our staff creates and maintains a sterile environment including hand cleansing with an alcohol-based surgical hand scrub, wearing powder-free sterile gloves, and putting on hair covers, face masks and gowns. The staff then cleans the work area where the vials will be mixed with 70 percent isopropanol (alcohol) that does not contain added ingredients, such as dyes and glycerin. Behind the scenes:

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