Allergy Testing
You are ten minutes into your patient's allergy test, the wheals are running together, do you stop the entire test and begin measuring?
No, you only need to wipe and measure the wheals that are running together. The other part of the testing can continue until your timer goes off. Be sure to document time on your handwritten test results sheet.
When you receive foundation vials from the pharmacy, when should they be mixed?
Patient's vials should be mixed as soon as possible.
When should a patient practice drawing up dosages?
This should be done at each visit. Don't forget the missed injection dosage log!
Who has to be on site in order to make testing wells and what PPE is required to fill your wells? (Two-part answer)
MD, DO, PA or NP.
Sterile gloves
How many days from a patients last test and mixing date be from their previous year?
366 days from both
A patient comes in for allergy testing, they were tested 2 years ago and never started treatment (meds were not made) what kind of test should be logged?
A retest.
What PPE is required for vial creation?
Mask, goggles, cap, gown and sterile gloves.
Your year 3 patient came in for their vial pick up, their provider waived the second and third injection, where do you document this?
A note should be placed in the patient's profile. Additionally, a note can be written on the IT pick up log.
How many drops is equal to .50ml? How many for .60ml?
20 and 24 drops
When should a patient be scheduled for their maintenance test?
Patients should be scheduled one week from their last injection.
If a patient has one or two wheal sizes of 50mm or greater, what is your next step?
Create clinical case, wait for guidance, the patient may be able to start treatment with a modified formulation.
You sent a POF for a patient who signed the consent form for treatment, they called you and stated that they changed their mind, what do you do?
Create a case right away.
What do you do if a patient calls in to let you know they are pregnant? (4 part answer)
In most cases, the patient can continue with treatment if provider approves, no hx of reactions, they are not deemed high risk and at least on vial set 4. You need to create a case.
How many times could your testing wells be washed and reused?
Testing wells can be washed and reused one time.
When do you select the patient level?
When consultation visit is logged. Remember to check the treatment year and ensure the level is correct.
What is the criteria to schedule a maintenance allergy test? (Four-part answer.)
Provider saw patient within 30 days, ordered test, patients last allergy test should have been at least 366 days and last injection at least 7 days ago.
What do you do if you have not received your patients foundation vials?
Create a clinical case.
What are 3 examples of best practices to help keep your patients compliant?
Mid-month calls, scheduling the patient for their next vial advancement before they leave the office and ensuring they are having follow up appointments with their provider through the course of treatment.
Please name the 4 reasons you would need to make new testing wells.
Upon expiration of an extract, chance of cross contamination, depleted wells, accidentally stamped the patient and put tester back into well.
Your patient is leveled as a 2 at their most recent allergy test appointment because of their last injection and when their vial pick up is scheduled, however, they are coming in a week earlier and now are a level 1. What do you do?
Create a clinical case right away.
Patient had a histamine response of 4mm and a negative control was a 3mm, the patient had five wheal responses that were 7mm, is this a valid test?
No, this is not a valid test. However, a test can still be valid if the histamine response is larger than the negative control and if the extract wheal responses are 5mm greater than the negative control. For this patient, if their responses were 8mm it would be a valid test.
What are the expiration dates for Allay drops?
12 months from the mix date.
Patient comes in for their vial pick up, they had a change to their medical history, or a medication has changed, what do you do?
Fill out an updated patient history, if there is a contraindication, please discuss with provider prior to releasing the new vial.
You pulled your testing wells out of the refrigerator and accidentally dropped them. You noticed that you don't have any back-ups, what do you do?
Phone a friend and put in a purchase order. If you have already created one purchase order, please reach out to your FSM for approval.
Your patient came in for their maintenance test, upon checking, you see that they only have finished half of their vial 5 dosage log. What level would this patient be going into their continuation year?
Level 5