Q:

3/7/2013
I would like to start giving allergy shots in my office. What are the protocols, policy and procedures for this service?

A:

Thank you for your inquiry and the additional information as follows:

“We are a pulmonologist office and would like to start testing our own patients and giving the injections to them in our office. We are just trying to gather information on how to go about this and if there are any policy and procedures available with the AAAAI.”

First, a pulmonologist asking a trained and certified allergist-immunologist about testing and administering allergen immunotherapy in their office would be much like an allergist-immunologist asking a pulmonologist how to set up bronchoscopy in their office. Adeduate performance of bronchoscopy takes training and experience, and administering allergen immunotherapy is no different. An Allergy-Immunology fellowship is a two or three year training program, and the interpretive skills obtained during this program play an important role in being able to properly test, interpret tests, and institute allergen immunotherapy.

So, I personally do not encourage the procedure to be performed by non-trained individuals. If in spite of this you wish to proceed, there are literature sources which would be mandatory. They would be the following:

1. Middleton's Allergy: Principles and Practice, 7th Edition, edited by Atkinson F, Bochner B, Busse W, Holgate S, Lemanske R, and Simons FER (Publisher Mosby, an affiliate of Elsevier, Inc.) 2009.

2. Cox L, Nelson H, Lockey R, et al. Allergen immunotherapy: a practice parameter, third update. Journal of Allergy and Clinical Immunology, January 2011; Volume 127 (1), Supplement, page S1-S55.

3. Lieberman P, Nicklas R, Oppenheimer J, Kemp S, Lang D, et al. The diagnosis and management of anaphylaxis practice parameter: 2010 Update. In: Journal of Allergy and Clinical Immunology 2010 (September); 126(3):477-480 e42.

Thank you again for your inquiry.

Sincerely,
Phil Lieberman, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology