Injection Instructions for Allergy Patients - ENT East Division
Materials:
  • antigen vials
  • syringes
  • cotton balls/ alcohol (or alcohol pads)
  • EPI-PEN
  • Antihistamine (Benadryl, Allegra, Claritin, Zyrtec). Sudafed is a decongestant, not an antihistamine!
Dirctions:
  1. Swirl vial approximately 10 times to remix what has settled. DO NOT SHAKE AS THIS WILL BREAK DOWN THE ANTIGEN.

  2. Wipe the top of the vial with the alcohol swab.

  3. Wipe arm area for injection with another alcohol swab.

  4. Remove cap from syringe. Make sure the needle doesn’t touch anything. If it does, throw it away and start with a new one.

  5. Pull back plunger of syringe to ____ cc.

  6. Insert needle into vial and push plunger back in to put air into the vial.

  7. Turn vial upside down and pull enough antigen into the syringe to wet the syringe up to ____ cc and stopper. Push back into vial and expel all bubbles.

  8. Now pull plunger slowly back to ___ cc (if you have bubbles, you will have to repeat step 7.)

  9. Remove syringe from vial and hold in such a manner that a dart-like action will be comfortable.

  10. Quickly and firmly insert the needle into the injection site.

  11. While the needle is still in the injection site, pull back the plunger just a bit to be sure that you are NOT IN A VEIN. If you see blood come into the syringe, remove the needle from the injection site, dispose of the needle in a safe manner, and start over.

  12. If no blood comes up in the syringe, gently push the plunger all the way in until all the antigen is injected into the injection site.

  13. Remove the needle from the injection site and wipe the area again with a new cotton swab.

  14. If there is more than one injection, repeat the above steps.

  15. Make sure that you make notes on your dosage chart for each injection.

  16. DISPOSE OF YOUR NEEDLES IN A SAFE MANNER.

  17. HAVE YOUR EPI-PEN HANDY AND KNOW HOW TO USE IT.

  18. Please call and order your new vial about 1-2 weeks before the expiration date on your vial. If your insurance requires you to have a referral, you need to contact your primary care physician as well. It can sometimes take 10-14 days for the insurance to process referrals, so be sure that you call your primary care physician the same day you order your new vial.

EMERGENCY PROTOCOL FOR SELF-INJECTING PATIENTS:

You will use the Twinject (has 2 doses in one pen) auto-injector epinephrine pen. You should always have two doses available (LOCATED IN THE SAME PLACE; not one in car, one in home). If a reaction should occur, you will experience some of the following symptoms:
  • lightheadedness
  • palpitations
  • sweating
  • tightness in your throat
  • hoarseness
  • difficulty breathing
  • noisy breathing
  • swollen tongue, lips and/or eyelids
  1. CALL 911 and tell them that you’ve had a reaction to your allergy shot; arrange for an ambulance to take you to the emergency room.
  2. Use the Twinject pen:

    • twist and pull the blue case apart to remove the pen
    • unroll the instructions around the pen
    • read the instructions, starting at step 1
    • inject 1st dose into thigh (can go through your clothing)
    • hold needle in place for 10 seconds
    • prepare to inject second dose (see step 3 of instructions) if symptoms do not respond to the first dose within 5 minutes

  3. Take a dose of your antihistamine

  4. If 5 minutes pass and your symptoms stay the same or get worse, take the second dose of epinephrine, followed by a second dose of the antihistamine.
ALWAYS HAVE THE TWINJECT PEN AVAILABLE DURING YOUR ALLERGY SHOT. IT IS BETTER TO USE THE EPI-PEN AS SOON AS YOU THINK YOU MAY BE HAVING A REACTION TO THE SHOT THAN TO WAIT TOO LONG!