Should known allergy status be included as a medication administration 'right'?

This article employs a paediatric case study, involving a 3-year-old child who had an anaphylactic reaction that occurred as a result of the multidisciplinary team's failure to identify and acknowledge the patient's documented 'known allergy' status. It examines and reconsiders the ongoing healthcare dilemma of medication errors and recommends that known allergy status should be considered the second medication administration 'right' before the prescribing, transcribing, dispensing and administration of any drug. Identifying and documenting drug allergy status is particularly important when caring for paediatric patients, because they cannot speak for themselves and must rely on their parents, guardians or health professionals as patient advocates. The literature states that medication errors can be prevented by employing a 'rights of medication administration' format, whether that be the familiar '5 rights' or a more detailed list. However, none of these formats specify known allergy status as a distinct 'right'. The medication safety literature is also found wanting in respect of the known allergy status of the patient. When health professionals employ a medication administration rights format prior to prescribing, transcribing, dispensing or administering a medication, the 'known allergy status' of the patient should be a transparent inclusion. PMID: 31714835 [PubMed - in process]
Source: British Journal of Nursing - Category: Nursing Authors: Tags: Br J Nurs Source Type: research

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ConclusionsAppropriate policies to manage food anaphylaxis events and anaphylaxis management training were missing in a substantial proportion of camps. Camp-tailored food allergy training is needed given the number of camps reporting food allergy reactions requiring epinephrine.
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
ConclusionsA multicenter, international study of simulated pediatric anaphylaxis reveals (1) variation in management between institutions in the use of protocols, cognitive aids, and medication formularies, (2) frequent errors involving epinephrine, and (3) latent safety threats related to cognitive aids among multiple sites.
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
AbstractMast cells (MCs) are portions of the innate and adaptive immune system derived from bone marrow (BM) progenitors that are rich in cytoplasmic granules. MC maturation, phenotype, and function are determined by their microenvironment. MCs accumulate at inflammatory sites associated with atopy, wound healing, and malignancies. They interact with the external environment and are predominantly located in close proximity of blood vessels and sensory nerves. MCs are key initiators and modulators of allergic, anaphylactic, and other inflammatory reactions, by induction of vasodilation, promoting of vascular permeability, r...
Source: Clinical Reviews in Allergy and Immunology - Category: Allergy & Immunology Source Type: research
ConclusionOur aggregate findings suggest that most APTs, but not dust mite, behave like conventional patch tests to low ‐potency allergens. They are more likely to be positive in patients with chronically inflamed skin and to identify allergens that cause SCD. The higher prevalence of APT positivity to foods in young children is consistent with food allergy as a trigger of AD (also known as SCD) being more common i n children than adults. Positive APTs define patients who may have SCD; negative APTs may guide elimination diets.
Source: Immunity, Inflammation and Disease - Category: Allergy & Immunology Authors: Tags: ORIGINAL RESEARCH Source Type: research
Although inoculating humanized mice with a large dose of anti-human Fc εRIα mAb induces anaphylaxis, administering the same mAb through a rapid desensitization approach safely removes nearly all IgE from mast cells and blocks IgE-mediated anaphylaxis.
Source: Journal of Allergy and Clinical Immunology - Category: Allergy & Immunology Authors: Source Type: research
AbstractPurpose of reviewAnaphylaxis is the most severe form of an allergic reaction and is characterized by being rapid in onset with potentially life-threatening airway, breathing, or circulatory problems; medications are able to provoke immediate acute reactions whose severity varies from mild (i.e., urticaria) to severe reactions (anaphylaxis). The management and prevention of anaphylactic reactions represent a crucial challenge for allergists that must perfectly know the symptoms and the best treatments of this severe disease.Recent findingsAcute treatment of anaphylaxis is based on the immediate administration of adr...
Source: Current Treatment Options in Allergy - Category: Allergy & Immunology Source Type: research
Publication date: Available online 9 December 2019Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Emily H. Liang, Lie H. Chen, Eric MacyAbstractBackgroundLimited population-based data on penicillin-, carbapenem-, monobactam-, and clindamycin-associated reported adverse reactions exists.ObjectiveCollect data on penicillin, carbapenem, monobactam, and clindamycin usage and associated adverse reactions.MethodsData from 1-1-2009 to 12-31-2017 in Kaiser Permanente Southern California was collected.ResultsThere were 6,144,422 unique individuals, mean age 33.6 ± 21.1 years, 52.2% females, with...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
CONCLUSION: IV NEPA was highly effective and safe with no associated hypersensitivity and injection-site reactions in patients receiving AC. IMPLICATIONS FOR PRACTICE: As a combination of a neurokinin-1 (NK1) receptor antagonist (RA) and 5-HT3RA, NEPA offers 5-day chemotherapy-induced nausea and vomiting prevention with a single dose and an opportunity to improve adherence to antiemetic guidelines. In this randomized multinational phase IIIb study, intravenous (IV) NEPA (fosnetupitant/palonosetron) was safe and highly effective in patients receiving multiple cycles of anthracycline-cyclophosphamide (AC)-based chemothe...
Source: The Oncologist - Category: Cancer & Oncology Authors: Tags: Oncologist Source Type: research
Abstract Shrimp allergy, a common form of food allergy is an adverse immunological response to shrimp proteins. BALB/c mice was sensitized by an adjuvant free oral administration of purified tropomyosin, from Metpenaeus dobsonii to characterize intestinal histological responses and immunological protein recognition pattern as it is unpractical in human subjects. Sensitized mice with higher dose of tropomyosin expressed symptoms of anaphylaxis including puffiness around eyes and snout, no activity, tremor and convulsion after challenge. The responses of high level of sera IgE, tropomyosin specific IgE and histamine...
Source: Immunology Letters - Category: Allergy & Immunology Authors: Tags: Immunol Lett Source Type: research
Neutrophil extracellular traps (NETs) have been initially described as main actors in host defense owing to their ability to immobilize and sometimes kill microorganisms. Subsequent studies have demonstrated their implication in the pathophysiology of various diseases, due to the toxic effects of their main components on surrounding tissues. Several distinct NETosis pathways have been described in response to various triggers. Among these triggers, IgG immune complexes (IC) play an important role since they induce robust NET release upon binding to activating FcγRs on neutrophils. Few in vitro studies have documented...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
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