Are there guidelines about nurses administering allergy shots when the vial contains more than 2 extracts or allergens? Does a physician need to be on-site?


Thank you for your inquiry.

The suggested personnel to supervise the administration of allergy injections is noted for you below in a quote taken directly from our Joint Task Force Parameters on Immunotherapy. This is our major guideline. The issue of whether a vial contains one two or more allergens would be irrelevant in this regard. The same supervisory personnel would be suggested for all immunotherapy regardless of the number of allergens or extracts employed.

Thank you again for your inquiry and we hope this response is helpful to you.

“Supervising medical personnel
Summary Statement 62: Regardless of the location, allergen immunotherapy should be administered under the direct supervision of an appropriately trained physician, qualified
physician extender (nurse practitioner or physician assistant), or both in a facility with the appropriate equipment, medications, and personnel to treat anaphylaxis."

"A physician or qualified physician extender (nurse practitioner or physician’s assistant)
should be present and immediately available and be prepared to treat anaphylaxis when immunotherapy injections are administered."

1.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.

Phil Lieberman, M.D.

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