What does an allergy nurse do
Anaphylaxis generally develops suddenly and gets worse extremely quickly.
The symptoms include:
There may also be other allergy symptoms, including an itchy, raised rash (hives); feeling or being sick; swelling (angioedema) or stomach pain.
What to do if someone has anaphylaxis
Anaphylaxis is a medical emergency. It can be extremely serious if not treated quickly.
If someone has symptoms of anaphylaxis, you should:
- Use an adrenaline auto-injector if the person has one – but make certain you know how to use it correctly first.
- Remove any trigger if possible – for example, carefully remove any stinger stuck in the skin.
- Lie the person below flat – unless they’re unconscious, pregnant or having breathing difficulties.
- Call 999 for an ambulance immediately (even if they start to feel better) – mention that you ponder the person has anaphylaxis.
- Give another injection after 5 to 15 minutes if the symptoms do not improve and a second auto-injector is available.
If you’re having an anaphylactic reaction, you can follow these steps yourself if you feel capable to.
Read about how to treat anaphylaxis for more advice about using auto-injectors and correct positioning.
If you’re having an anaphylactic reaction, you can follow these steps yourself if you feel capable to.
Read about how to treat anaphylaxis for more advice about using auto-injectors and correct positioning.
Triggers of anaphylaxis
Anaphylaxis is the result of the immune system, the body’s natural defence system, overreacting to a trigger.
This is often something you’re allergic to, but not always.
Common anaphylaxis triggers include:
In some cases, there’s no obvious trigger.
This is known as idiopathic anaphylaxis.
If you own a serious allergy or own experienced anaphylaxis before, it’s significant to attempt to prevent future episodes.
The following can assist reduce your risk:
- identify any triggers – you may be referred to an allergy clinic for allergy tests to check for anything that could trigger anaphylaxis
- avoid triggers whenever possible – for example, you should be careful when food shopping or eating out if you own a food allergy
- carry your adrenaline auto-injector at every times (if you own 2, carry them both) – give yourself an injection whenever you ponder you may be experiencing anaphylaxis, even if you’re not completely sure
Read more about preventing anaphylaxis
Sheet final reviewed: 29 November 2019
Next review due: 29 November 2022
Believe it or not, allergy season has already begun.
Spring allergens were in the air as of final week, and I own seen some students with eye symptoms already.
If your kid has a history of seasonal allergies, please speak with your pediatrician. It helps to start a daily medication a week or two before you child’s allergy symptoms normally start. If they are already symptomatic, it may take a few days on an antihistamine to maximize the benefit of the medication.
If your kid may need medication at school (including eye drops), please bring the medication in to me. Older students may carry and ister their own eye drops with parental permission. The only stock medication that I own for allergies is Benadryl. Please use the School/Farm Medication Permission Form (downloadable from Magnus) if your kid will need allergy medications at school.
See under for information about seasonal allergies and seasonal allergic conjunctivitis, including causes, symptoms, treatment and prevention. I own taken this information from UpToDate, an incredible medical database that gathers the latest research and treatment recommendations.
There are also numerous homeopathic and non-medical interventions that can assist (Try putting two spoons in the freezer and then placing them on itchy, swollen eyes!)
SEASONAL ALLERGIES are a group of conditions that can cause sneezing, nasal congestion and eye irritation. Most seasonal allergies are caused by:
●Pollen from trees (normally spring), grasses (normally summer) or weeds (late summer/early fall).
●Mold spores, which grow when the weather is humid, wet or damp
Normally, people breathe in these substances without a problem.
When a person develops a seasonal allergy, their immune system acts as if the substance is harmful to the body. This causes symptoms.
Symptoms of seasonal allergies can include:
●Stuffy nose, runny nose or sneezing
●Itchy or red eyes
●Sore throat, or itchy throat or ears
●Waking up at night or trouble sleeping, which can lead to feeling tired or having trouble concentrating during the day
Young children often do not blow their nose but instead smell, cough or clear their throat a lot.
If a child’s throat is itchy, he or she might make clicking noises as they attempt to scratch their throat with their tongue. They might also get into the habit of breathing through their mouth because their nose is stuffy.
Treating Seasonal Allergies:
●Nose rinses – generally recommended for older children.
●Steroid nose sprays – Best to consult with your pediatrician first. Use for longer than two months should be monitored by a medical provider. Extremely effective treatment for localized symptoms and nasal congestion.
●Antihistamines – These medicines assist stop itching, sneezing and runny nose symptoms.
Speak to your pediatrician regarding their recommendations for antihistamine use.
●Allergy shots – Your child’s medical provider might propose that they get allergy shots.
●Allergy pills (under the tongue) – For some types of pollen allergies, there are pills that work much love allergy shots.
Talk with your child’s medical provider about the benefits and downsides of the diverse treatments. The correct treatment for your kid will depend on their specific symptoms.
SEASONAL ALLERGIC CONJUNCTIVITIS — Seasonal allergic conjunctivitis (SAC) is a form of eye allergy that generally causes milder (but more persistent) symptoms during a specific pollen season(s).
Symptoms of allergic conjunctivitis — The most common symptoms of allergic conjunctivitis include redness, watery discharge and itching of both eyes.
Other symptoms can include burning, sensitivity to light and swelling of the eyelids. Both eyes are generally affected, although symptoms may be worse in one eye. Rubbing the eyes can worsen symptoms.
Treating allergic conjunctivitis — There are a number of treatments available for the symptoms of allergic conjunctivitis. In addition, basic eye care is important.
Basic eye care
●Avoid rubbing the eyes. If itching is bothersome, use artificial tears, a cool compress or antihistamine eye drops.
●Minimize exposure to pollen by staying inside when possible, using air conditioning and keeping car and home windows closed during the peak allergy seasons
Medications: Consult with your child’s medical provider
●People with sudden-onset symptoms can use a combination antihistamine/vasoconstrictor eye drop four times daily for up to two weeks.
These are available without a prescription.
●People with seasonal or year-round symptoms are generally treated with a combination antihistamine/mast cell-stabilizer eye drops. Most of these require a prescription. Ketotifen is an eye drop in this category that is available without a prescription.
●An oral antihistamine may be most helpful when it is taken preventively (before symptoms develop). However, antihistamines may also be used to treat symptoms after they own started, although the greatest benefit may not be seen for several days.
CAN SEASONAL ALLERGY SYMPTOMS BE PREVENTED?
— Yes. If your kid gets symptoms at the same time every year, talk with their medical provider. Some people can prevent symptoms by starting their medicine a week or two before that time of the year.
You can also assist prevent symptoms by having your kid avoid the things they are allergic to. For example, if your kid is allergic to pollen, you can:
●Keep your kid inside during the times of the year when he or she has symptoms
●Keep car and home windows closed, and use air conditioning instead
●Have your kid take a bath or shower before bed to rinse pollen off the hair and skin
●Use a vacuum with a special filter (called a HEPA filter) to hold indoor air as clean as possible
Your caring, compassionate, experienced allergy, asthma and immunology team.
Applebaum, MD, FACAAI
“I had a longstanding interest in how the immune system works. Allergy and immunology was a way to pursue my interest in caring for patients. I also enjoyed the thought of specializing; becoming an expert in one area rather than trying to remain capable in every areas as a generalist. I was interested in seeing patients of every ages, especially multiple family members. I wanted to make a difference in patients’ lives and assist with illnesses often ignored by other physicians.
“I most enjoy seeing how much better patients feel and how quickly they realize that they own been suffering unnecessarily for such extremely endless periods of time.
I treat patients love intelligent people capable of understanding their conditions and the treatment options available. I treat patients the way I desire to be treated when I own to see a doctor. I desire my patients to know that there are no hopeless cases.
I am their advocate in every way they need me for their allergic problems. I take it as a personal challenge to assist them live better.”
When not working, Dr. Applebaum enjoys spending time with his wife and daughters, traveling, watching pro basketball, reading and cooking.
Board-Certified:American Board of Allergy & Immunology, American Board of Internal Medicine
Fellow:American College of Allergy, Asthma & Immunology
Fellowship-Trained:Allergy & Immunology, Schneider Children’s Hospital & Endless Island Jewish Medical Middle, New Hyde Park, NY
Residency:Internal Medicine, Endless Island Jewish Medical Center
MD:Special Distinction for Research in Psychoneuroimmunology, Albert Einstein College of Medicine, Bronx, NY
Member:American Academy of Allergy, Asthma & Immunology, New Jersey Allergy, Asthma & Immunology Society, Medical Society of New Jersey, Morris County Medical Society
Awards:Castle Connolly Guide to Top Doctors in the New York Metro Area, 2000 to present
Priscilla Leon, Office Manager
Favorite Quote:«I enjoy working in the allergy field as I can see the transition in patients from when they start treatment (a not so happy patient), to a patient that constantly praises how much better they are feeling ever since treatment began with Dr.
«In my spare time I am an avid runner, beach-goer and I enjoy photography»
Make us your trusted partners in effective allergy and asthma treatment. Believe Eric S. Applebaum, MD, for comprehensive allergy, asthma, sinusitis and immunology care. Call us at 973.335.1700 in Parsippany or use our online Request an Appointment form to schedule your consultation. We welcome patients from Mountain Lakes and Parsippany Troy Hills, including Montville, Parsippany, Denville (Morris County, NJ), Passaic (Passaic County, NJ).
How to Become a Nurse Anesthetist, Nurse Midwife, or Nurse Practitioner About this section
APRNs must earn a master’s degree which typically includes clinical experience.
Nurse anesthetists, nurse midwives, and nurse practitioners, also referred to as advanced practice registered nurses (APRNs), must earn at least a master’s degree in one of the specialty roles.
APRNs must also be licensed registered nurses in their state and pass a national certification exam.
Licenses, Certifications, and Registrations
Most states recognize every of the APRN roles. In states that recognize some or every of the roles, APRNs must own a registered nursing license, finish an accredited graduate-level program, and pass a national certification exam.
Each state’s board of nursing can provide details.
The Consensus Model for APRN Regulation, a document developed by a wide variety of professional nursing organizations, including the National Council of State Boards of Nursing, aims to standardize APRN requirements. The model recommends every APRNs to finish a graduate degree from an accredited program, be a licensed registered nurse, pass a national certification exam, and earn a second license specific to one of the APRN roles and to a certain group of patients.
Certification is required in the vast majority of states to use an APRN title. Certification is used to show proficiency in an APRN role and is often a requirement for state licensure.
The National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) offers the National Certification Examination (NCE).
Certified registered nurse anesthetists (CRNAs) must recertify via the Continued Professional Certification (CPC) Program every 4 years.
The American Midwifery Certification Board offers the Certified Nurse-Midwife (CNM). Individuals with this designation must recertify via the Certificate Maintenance Program every 5 years.
There are a number of certification exams for nurse practitioners because of the large number of populations NPs may work with and the number of specialty areas in which they may practice. Certifications are available from a number of professional organizations, including the American Nurses Credentialing Middle and the Pediatric Nursing Certification Board.
In addition, APRN positions may require certification in cardiopulmonary resuscitation (CPR), basic life support (BLS) certification, and/or advanced cardiac life support (ACLS).
Communication skills. Advanced practice registered nurses must be capable to communicate with patients and other healthcare professionals to ensure that the appropriate course of action is understood.
Critical-thinking skills. APRNs must be capable to assess changes in a patient’s health, quickly determine the most appropriate course of action, and decide if a consultation with another healthcare professional is needed.
Compassion. APRNs should be caring and sympathetic when treating patients who are in pain or who are experiencing emotional distress.
Detail oriented. APRNs must be responsible and detail oriented because they provide various treatments and medications that affect the health of their patients.
During an evaluation, they must pick up on even the smallest changes in a patient’s condition.
Interpersonal skills. APRNs must work with patients and families as well as with other healthcare providers and staff within the organizations where they provide care. They should work as part of a team to determine and execute the best possible healthcare options for the patients they treat.
Leadership skills. APRNs often work in positions of seniority.
They must effectively lead and sometimes manage other nurses on staff when providing patient care.
Resourcefulness. APRNs must know where to discover the answers that they need in a timely fashion.
Julie Applebaum, MSN, RN, FNP-C
“I enjoy working here because while we are making an improvement in our patients’ health, we develop interpersonal relationships with our patients and their families on a professional level. As a longtime allergy sufferer myself, I see the importance of treatment. Following patients from an initial visit through testing and then a step further by actually treating the underlying cause of their numerous years of suffering, it is rewarding to see the relief they experience when they are properly cared for.»
Board-Certified:Family Practice, American Academy of Nurse Practitioners (AANP)
Graduate School:Chamberlain College of Nursing
Member:American Academy of Nurse Practitioners, American College of Asthma, Allergy and Immunology
Favorite Quote:«Don’t ever let anybody tell you you’re not excellent enough.»
Nurse anesthetists, nurse midwives, and nurse practitioners must earn a master’s degree from an accredited program.
These programs include both classroom education and clinical experience. Courses in anatomy, physiology, and pharmacology are common as well as coursework specific to the chosen APRN role.
An APRN must own a registered nursing (RN) license before pursuing education in one of the advanced practice roles, and a strong background in science is helpful.
Most APRN programs prefer candidates who own a bachelor’s degree in nursing. However, some schools offer bridge programs for registered nurses with an associate’s degree or diploma in nursing.
Graduate-level programs are also available for individuals who did not obtain a bachelor’s degree in nursing but in a related health science field. These programs prepare the student for the RN licensure exam in addition to the APRN curriculum.
Although a master’s degree is the most common form of entry-level education, APRNs may select to earn a Doctor of Nursing Practice (DNP) or a Ph.D. The specific educational requirements and qualifications for each of the roles are available on professional organizations’ websites.
Prospective nurse anesthetists must own 1 year of clinical experience as a prerequisite for admission to an accredited nurse anesthetist program.
Candidates typically own experience working as a registered nurse in an acute care or critical care setting.
Some APRNs may take on managerial or istrative roles, while others go into academia. APRNs who earn a doctoral degree may conduct independent research or work in an interprofessional research team.
In July 2016, Natasha Ednan-Laperouse collapsed on a flight from London to Nice, suffering a fatal allergic reaction to a baguette bought from Pret a Manger. At an inquest, the court heard how Natasha, who was 15 and had multiple severe food allergies, had carefully checked the ingredients on the packet.
Sesame seeds – which were in the bread dough, the family later found out – were not listed. “It was their fault,” her dad Nadim said in a statement. “I was stunned that a large food company love Pret could mislabel a sandwich and this could cause my daughter to die.”
This horrifying case highlights how careful people with allergies need to be, as do the food companies – not least because allergies own been growing in prevalence in the past few decades.
“Food allergy is on the rise and has been for some time,” says Holly Shaw, nurse adviser for Allergy UK, a charity that supports people with allergies.
Children are more likely to be affected – between 6 and 8% of children are thought to own food allergies, compared with less than 3% of adults – but numbers are growing in westernised countries, as well as places such as China.
“Certainly, as a charity, we’ve seen an increase in the number of calls we get, from adults and parents of children with suspected or confirmed allergy,” says Shaw. Certain types of allergy are more common in childhood, such as cow’s milk or egg allergy but, she says: “It is possible at any point in life to develop an allergy to something previously tolerated.”
Stephen Till, professor of allergy at King’s College London and a consultant allergist at Guy’s and St Thomas’ hospital believe, says that an allergic reaction occurs when your immune system inappropriately recognises something foreign as a bug, and mounts an attack against it.
“You make antibodies which stick to your immune cells,” he says, “and when you get re-exposed at a later time to the allergen, those antibodies are already there and they trigger the immune cells to react.”
Allergies can own a huge impact on quality of life, and can, in rare cases such as that of Natasha Ednan-Laperouse, be fatal.
There is no cure for a food allergy, although there has been recent promising work involving the use of probiotics and drug treatments. The first trial dedicated to treating adults with peanut allergy is just starting at Guy’s hospital.
“There is a lot of work going on in prevention to better understand the weaning process, and there’s a lot of buzz around desensitisation,” says Adam Fox, consultant paediatric allergist at Guy’s and St Thomas’ hospitals. Desensitisation is conducted by exposing the patient to minuscule, controlled amounts of the allergen.
It’s an ongoing treatment though, rather than a cure. “When they stop having it regularly, they’re allergic again, it doesn’t change the underlying process.”
What we do know is that we are more allergic than ever. “If you ponder in terms of decades, are we seeing more food allergy now than we were 20 or 30 years ago?
I ponder we can confidently tell yes,” says Fox. “If you glance at the research from the 1990s and early 2000s there is beautiful excellent data that the quantity of peanut allergy trebled in a extremely short period.”
There has also been an increase in the number of people with severe reactions showing up in hospital emergency departments. In 2015-16, 4,482 people in England were admitted to A&E for anaphylactic shock (although not every of these will own been below to food allergy).
This number has been climbing each year and it’s the same across Europe, the US and Australia, says Fox.
Why is there this rise in allergies? The truth is, nobody knows. Fox doesn’t believe it is below to better diagnosis. And it won’t be below to one single thing. There own been suggestions that it could be caused by reasons ranging from a lack of vitamin D to gut health and pollution. Weaning practices could also influence food allergy, he says. “If you introduce something much earlier into the diet, then you’re less likely to become allergic to it,” he says. A 2008 study found that the prevalence of peanut allergy in Jewish children in the UK, where the advice had been to avoid peanuts, was 10 times higher than that of children in Israel, where rates are low – there, babies are often given peanut snacks.
Should parents wean their babies earlier, and introduce foods such as peanuts?
Fox says it’s a “minefield”, but he advises sticking to the Department of Health and World Health Organization’s line that promotes exclusive breastfeeding for six months before introducing other foods, “and to not delay the introduction of allergenic foods such as peanut and egg beyond that, as this may increase the risk of allergy, particularly in kids with eczema”. (Fox says there is a direct relationship between a baby having eczema and the chances of them having a food allergy.)
The adults Till sees are those whose allergies started in childhood (people are more likely to grow out of milk or egg allergies, than peanut allergies, for instance) or those with allergy that started in adolescence or adulthood.
Again, it is not clear why you can tolerate something every your life and then develop an allergy to it. It could be to do with our changing diets in recent decades.
“The commonest new onset severe food allergy I see is to shellfish, and particularly prawns,” says Till. “It’s my own observation that the types of food we eat has changed fairly a lot in recent decades as a result of changes in the food industry and supply chain.” He says we are now eating foods such as tiger prawns that we probably didn’t eat so often in the past.
He has started to see people with an allergy to lupin flour, which comes from a legume in the same family as peanuts, which is more commonly used in continental Europe but has been increasingly used in the UK.
Sesame – thought to own been the cause of Natasha Ednan-Laperouse’s reaction – is another growing allergen, thanks to its inclusion in products that are now mainstream, such as hummus. One problem with sesame, says Till, is: “It often doesn’t show up extremely well in our tests, so it can be hard to gauge just how allergic someone is to it.”
Fox says it’s significant to stress that deaths from food allergy are still rare. “Food allergy is not the leading cause of death of people with food allergies – it’s still a extremely remote risk,” says Fox. “But of course you don’t desire to be that one who is incredibly unlucky, so it causes grand anxiety.
The genuine challenge of managing kids with food allergy is it’s really hard to predict which of the children are going to own the bad reactions, so everybody has to act as if they might be that one.”