Our services

 

Skin Prick Testing

 

Skin prick testing is one of the major tools used to confirm the diagnosis of IgE mediated allergies in most allergic diseases.  On the day of your appointment your Doctor or Nurse Practitioner may request a skin prick test (SPT).   Skin Prick Testing at Epworth Allergy Specialists is performed by trained allergy nursing and medical staff. 

 

The SPT devices are stored in a tray system which holds the different allergen extracts.

 

The SPT device is removed from the tray and placed perpendicular to the skin and is pressed down with medium pressure. A small circle indicating the correct amount of pressure was applied will be seen.

 

The site will then be blotted to remove any residual allergen extract. After 15 minutes the test will be read. It is important not to scratch the site where the SPT was undertaken as it can create false results.

 

For children under 16 years the SPT is carried out on the volar aspect of the arm and for those over 16 years and over the SPT is carried out on the back.

 
 
Please remember:
 
  • Do not take antihistamines for at least 5 days prior to your appointment as this will interfere with SPT and therefore this will not be able to be undertaken.

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  • Most food allergy occurs to a limited number of foods where commercial extracts are available for skin prick testing. If there are concerns about allergy to less common food allergens particularly fruit, meats or fish and shellfish we request that you bring a small portion of the food in question for prick prick testing.

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  • On the day, your appointment may take up to 3 hours so please ensure you come prepared

 
 

Respiratory Function Tests (spirometry)

 

Your doctor may recommend you undertake respiratory function testing, also known as spirometry.

 

A spirometry is a device used to measure timed expired and inspired volumes, and from these your doctor can calculate how effectively and how quickly the lungs can be emptied and filled.

 

Spirometry is done to diagnose certain types of lung disease such as asthma, assess the effect of medication and measure progress in disease treatment.  One of our trained allergy nurses will explain the procedure to you and then carry out the test.


Skin Prick Test Service

 

Patients will be required to make an appointment for this service that will be performed by one of our trained allergy nurses under the supervision of an Allergist/Immunologist. Patients will be provided with a written report documenting the results of the test as well as patient information sheets about relevant allergen avoidance information where appropriate. A report with the results will also be forwarded to the referring doctor.


Simple Respiratory Function Testing is also available and may be of value in the management of patients with Asthma.

 
 

Inpatient Procedures

 

Food/Medication Challenges

 

Your doctor may recommend an inpatient challenge to clarify the allergy.  A challenge is a procedure where a food or medication is given to determine tolerance or confirm allergy. In some instances latex challenges may also be carried out.


Challenges are carried out in our inpatient day procedure area by our highly trained allergy nurses and are supervised by your specialist.


Incremental amounts of the food or medication will be given following a strict protocol (developed by ASCIA) over a few hours with observations taking place throughout to monitor for any signs of reaction.


The first dose is very small and if tolerated increasing amounts of the challenge substance will be given in subsequent order.


A challenge typically takes around four hours.  After the last dose the patient will be required to stay within the hospital for a further 1 – 2 hours for observation.


If there are no signs of reaction the challenge will be deemed successful and you will be given instructions to continue the challenge at home for the next week.


If a challenge is unsuccessful you will be given further instructions on the day by the nurse and/or doctor.  All symptoms are monitored closely and treated accordingly.  All symptoms need to be resolved prior to discharge.


Very occasionally we need to conduct the challenge over two days, but you will go home after each session.


 

Double Blind Placebo Controlled Challenges (DBPCC)

 

Sometimes for different reasons a DBPCC is carried out. DBPCC is the most scientific method of conducting a food challenge and involves disguising the food in another food vehicle that the patient enjoys and is not allergic to.


The patient and the nurse looking after the patient are both blinded to the contents while a third nurse makes up the ‘meals’. These are prepared according to a code, and some meals will have the challenge food in them (active) and some will not have the challenge food (placebo). This eliminates bias from the supervising nurse, patient and/or parent as neither knows which are the active meals or the placebo meals and symptoms of an allergic reaction can be observed.

 
Please remember:
 
  • Do not take antihistamines for at least 5 days prior to your challenge as this will interfere with the challenge and therefore will not be able to be undertaken
  • The patient must be well on the day of the challenge.  If the patient is unwell the challenge will not be able to proceed. Please call the clinic prior to your appointment to seek advice
  • Allow extra time for parking and to go to the admissions office
  • Your challenge may take up to four hours so please ensure you come prepared 


 

Immunotherapy (desensitisation) (Sublingual/Subcutaneous)

 

Epworth Allergy Specialists offers both sublingual and subcutaneous immunotherapy. Immunotherapy (desensitisation) treats the cause of environmental allergies by giving small doses of what a person is allergic to, most commonly grass pollens and house dust mite. This increases “immunity” or tolerance to the allergen and reduces the allergic symptoms.


 

Sublingual Immunotherapy (SLIT)

 

Sublingual Immunotherapy is given as drops under the tongue and requires a one-off inpatient admission on commencement. At this appointment our specialist allergy nurses will explain how to administer the drops and provide additional information regarding the treatment. After the initial appointment SLIT can be done in the convenience of your own home.

 

SLIT treatment must be taken in the morning before food, drink and brushing teeth.  If more than one sublingual immunotherapy is prescribed a 15 minute break is needed before commencing additional treatments.

 

SLIT must be stored in the fridge in an upright position. 


 

Subcutaneous immunotherapy (SCIT)

 

Subcutaneous immunotherapy is given via a subcutaneous injection (into the fat layer between the skin and muscle) and requires weekly updosing, in our inpatient challenge unit until maintenance is reached (usually over a 13 week period).  Following this you will return as an inpatient for SCIT in 2, then 3, then 4 weeks.  Once this has been completed monthly maintenance injections are continued at the local GP.

 

During SCIT appointments pre and post spirometry testing will also be undertaken to assess respiratory function.

 

It is important to take antihistamine at least 30 mins prior to your injection to minimise any localised reactions.


 

Intra-Dermal Testing (IDT)

 

If you have had a reaction to a medication or antibiotic IDT may be indicated.

 

IDT is typically used to test for allergies to medications or antibiotics when greater sensitivity is required.

 

IDT is the injection of a small amount of the diluted medication into the dermal layer of the skin. Trained allergy nursing and medical staff will undertake this procedure.

 

If the intradermal test is negative the patient may proceed with a medication or antibiotic challenge on the day of testing or at a later date. This is to clarify if they are now tolerant to the medication/antibiotic they have been tested for.

 
Please remember: 
 
  • Not to take antihistamines for at least 5 days prior to your appointment as it interferes with the IDT procedure and therefore will not be able to be undertaken
  • That the patient needs to be well on the day of the challenge. If the patient is unwell the admission may not be able to proceed. Please call the clinic prior to your appointment to seek advice
  • To allow extra time for parking and to go to the admissions office. Your appointment may take up all day so please ensure you come prepared
 

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