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Immunology & Allergy Guidelines

Checked: 23-08-2020 by 3 Vicky Ryan Next Review: 23-08-2022

Referral Guidelines

Refer to the Immunology and Allergy Referral Guidelines compiled by Dr Mark Gompels, Consultant in Immunology at NBT.  The guidelines include advice on:

  • Anaphylaxis - see also advice on adrenaline autoinjector action plans in the section below.
  • Allergy to Bee or Wasp Venom
  • Allergic Rhinitis - For non- allergic rhinitis see  the Chronic rhinosinusitis and nasal polyps page.
  • Suspected Drug Allergy
  • Anaesthetic allergy
  • How to identify food allergy
  • Management of suspected food allergy
  • Urticaria & Angiodema
  • C1 - Inhibitor Deficiency
  • Asthma
  • Eczema
  • Other Immunodeficiency
  • Periodic fevers
  • Clinical Situations Unrelated to Allergy
  • Which clinics to refer to?

Advice & Guidance

Routine Allergy and Immunology Advice & Guidance (at NBT) are both available on eRS.

Urgent advice is available for GPs via the Southmead Hospital Switchboard – ask for Immunology Allergy Registrar/Specialist

Anaphylaxis action plans

The Dept of Allergy and Immunology have shared the most up to date allergy action plans (Dec 2022).  Patients with autoinjector adrenaline should ideally carry such a plan to assist them in determining when to use the autoinjector and to which allergen, if possible.

The new guidelines better stratify when to use the adrenalin autoinjector and in what sequence to proceed. They are also specific for which autoinjector device is used by the patient. When patients need a renewal of their auto injectors, or are at high risk, they should be issued with a new updated plan. 

The Allergy and Immunology Department do not routinely follow up patients who are stable in whom the diagnosis of an allergy is made, so would appreciate GPs help with this.

Anaphylaxis action plan - For use with Epipen® adrenaline autoinjectors

Anaphylaxis action plan - For use with Emerade® adrenaline autoinjectors

Anaphylaxis action plan - For use with Jext® adrenaline autoinjectors


How to use Adrenaline Autoinjectors (AAI)

MHRA information on AAI safety campaign has some really helpful resources for patients. MHRA webpage/update includes an infographic and video on how to correctly use an AAI.

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.