Allergy Injections in the Home Care Setting

[skittlebear]

I have just started a part-time job as a nurse that works with MRDD patients in a home care setting. One of the patients has an order for allergy injections weekly. This patient does have an Epi-pen available. No oxygen is available in the house. My conscious is saying, "Nooo...this is so wrong, why don't they just make an appointment weekly for these allergy injections to be given in the office?" All the other nurses administer these injections weekly, and have been for years. They think it's no big deal since this pt has never had an anaphylactic reaction. I'm not very familiar with allergy injections so I did some quick research, asked a lot of questions, and gave the injections. I watched this patient for over an hour, checking the sites of injection every 10 minutes. The pt was fine, but I wasn't. What are your thoughts? Am I overly paranoid?

[rubystar]

I'm seeing the same red flags. I did a few of those injections on my doctors office rotation the other week and I'm fairly certain in the leaflet it says that you have to have adrenaline available when you administer that stuff. The nurse I was with explained to me about how the doses were increased gradually, then onto a maintenance dose. You could get a reaction because the dose was increased past a level the patient could cope with, or just because. It's not exactly rocket science that if you give somebody something they are allergic to you have to be prepared for things to go sideways.

[SolaireSolstice, BSN, RN]

My son has been getting his allergy shots at home for 3 years. His allergist is on board with it. We keep an epi-pen on hand.

[BrnEyedGirl, BSN, MSN, RN, APRN]

I was giving myself my own allergy injections at home when I was 10. The office taught me and my Mom how to do it and I thought it was cool so I did it myself. Yes we did have an epi pen in the fridge and had been taught what to watch for.

[Lacie, BSN, RN]

Same here, I have given my son home allergy injections for years. We keep an epi-pen close by. I think it is standard for someone who has been on these injections for a period of time. I could see being nervous about injections that are newly started and havent reached thier peak dosing. As you said the pt has been recieving them for "years". Just keep your eyes and ears open, monitor as you should. Know where your epi-pen is and that it hasnt reach expiration date. You should be fine. It's good that you are questioning though rather then living by the old adage "This is the way we've always done it". :)

[skittlebear]

Thanks everyone for responding. I feel better now! : )