PATIENT INSTRUCTIONS AND INFORMATION FOR ALLERGY TESTING
Your physician has recommended allergy testing to determine what individual allergens are contributing to your illness. The SWENT Allergy Department uses a combination of prick and intradermal skin testing to determine the specific allergen(s) that may be causing your reactions.
Testing will take approximately one hour. An appointment with your SWENT physician may be required due to untimely cancellations or no shows of your appointments in the allergy department.
YOU MUST FOLLOW THESE INSTRUCTIONS PRIOR TO TESTING
IMPORTANT MEDICAL ISSUES THAT MUST BE REVIEWED PRIOR TO TESTING
If you are pregnant or contemplating pregnancy during the next six months, you may not wish to proceed with testing. Allergy
shots are safe when a pregnant woman has consistently been receiving allergy shots for six months or more before becoming pregnant.
Disorders of the Immune System:
Skin testing or immunotherapy for allergic disorders places variable degrees of stress on the immune
system and may adversely effect the health of some patients with disorders of the immune system. Please discuss any concerns with your SWENT physician.
Beta Blocker Medications:
Beta Blockers are a commonly prescribed medication for hypertension, glaucoma, heart disease and
migraine prophylaxis. Use of these medications may be contraindicated with allergy testing and treatment. You may not be on any type of
Beta Blocker medication during skin testing or immunotherapy injections unless approved by your SWENT physician. DO NOT
DISCONTINUE THIS MEDICATION ON YOUR OWN
. Either your prescribing physician or your SWENT physician must approve any
Do not receive any immunization/vaccine within 5 days of testing
(flu shot, tetanus, hepatitis, etc).
Please inform your physician or the allergy department staff if you have any tattoos on your arms as this may interfere with skin
SEVEN (7) FULL DAYS PRIOR TO TESTING:
Do not take any antihistamines
or medications that have an antihistamine effect.
This includes prescribed and over the counter
READ ALL LABELS FOR ANY OVER THE COUNTER COLD OR ALLERGY MEDICATIONS, LOOK FOR WORDS SUCH AS
“ANTIHISTAMINE” OR “DRYING EFFECT”
Do not take anti-depressants that have antihistamine-like qualities .
Please check with your prescribing physician prior to discontinuing
ANTIDEPRESSANTS (TRICYCLIC, MAO INHIBITORS and BENZODIAZEPINES)
Do not take any of these MISCELLANEOUS MEDICATIONS:
Do not take any Vitamin C supplements
(multi-vitamin with C, EmergenC, etc.)
***IF YOU ARE UNCERTAIN ABOUT TAKING ANY PARTICULAR MEDICATION(S) OR FEEL
YOU CANNOT STOP YOUR MEDICATION(S) PRIOR TO YOUR TESTING APPOINTMENT,
PLEASE CONTACT THE ALLERGY DEPARTMENT NURSES AT
DO NOT STOP TAKING ASTHMA MEDICATIONS
THREE (3) FULL DAYS PRIOR TO TESTING:
No Beta Blockers (make sure you have discussed this with the prescribing physician as well as your SWENT physician)
DAY OF TESTING:
The allergy department is a “scent-free” environment. Please do not wear ANY scent
(perfume, cologne, hair spray, lotions, after shave,
Wear a loose short sleeve or sleeveless shirt. Testing will be done on both arms (shoulder to wrist). Be sure to eat breakfast/lunch prior to testing. A full stomach can help reduce the stress of testing.
If you have ASTHMA
, you must bring your prescribed inhaler with you. Do not stop taking your asthma medication
Please do not bring your children to your testing session; we do not have the facilities or staff to monitor them. If you are driven to your appointment, please have your driver wait until the first step in allergy testing is completed to be sure that all of
your tests can be performed. This will be determined within the first 20 minutes of your appointment.
A parent must be present throughout testing for minors (under 18). You will be asked to sign a skin testing consent on the day of testing. This form will say the following:
AUTHORIZATION AND CONSENT FOR ALLEGY SKIN TESTING, RAST AND IMMUNOTHERAPY
Patient’s Name: _____________________________________ Date: ___________________ My doctor has determined that allergy skin testing by skin prick and intradermal skin testing may be beneficial in the diagnosis of my condition.
Allergy testing and immunotherapy involve risks of complications, serious injury or even death. These risks of complications involve exacerbation of the underlying allergic condition by stimulating hives, asthma and anaphylaxis. The nursing staff of SWENT will monitor your testing to minimize
these risks and will contact your physician or other SWENT physicians should they become concerned that you require urgent treatment for these complications of testing.
I authorize and direct ___________________________ and/or associates or assistants to perform allergy skin testing. Should my physician and I agree, I authorize and direct my physician and his/her staff to proceed with treating my condition with immunotherapy. I have discussed the pros and cons of immunotherapy with my physician and understand that I have the right to consent or refuse to proceed with immunotherapy.
Your signature below constitutes your acknowledgement that (1) you have read the above and agree to allergy skin testing; (2) you have the right to
consent or refuse to proceed with immunotherapy. Patient: ____________________________________________________________________
Responsible Adult: ___________________________________________________________ Allergy Nurse: _______________________________________________________________ Physician: ___________________________________________________________________
15235 Shady Grove Road, Suite 102, Rockville, MD 20850 Phone: (301) 330-9430 Fax: (301) 330-6515 www.ohpmd.com Name: _________________________________________ DOB: _____________ Date: _________________ IV antibiotics are given only when the severity of the condition warrants the risk-benefit considerations of intravenous access catheters and medications. These risks include but are not limited
Ekloef and Schmidt Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine2012, 20(Suppl 2):P10http://www.sjtrem.com/content/20/S2/P10Community-acquired pneumonia: a comparisonof clinical treatment failure in patients treatedwith either penicillin or cefuroximeJosefin Ekloef*, Thomas A SchmidtFrom 4th Danish Emergency Medicine ConferenceRoskilde, Denmark. 25-26 November 2011cefurox