Objectives Clinical Assessments and Interventions Follow-up Actions 56 ● Counsel employee on signs of anaphylaxis and actions to take. ● Be alert for any latent allergic reaction to allergy injection. Educate employee on signs of anaphylaxis. equipment should include epinephrine 1:1,000 solution or EpiPen, oropharyngeal or nasopharyngeal airways, oxygen, and access to the Emergency Medical Service (EMS) system. ● Review order carefully, and remove sera from refrigerator approximately 15 minutes prior to the appointment so it will warm to room temperature. ● Obtain employee’s written, informed con- sent for each injection. ● Prepare sera and give injection, using a dry-needle technique. If more than one in- jection is given, be certain to have detailed dosing schedule from the prescribing health care provider outlining the dosing interval (e.g., 1 minute between injections). Em- ployee must be monitored in the health unit for 20 to 30 minutes after injection. ● Document in employee’s health record the sera, dosage, date, site of injection, and any employee reaction up to 20 minutes after injection, including the measurement of any erythema and wheal. ● Discuss signs of anaphylaxis (include wheezing, asthmatic reaction, hives, rash, difficulty in breathing, urticaria, and facial swelling). ● Advise employee to seek immediate med- ical attention if symptoms of anaphylaxis occur.