Allergy Testing

Hello. My name is rodeo Fellatio.

I am a nurse practitioner student at the Music School

of Nursing at UT Health Science Center in Houston texas.

So today I will be presenting information on allergy testing.

Um We will be discussing its clinical importance,

the procedural process as well as patient care.

So to begin let's look at our objectives for this presentation.

So first we're going to define allergies.

I know allergies are very common and

something that we're all probably familiar with.

But I will be providing um

a definition as well today and then we're also going to discuss

the actual process of an allergic reaction how occurs in your body um And the process

that gives us the symptoms that we all

know and recognize as you know allergic symptoms.

Next we're gonna talk about the indications for allergy testing,

why would anybody actually get allergy testing?

What purpose doesn't serve? How do you know if should get tested?

Who should get tested?

Um Following that we will discuss the process of allergy testing.

So we'll talk about history gathering and preparation for the exam.

Then we'll talk about the actual examine

the procedures for that as well as interpreting

the results and what that might mean for the patient and how they you know,

will go forward in life and the plan of care that will create for them afterwards.

So if we are defining allergies.

Um this allergy um definition I got from medicine dot net. It's very layman's term.

Um layman's definition but I feel like it encompasses

it simplifies allergies well enough to be fully understood.

So the definition for allergies,

it's a misguided reaction to foreign substances by the immune system.

Um some facts about allergies.

More than 50 million Americans have experienced

various types of allergies each year.

Um Allergies are the sixth leading cause for chronic illness in the United States.

And there are so many allergy types from environmental to

indoor and outdoor um as well as skin allergies.

Food allergies, drug allergies as well as insect allergies.

So if we're talking about some allergies that we do that,

we're familiar with some very common ones.

Um One is paul in as a houstonian who suffers from seasonal allergies.

I know all about pollen allergies and how um and how they kind of

ruin your life for a good amount of time. Other common allergies or latex allergies.

Um A common drug allergy that's become a problem for us now. It's penicillin.

Um you can have allergies to mold

pet dander. I'm allergic to my cat, I still have him, I will suffer through it.

Um Food allergies like peanuts and shellfish as well as um sofa

allergies that are becoming a lot more common nowadays as well.

So going on to talk about the allergic reaction. So you're

your immune system plays a huge role or it

plays the main role when it comes to allergies.

So your immune system,

the purpose of it is to defend itself

and keep microorganisms such as certain bacterias,

viruses and fungi out of the body

as well to destroy any that may invade the body.

So what happens with allergic reactions? It's a I. G. Meditated response.

So it's an overreaction by the immune system that leads to the production of I. G.

Antibodies. So for example when your body gets exposed to an insurgent

the first time it sees this it overreacts to it.

So now your body starts producing antibodies to it.

Therefore the next time that your body is exposed to the same antegren you know

um those antibodies now trigger a histamine reaction

inflammatory reaction from your other um immune cells

mm hmm.

Now and we recognize these symptoms caused by um

by these um inflammatory cells things like um nasal drip ege or sneezing, coughing,

slight irritation, things like that.

And a lot of the times for some people allergies are just kind of a nuisance.

They're not too bad. They're just irritating and you know kind of slow down your day.

Make it a little harder to breathe. Things like that.

But the issue that we have is when certain allergies lead to anaphylaxis.

Now anaphylaxis is um considering a life

a serious life threatening allergic reaction and this

usually presents with symptoms such as severe itching and hives all over the body.

You can start feeling warm. You have swelling of the throat and the tongue.

It can lead to like tightness in your throw your airway closing dizziness,

severe headaches.

Um Shock a lot of loss of consciousness, anxiety as well as like abnormal heart rate.

You can either be too fast or it can be too slow.

The most common an epileptic reactions are to food.

So you know those with peanut allergies you need to carry the EpiPen um insect sting.

So bees washed things like that as well as medications and latex.

So this is a natural illustration of how I. G.

Meditated allergic responses occur and I explained it um

a little earlier but that's just the process.

So now we'll talk about the indications reality to testing.

Exactly why would someone get tested? Usually people start um

think about getting tested when they realize that they're having like

an allergic response it's present and it's bothering the patient.

So they'll say you know I'm having these rashes or

you know I'm constantly my nose is constantly running,

I'm having headaches, congestion,

things like that and it bothers them enough to try

and figure out what exactly is um causing their symptoms.

Another reason you would get tested to prevent future harm.

Um For a lot of parents it's comforting when they get their Children

tested to see are they going to have a reaction to certain foods,

especially whenever they start and um introducing new foods to Children.

Um You can also get tested in order to desensitize like

if you know that a certain allergy is causing your problem,

you can get tested to confirm it and then you might start desensitizing them to it.

Or certain medications that they might have an allergy to

and it's still a necessary medication for them to take.

Um we might, and if there is no alternative,

you might try desensitizing them as well.

And also what I would say is to encourage better health.

There are a lot of um there's a there's been a push for

a healthier movement when it comes to food and taking things like that.

So a lot of people now are getting tested to see if they're allergic to

certain foods that are causing inflammatory reactions within

their gut to see if that will help

and help improve their gut motility and things like that.

And who can get tested all ages can get tested,

but typically it's not performed on Children under six months.

So currently I'm going to do a little caveat and talk about home testing kits.

So these are becoming significantly more popular,

especially people they want to do food testing to see, oh my God,

well is gluing actually affecting me if I exclude gluten from my diet, will,

you know, make things better.

So a lot of these home testing kits that are very popular now,

something test like test my allergies everly Well is one that's very, very popular.

23 me now also um includes allergy testing.

Health labs dot com and prime 1 10 allergy tests.

These are like home kids where you buy them, they're usually super expensive,

you spit into a tube and then you send it off to them and they kind of tell you,

you know what you're allergic to.

The issue with a lot of these um drugstore kids

are these at home offering kids is that the results

are often a little bit misleading.

They come with a lot of false positive and a lot of false negatives.

So if you do consider these, you know,

kind of take it with a grain of salt and

if something does come back that you know concerns you,

then I would recommend, you know,

you're going to see a provider and tested getting tested properly in office.

So moving on, we'll talk about the process of testing.

So what can your patient expect when it comes to skin testing.

So first off, it's fairly quickly. It takes anywhere from 20 to 40 minutes.

Um And then there's some tests determine allergic reactions

immediately while others detect a delayed allergic response.

And then the type of skin test that you do depends on what's being tested.

But prior to this,

you want to make sure that you are prepared to your patient is prepared as well.

So, in the spirit of preparation,

right,

you need to gather a extremely detailed medical medical history.

So you want to know what type of reaction they've had in the past,

um family history signs and symptoms.

It's very important to

figure out what the signs and symptoms are for this patient.

So if they say that they're allergic to certain things like, well, okay,

how does present?

Is it just if she knows, are you sneezing? Are you coffee? Does it cost systemic

systemic reactions? Are you having trouble breathing

as well as how are they treating it to over the counter

medications work does rest work does just being away from that allergy in

make things better.

So you want to get a detailed medical history as well as the family history.

Family history to a certain allergy is a lot

of the times creates a predisposition to certain allergies.

So if you can tell whether or not someone has a family history um that might help

you in the right direction of you know what exactly you should be testing for him.

What you can almost assume that the results will be

um as well as being prepared,

you also need to tell your patient to um

avoid certain medications leading up to the test.

There's certain medications that may interfere with the results of the skin test.

So, uh prescription anti histamines, like hydroxy mean,

or even over the counter afghan history means.

These are your Claritin's, your your Benadryl Als,

um Allegra and Zyrtec as well as some tricyclic antidepressants,

some heartburn medications and the asthma medication?

I'm Eliza nap And this is your

it's the generic name is Zoeller, I believe. So these medications may interfere.

So you want to tell them to stop taking it leading up to the exam.

So when we talk about the different types of tests,

so the most common test that you've probably all seen as the skin protest.

So this one it determines immediate allergic reactions.

And you can test as many as 50 different substances.

That's once it's done to identify allergies to pollen, mold,

pet dander dust mites and food.

And

when it comes to placement, it's all about prime real estate.

So for adults,

usually they'll have enough real estate on their forearms while Children

you might have to do the up their upper back.

So when you're doing these tests,

you have to make sure that you tell the patient it's not painful.

It's a it's a very very thin little prick of you um

attaching um the substance to it whichever substance you're testing.

So first of course we will clean the side,

you prep the side with alcohol um And then whoever is administering it.

Usually it's a nurse might be you as a nurse practitioner.

Um You draw small marks on the skin,

you kind of mark which allergy you're dropping into which location.

Um along with the allergies,

you also have control substances to make sure that these

um that their reactions are accurate.

So you'll have histamine which most people are allergic to and this

will be your base as well as either glycerin or saline,

which most people are not.

So you would expect, Okay,

not an allergic reaction to look like the glycerin or the saline.

And if there is an allergic reaction it looks like the history.

Another type of skin test is the skin injection test.

So this is when the allergen is injected slightly into the skin.

Um This is more recommended for screening

for allergies to insect venom or penicillin.

Um One way you might be familiar with it is the TB skin tests,

it's administered in the same way.

Um And then the patch test.

So this is taking its used as like the rule out test for contact dermatitis.

It's non invasive. You place 20 to 30 patches on the skin and it contains different um

Different substances such as latex, different medications,

favorites is preservatives and things like that.

And the patches are worn for 48 hours.

Um while they're doing while they have the patches on,

you need to educate your patient to avoid bathing and activities that cause heavy

sweating because you don't want these patches to like fall off or be removed.

So these are a couple of pictures. So this is pictures of the

of the skin prick test. You can see it on the arm. The religion is marked.

Um And then that upper picture is of the skin

injection test and then lower picture shows the patch test.

So that results in plan of care.

So certainly certain results are immediate and then some are

delayed just like the patch test takes about 48 hours.

So a negative skin test clearly where there is no reaction, no redness, no

no swelling while the positive test indicates an allergy.

So the rule of thumb is the more severely allergy is

the larger the wheel and the more wetness um is present,

the more complaints that the patient might give you.

So when it comes to plan of care,

a lot of the times you give them

preventative medication or medication for post exposure.

So for those would as but if they're exposed to there,

whatever their triggers are, so whether it's pet dander,

you give them a rescue inhaler, you might have immunotherapy um

treatments as well.

But mainly avoidance therapy, avoidance therapy works extremely well.

Allergy Testing

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