95149 Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 5 single stinging insect venoms

Name of the Procedure:

Professional Services for the Supervision of Preparation and Provision of Antigens for Allergen Immunotherapy; 5 Single Stinging Insect Venoms

• Common Name(s): Allergen Immunotherapy, Venom Immunotherapy, Allergy Shots

Summary

Allergen immunotherapy involves administering gradually increasing doses of specific insect venoms to an allergic patient to build up their immunity and reduce their allergic reactions over time. This procedure focuses on five specific stinging insect venoms.

Purpose

The purpose of this procedure is to treat patients with severe allergies to stinging insects (e.g., bees, wasps, hornets). The expected outcome is to reduce or eliminate the severity of allergic reactions, potentially preventing life-threatening anaphylaxis.

Indications

• History of severe allergic reactions or anaphylaxis due to stinging insects.
• Positive skin test or blood test confirming sensitivity to specific insect venoms.
• Patients who are frequently exposed to stinging insects due to lifestyle or occupation.

Preparation

• Patients may be required to stop taking antihistamines a few days before the procedure.
• A thorough medical history and allergy testing should be conducted before starting immunotherapy.
• No fasting is generally required.

Procedure Description

1. Preparation of Antigens: Clinical staff prepares the specific insect venoms in sterile conditions.
2. Supervision: A healthcare provider supervises the mixing and dosing of antigens.
3. Administration: The antigen is injected into the patient's arm under the skin in gradually increasing doses.
   • Initial phase: Small doses are administered weekly or bi-weekly.
   • Maintenance phase: Once an effective dose is reached, administration usually occurs monthly.
4. Observation: The patient is monitored for 30 minutes post-injection for any adverse reactions.

Duration

• Each injection visit typically takes about 30 to 60 minutes, including the observation period.

Setting

• The procedure is typically performed in an outpatient clinic or an allergy specialist's office.

Personnel

• Allergist or Immunologist
• Nurse or Medical Assistant

Risks and Complications

• Common: Local reactions at the injection site (e.g., redness, swelling).
• Rare: Systemic allergic reactions (e.g., hives, anaphylaxis), which require immediate medical attention.
• Management: Emergency medications and equipment are available on-site to handle severe reactions.

Benefits

• Significant reduction in the severity and frequency of sting-related allergic reactions.
• Improvement in the patient’s quality of life by allowing them to safely resume activities where stinging insects may be present.

Recovery

• Minimal downtime is required.
• Patients can typically resume normal activities immediately after the observation period.
• Regular follow-up appointments are necessary to monitor progress and adjust dosing.

Alternatives

• Avoidance strategies (e.g., avoiding areas where stinging insects are prevalent).
• Emergency medications (e.g., carrying an epinephrine auto-injector).
• Oral antihistamines or corticosteroids for less severe reactions.
• Pros: Non-invasive, immediate relief in some cases.
• Cons: Less effective long-term prevention compared to immunotherapy.

Patient Experience

• During: Mild discomfort from the injection; possible itching or swelling at the injection site.
• After: Patients may experience minor local reactions and should avoid strenuous activities for a day.
• Pain Management: Pain relief options such as topical anesthetics or ice packs can be available for injection site reactions.