TABLE 2.
Investigations and diagnostics
| Secondary Services (N = 126) | Tertiary Services (N = 28) | All services | |
|---|---|---|---|
| % (n/N) | % (n/N) | % (n/N) | |
| Investigations | |||
| Specific IgE | 100 (126/126) | 100 (28/28) | 100 (154/154) |
| Skin prick testing | 95 (120/126) | 100 (28/28) | 96 (148/154) |
| Component resolved diagnostic testing b | 71 (89/126) | 89 (25/28) | 74 (114/154) |
| ISAC macro‐array testing | 21 (27/126) | 46 (13/28) | 26 (40/154) |
| Intradermal testing | 5 (6/126) | 68 (19/28) | 16 (25/154) |
| Patch testing | 2 (3/126) | 7 (2/28) | 3 (5/154) |
| Spirometry a | 59 (74/126) | 79 (22/28) | 62 (96/154) |
| Exhaled nitric oxide b | 25 (32/126) | 54 (15/28) | 31 (47/154) |
| Other c | 1 (1/126) | 11 (3/28) | 3 (4/154) |
| Skin prick testing | |||
| Skin prick testing available on same day a | 93 (111/120) | 96 (27/28) | 93 (138/148) |
| Skin testing for drugs, food, venom and latex b | 9 (11/120) | 46 (13/28) | 16 (24/148) |
| Staff undertaking skin prick testing | |||
| Consultant | 31 (37/120) | 14 (4/28) | 28 (41/148) |
| Associate specialist | 3 (3/120) | 4 (1/28) | 3 (4/148) |
| Nurse | 91 (109/120) | 100 (28/28) | 93 (137/148) |
| Specialist registrar | 2 (2/120) | 4 (1/28) | 2 (3/148) |
| Laboratory technician | 1 (1/120) | 0 (0/28) | 1 (1/148) |
| Dietician | 4 (5/120) | 14 (4/28) | 6 (9/148) |
| Other d | 7 (8/120) | 0 (0/28) | 5 (8/148) |
| Skin prick testing undertaken | |||
| Foods—commercial SPT solutions | 99 (119/120) | 100 (28/28) | 99 (147/148) |
| Foods—fresh whole foods | 93 (111/120) | 100 (28/28) | 94 (139/148) |
| Aeroallergens | 93 (112/120) | 96 (247/28) | 94 (139/148) |
| Latex | 71 (85/120) | 86 (24/28) | 74 (109/148) |
| Bee/wasp venom | 26 (31/120) | 54 (15/28) | 31 (46/148) |
| Drugs | 18 (22/120) | 68 (19/28) | 28 (41/148) |
| Other e | 0 (0/120) | 4 (1/28) | 1 (1/148) |
| Skin prick testing to whole foods | |||
| Tahini (sesame) | 54 (59/110) | 64 (18/28) | 56 (77/138) |
| Fresh cow's milk | 62 (68/110) | 61 (17/28) | 62 (85/138) |
| Raw egg white | 30 (33/110) | 32 (9/28) | 30 (42/138) |
| Family brought food | 93 (102/110) | 96 (27/28) | 93 (129/138) |
| Nuts | 38 (42/110) | 50 (14/28) | 41 (56/138) |
| Component testing | |||
| Peanut | 98 (86/88) | 96 (23/24) | 97 (109/112) |
| Hazelnut | 74 (65/88) | 83 (20/24) | 76 (85/112) |
| Venom | 17 (15/88) | 75 (18/24) | 29 (33/112) |
| Birch | 42 (37/88) | 88 (21/24) | 52 (58/112) |
| Other | 33 (29/88) | 63 (15/24) | 39 (44/112) |
| Peanut specific components (if peanut component testing undertaken) | |||
| ara h1 | 56 (48/85) | 48 (11/23) | 55 (59/108) |
| ara h2 | 98 (83/85) | 100 (23/23) | 98 (106/108) |
| ara h3 | 40 (34/85) | 39 (9/23) | 40 (43/108) |
| ara h8 | 87 (74/85) | 78 (18/23) | 85 (92/108) |
| ara h9 | 51 (43/85) | 48 (11/23) | 50 (54/108) |
| Hazelnut specific components (if hazelnut component testing undertaken) | |||
| cor a1 | 73 (45/62) | 90 (18/20) | 77 (63/82) |
| cor a8 | 77 (48/62) | 80 (16/20) | 78 (64/82) |
| cor a9 | 84 (52/62) | 75 (15/20) | 82 (67/82) |
| cor a14 | 84 (52/62) | 80 (16/20) | 83 (68/82) |
| Food & Drug challenges | |||
| Provides food challenges b | 90 (114/126) | 100 (28/28) | 92 (142/154) |
| Provides drug challenges b | 44 (56/126) | 96 (27/28) | 54 (83/154) |
| Staff undertaking drug challenges | |||
| Consultant | 45 (25/56) | 59 (16/27) | 49 (41/83) |
| Associate specialist | 7 (4/56) | 4 (1/27) | 6 (5/83) |
| Specialist registrar | 7 (4/56) | 26 (7/27) | 13 (11/83) |
| Allergy nurse specialist | 50 (28/56) | 78 (21/27) | 59 (49/83) |
| Paediatric nurse | 43 (24/56) | 33 (9/27) | 40 (33/83) |
| Dietician | 0 (0/56) | 0 (0/27) | 0 (0/83) |
| Other f | 9 (5/56) | 0 (0/27) | 6 (5/83) |
| Drug challenges undertaken | |||
| Analgesics—paracetamol | 55 (31/56) | 85 (23/27) | 65 (54/83) |
| Analgesics—NSAIDs | 55 (31/56) | 81 (22/27) | 64 (53/83) |
| Antibiotics—IV | 5 (3/56) | 56 (15/27) | 22 (18/83) |
| Antibiotics—oral | 98 (55/56) | 100 (27/27) | 99 (82/83) |
| Local anaesthetics | 11 (6/56) | 70 (19/27) | 30 (25/83) |
| General anaesthetics b | 2 (1/56) | 44 (12/27) | 16 (13/83) |
| Other g | 4 (2/56) | 19 (5/27) | 8 (7/83) |
| Open food challenge location | |||
| Paediatric day ward | 80 (90/113) | 71 (20/28) | 78 (110/141) |
| Dedicated challenge unit | 1 (1/113) | 21 (6/28) | 5 (7/141) |
| Outpatient department | 8 (9/113) | 11 (3/28) | 9 (12/141) |
| Inpatient ward | 20 (23/113) | 4 (1/28) | 17 (24/141) |
| Supervised feeds location | |||
| Paediatric day ward | 73 (30/41) | 53 (9/17) | 67 (39/58) |
| Dedicated challenge unit | 0 (0/41) | 29 (5/17) | 9 (5/58) |
| Outpatient department | 20 (8/41) | 41 (7/17) | 26 (15/58) |
| Inpatient ward | 17 (7/41) | 12 (2/17) | 16 (9/58) |
| Staff undertaking food challenges | |||
| Consultant | 25 (28/114) | 39 (11/28) | 27 (39/142) |
| Associate specialist | 5 (6/114) | 7 (2/28) | 6 (8/142) |
| Specialist registrar | 4 (5/114) | 18 (5/28) | 7 (10/142) |
| Allergy nurse specialist | 39 (45/114) | 64 (18/28) | 44 (63/142) |
| Paediatric nurse | 69 (79/114) | 57 (16/28) | 67 (95/142) |
| Dietician | 3 (3/114) | 4 (1/28) | 3 (4/142) |
| Other h | 7 (8/114) | 4 (1/28) | 6 (9/142) |
| Challenge service configuration | |||
| Resuscitation facilities available for challenge a | 98 (112/114) | 100 (28/28) | 99 (140/142) |
| ≥2 challenges performed per month a | 99 (110/111) | 100 (28/28) | 99 (138/139) |
| Supervision of ≤2 challenges per nurse a | 89 (93/105) | 82 (23/28) | 87 (116/133) |
| Written information provided for challenges a | 86 (98/114) | 93 (26/28) | 87 (124/142) |
| Parental consent obtained for challenges a | 69 (78/113) | 82 (23/28) | 72 (101/141) |
| Challenge database kept a | 64 (73/114) | 86 (24/28) | 68 (97/142) |
a
Secondary Care BSACI Standard.
b
Specialist Paediatric Allergy Service Standards.
c
Other: Tertiary—basophil activation tests (BAT tests) (n = 1), ocular testing including visual acuity, intraocular pressure, staining and anterior rhinoscopy (n = 1), exercise challenge test (n = 2). Secondary—patch testing of standard dermatology panel (n = 1).
d
Other: includes healthcare assistants and ENT staff.
e
Other: includes major and minor determinants.
f
Other: includes junior doctor (with support) and clinical support worker.
g
Other: steroids, immunosuppressants, biologicals, codeine and “all” drugs.
h
Other: includes nurse practitioner, nurse clinician, associate practitioner, healthcare assistant and Senior House Officer.