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Subcutaneous immunotherapy (SIT) injections for aeroallergens are often utilized in
patients. SIT should be injected into the subcutaneous space in the mid-posterolateral
upper arm. If the injections are given intramuscularly (IM), there may be an increased
risk of anaphylaxis. In our allergy clinic, SIT is given with BD Safety Glide™ Allergy
syringes with needle length 13 mm. There is a risk of the SIT being injected IM if
patients have a skin to muscle depth (STMD) less than 13 mm.
Charts were reviewed in an allergy clinic for patients on SIT where an ultrasound
of the left posterolateral arm was done to measure STMD. Baseline characteristics
of the two groups of patients with STMD greater than, and less than or equal to 13
mm were compared. The proportions of patients with STMD greater than 4mm, 6 mm, 8
mm, and 10 mm were calculated. Multivariable logistic regression was performed with
age, sex, BMI and race.
Ultrasounds had been completed on 186 patients on SIT. There were 149 (80%) with STMD
less than 13mm. Baseline characteristics including age, sex and BMI differed among
the two groups (p < 0.05). Based on the logistic regression analysis, BMI was significantly
associated with STMD. There were 168 (90%) patients with more than 4mm STMD.
With standard allergy syringes, most patients on SIT are at risk of receiving the
injections IM. A needle length of 4 mm would significantly decrease the risk of SIT
being given IM.
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Canadian Society of Allergy and Clinical Immunology Annual Scientific Meeting 2012