AL7 Perform a skin prick test procedure

Overview

This standard is about conducting and reading skin prick tests chosen to identify specific allergens to which an individual immediately reacts. Skin prick tests can be performed by trained practitioners who are also trained in resuscitation techniques. Skin prick tests should always be interpreted in the context of clinical history. Many individuals have positive skin tests without having allergy symptoms. This standard does not cover the interpretation of tests. Users of this standard will need to ensure that practice reflects up to date information and policies. Version No 1

Knowledge and Understanding

You will need to know and understand:

1. common allergic conditions and their presentation
2. causes of anaphylaxis
3. symptoms and features of anaphylaxis/acute allergic reaction and how to monitor them
4. how to recognise and treat a severe adverse allergic reaction
5. which skin tests should be performed in different individuals
6. how to select allergens to skin test which are suitable for skin testing for different settings and expertise
7. the procedure for conducting skin prick tests on an individual
8. allergen extracts and their limitations
9. medications that can interfere with skin prick testing
10. protocols and guidelines for skin prick testing
11. the risks associated with skin prick testing
12. a standardised approach to measuring reactions to skin prick test
13. management of reactions to skin prick tests
14. quality storage and checking of standardised allergen extracts
15. infection control policy & practice
16. age appropriate doses for antihistamine, adrenaline, hydrocortisone cream

Performance Criteria

You must be able to do the following:

1. select the procedure appropriate for the individual, the diagnosis so far and the diagnostic setting
2. provide a clean, safe environment for the individual according to local guidelines
3. ensure emergency equipment and medication are available and ready for use
4. assess the risks the procedure poses for the individual
5. fully inform the individual and/or responsible adult about skin prick testing procedure, what it involves, and reassure them about its safety
6. assess the individual’s understanding of and likely compliance for the procedure and seek to resolve factors causing reluctance and gain their valid verbal consent
7. check that the individual is in optimal condition for the procedure to begin and has healthy skin for testing with no creams or lotions applied
8. confirm that anti-histamine medication was not taken for at least 3 days before testing
9. give the individual time and opportunity to ask questions before, during and after the skin prick test procedure and check their understanding and the value of your answers
10. conduct the skin prick test procedure according to protocols, guidelines and criteria for best practice, using standardised allergen extracts, fresh foods (for prick-prick tests) and positive and negative controls
11. read and record the results with exact measurements of the test procedure within the prescribed time frame and explain who will interpret the results
12. inform the individual what will happen next in the management of their condition
13. ensure that the individual is well enough to leave
14. complete an accurate record of the test results and pass on to those who are directly involved with the individual’s care

Additional Information

This National Occupational Standard was developed by Skills for Health. This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004): Dimension: HWB6 Assessment and treatment planning