{"id":16832,"date":"2023-10-02T11:27:53","date_gmt":"2023-10-02T10:27:53","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/?page_id=16832"},"modified":"2024-11-04T15:07:27","modified_gmt":"2024-11-04T15:07:27","slug":"allergy-service","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/paediatrics\/allergy\/allergy-service\/","title":{"rendered":"Allergy Service"},"content":{"rendered":"\n<p>RHCYP NHS Lothian <\/p>\n\n\n\n<p><strong>Service<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>The allergy service offers diagnosis and management of allergies including allergy diagnostic testing, avoidance education, auto injector training and food challenges when applicable.&nbsp; A multidisciplinary allergy clinic is held weekly at RHCYP attended by Professor Jurgen Schwarze, Dr Helen Rhodes, Dr David Cordiner, Dr Aziz Sheikh, Juliet Dykes and Vicky McConnachie Allergy Nurse Specialists and Maria Mitchell, Specialist Paediatric Allergy Dietitian.&nbsp; The joint clinic usually provides a one-stop service offering skin prick testing and dietetic advice alongside a medical consultation.&nbsp;<\/li>\n\n\n\n<li>The service also provides weekly clinics at St John\u2019s Hospital<\/li>\n\n\n\n<li>A Nurse led allergy clinic is available twice weekly<\/li>\n\n\n\n<li>A dietetic led allergy clinic is available fortnightly.<\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\"><strong>Who to refer<\/strong>:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Children with anaphylaxis, i.e. allergy symptoms that affect breathing (cough, wheeze, stridor or breathlessness), the gut (severe prolonged vomiting) or the circulation (faintness, floppiness or signs of shock, collapse)<\/li>\n\n\n\n<li>Children with food allergies who receive regular asthma preventative treatment and\/or poorly controlled asthma<\/li>\n\n\n\n<li>Poorly controlled allergic rhinitis only after a trial of daily nasal steroid spray together with a daily non-sedating antihistamine for a minimum of 3 months.<\/li>\n\n\n\n<li>Where diagnosis is not clear and needs to be confirmed or excluded<\/li>\n\n\n\n<li>Children with suspected food allergy who also have severe eczema<\/li>\n\n\n\n<li>Multiple food allergies<\/li>\n\n\n\n<li>Systemic insect sting reactions<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Who not to refer<\/strong>:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>People over the age of 18 years.<\/li>\n\n\n\n<li>Single uncomplicated food allergies, i.e. not anaphylaxis.&nbsp; These patients may be referred to the General Medical Pediatric Service if not able to be managed in Primary Care<\/li>\n\n\n\n<li>Minor reactions to foods such as strawberries, tomatoes and aubergines are common and do not generally need referral into the allergy service. (See Oral Allergy Syndrome tab above)<\/li>\n\n\n\n<li>Egg allergy (See Egg Allergy tab above)<\/li>\n\n\n\n<li>Non-IgE CMPA&nbsp;\u2013 Please refer to Infant Feeding Difficulty Dietics see\u2013<a href=\"https:\/\/eur01.safelinks.protection.outlook.com\/?url=https%3A%2F%2Fapps.nhslothian.scot%2Frefhelp%2Fguidelines%2Fpaediatrics%2Fallergy%2Fcows-milk-protein-allergy-cmpa%2F&amp;data=05%7C02%7CHeather.Levy%40nhs.scot%7C2bcd3938d72f491dea4508dcf9c20d39%7C10efe0bda0304bca809cb5e6745e499a%7C0%7C0%7C638659859038637890%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&amp;sdata=H8A6tleng3ZOcpIPK0mMeyyokh4ZQ2rA7Zu0opvLB4Y%3D&amp;reserved=0\" target=\"_blank\" rel=\"noreferrer noopener\">Cow\u2019s Milk Protein Allergy (CMPA) \u2013 RefHelp (nhslothian.scot)<\/a><\/li>\n\n\n\n<li>IgE CMPA \u2013 Refer to&nbsp;general&nbsp;paedaitric dietetics &#8211;&nbsp;<a href=\"https:\/\/eur01.safelinks.protection.outlook.com\/?url=https%3A%2F%2Fapps.nhslothian.scot%2Frefhelp%2Fguidelines%2Fpaediatricdietetics%2F&amp;data=05%7C02%7CHeather.Levy%40nhs.scot%7C2bcd3938d72f491dea4508dcf9c20d39%7C10efe0bda0304bca809cb5e6745e499a%7C0%7C0%7C638659859038657041%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&amp;sdata=y%2BgezhBAaf4id2CiMj4IbFFNQyM1YTm0m0%2B4c2q9APQ%3D&amp;reserved=0\" target=\"_blank\" rel=\"noreferrer noopener\">Dietetics \u2013 RefHelp<\/a>\n<ul class=\"wp-block-list\">\n<li>Advise to avoid cows milk protein and prescribe allergy formula if appropriate (add link to appendix 2 \u2013 Prescribing allergy formula\u2019s)<\/li>\n\n\n\n<li>If combination fed and infant did not previously react to cow\u2019s milk in maternal diet please advise Mum to continue to keep cow\u2019s milk in her diet.<\/li>\n\n\n\n<li>Dietetics to provide skin prick testing on receipt of referral in order to confirm diagnosis. Dietetics to offer milk free weaning advice and reintroduction at 12 months as appropriate.<\/li>\n\n\n\n<li>Please advise to avoid lactose free milks\/products as these contain cow\u2019s milk protein.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Single urticarial reactions without obvious triggers<\/li>\n\n\n\n<li>Non-allergic chronic urticaria<\/li>\n\n\n\n<li>Well controlled allergic rhinitis, asthma or eczema<\/li>\n\n\n\n<li>Mild to moderate eczema without obvious allergic trigger<\/li>\n\n\n\n<li>Localized insect sting reactions<\/li>\n\n\n\n<li>Delayed type food allergy presenting primarily with gastrointestinal symptoms<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>How to refer<\/strong>:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Referrals should be made via the SCI gateway<\/li>\n\n\n\n<li><strong>For patients within the city of Edinburgh, East and Midlothian<\/strong>, please refer to RHCYP via Paediatric Allergy Service<\/li>\n\n\n\n<li><strong>For patients within West Lothian, <\/strong>please refer to St John\u2019s via Medical Paediatrics<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"> <strong>Essential information to include in referral:<\/strong> <strong>\u00a0<\/strong> <\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Symptoms of allergic reaction <\/li>\n\n\n\n<li>Suspected triggers <\/li>\n\n\n\n<li>Timing between trigger exposure and onset of symptoms.<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<ul class=\"wp-block-list\">\n<li>Children and Young People\u2019s Allergy Network Scotland<\/li>\n<\/ul>\n\n\n\n<p><a href=\"http:\/\/www.cyans.scot.nhs.uk\">www.cyans.scot.nhs.uk<\/a>&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Allergy UK<\/li>\n<\/ul>\n\n\n\n<p><a href=\"http:\/\/www.allergyuk.org\">www.allergyuk.org<\/a>&nbsp;&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"\/Users\/victoria.mcconnachie\/Downloads\/BSACI%20egg%20guidelines.pdf\">BSACI guidelines for the management of egg allergy<\/a> <a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cea.14009\">https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cea.14009<\/a><\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>RCPCH -Taking as Allergy Focused History <a href=\"https:\/\/www.rcpch.ac.uk\/sites\/default\/files\/Taking_an_Allergy_Focused_Clinical_History_-_Allergy_Care_Pathways_Project.pdf\">https:\/\/www.rcpch.ac.uk\/sites\/default\/files\/Taking_an_Allergy_Focused_Clinical_History_-_Allergy_Care_Pathways_Project.pdf<\/a><\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Epipen Adrenaline Device&nbsp;&nbsp;<\/li>\n<\/ul>\n\n\n\n<p><a href=\"http:\/\/www.epipen.co.uk\">www.epipen.co.uk<\/a><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>JEXT Adrenaline Device &nbsp;&nbsp;<\/li>\n<\/ul>\n\n\n\n<p><a href=\"http:\/\/www.jext.co.uk\">www.jext.co.uk<\/a><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Emerade Device<\/li>\n<\/ul>\n\n\n\n<p><a href=\"http:\/\/www.emerade.com\">www.emerade.com<\/a>&nbsp;<\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>RHCYP NHS Lothian Service<\/p>\n","protected":false},"author":6,"featured_media":0,"parent":13346,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[869],"class_list":["post-16832","page","type-page","status-publish","hentry","category-https-apps-nhslothian-scot-refhelp-allergy-services"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"heatherlevy","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/heatherlevy\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/paediatric\/https-apps-nhslothian-scot-refhelp-allergy-services\/\" rel=\"tag\">Allergy Services<\/a>","rttpg_excerpt":"RHCYP NHS Lothian Service","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/16832","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=16832"}],"version-history":[{"count":4,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/16832\/revisions"}],"predecessor-version":[{"id":21432,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/16832\/revisions\/21432"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/13346"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=16832"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=16832"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}