- Paps
- STD checks
- Physicals
- TB Vaccines
- Illnesses (rashes, sinus, and other)
- Allergy shots
- Medications
- Order testing (labs and radiology)
- Blood pressure monitoring
- Minor suturing
- HIV testing
- Drug testing
- Pregnancy testing
- Nexplanon insertion
- Breathing treatments
- Glucose testing
- Contraceptives
- Prescriptions
- School excuses as long as seen in the clinic
- First aid
- B 12 injections
- Flu vaccines
- Physicals
- Referrals
If you have medical concerns, you may be seen by a physician, a nurse practitioner, or a nurse for medical services. We typically see students for problems ranging from colds, allergies, urinary tract infections, and minor injuries to more serious problems like pneumonia.
At each appointment please bring your BSU ID badge. Your demographics and health history will be updated. Your vital signs will be taken along with the reason for your visit.
We have in-house rapid testing for Strep, urinalysis, influenza, urine pregnancy, and Covid. We do not draw blood or take x-rays at the BSU but these services are available at a local lab or hospital.
Please call to schedule an appointment at 304-327-4170. Our last appointment time is 2:30 pm.
For you:
We are happy to continue treatment for those students who are already under the care of an Allergist and are receiving allergy shots. Please read, sign, and return our Allergy Shot Clinic Policy and Allergy Shot Clinic Informed Consent to the Student Health Center prior to starting immunotherapy at the Student Health Center.
We require completed forms and serum vials to be turned in to the BSU SHC at least one day before your first appointment. This allows the provider time to review your treatment plan and consult with your allergist if needed.
For your Allergist:
Please ask your Allergist to review, sign, and return the Referring Allergist Agreement and Allergen Immunotherapy Order Form. These forms must be returned to us before we can administer any allergy shots.
Allergy Clinic Forms (These can be printed to complete with your Allergist, scanned into your computer, and then uploaded onto the STUDENT PORTAL under uploads.
- Allergy Shot Clinic Policy
- Allergy Shot Clinic Informed Consent
- Referring Allergist Agreement
- Allergen Immunotherapy Order Form
- Allergy Immunotherapy Policy and Procedures
- Provider Management of Anaphylaxis and Systemic Reactions
The BSU Allergy Shot Clinic helps you continue the allergy shots prescribed by your allergist while here at BSU. We do not have an allergist on staff so we cannot test you for allergies, prescribe allergy serum, or start you on allergy shots. These guidelines will help you receive optimum benefit from your allergy immunotherapy under the safest possible conditions while at the University.
What we need from you
Before any allergy injections will be given the following information from your Allergist is required:
- Your Serum is clearly labeled with antigen name, concentration, and expiration date on each vial.
- Your current allergy serum injection schedule with the amount, frequency, and date of the last injection you received and any reaction experienced.
- Instructions for missed or late injections.
- Instructions for reactions.
- Phone and fax numbers for your Allergist in case we need to contact them.
- Signed Referring Allergist Agreement Form – must be done annually
Bring the serum and papers from your Allergist to the BSU SHC, when you arrive on campus, and allow time for the provider to review everything before scheduling your first appointment. You may schedule an appointment for this by calling 304-327-4170.
Safety Rules
Allergy serum injections will be administered by a provider in the BSU SHC clinic and should be present during your entire wait time. You must wait in the BSU SHC for 15 minutes under observation after each allergy injection in case of a reaction.
This is mandatory.
Notify the nurse if you experience swelling or itching at the injection site, hives, wheezing or shortness of breath, coughing, facial swelling, flushing, increased nasal congestion, or sneezing. In case of delayed reactions after leaving the BSU: take an antihistamine (e.g., Benadryl, Zyrtec, Allegra, or Claritin), apply ice and over-the-counter hydrocortisone cream, record the size and duration of the reaction, and return to the BSU SHC during normal business hours. If your symptoms continue or worsen: use your Epi-pen as directed by your allergist, go directly to the nearest Emergency Room, and in case of severe reaction, call 911.
Avoid vigorous exercise (workouts) for 1 hour before and 2-4 hours after allergy injections. Wait 48 hours before and after receiving allergy serum for any other immunizations, including flu shots.
Your Allergy Serum
Current patients are responsible for re-ordering allergy serum and bringing it to the BSU SHC. We will be happy to assist in re-ordering serum by faxing the appropriate forms to your allergist, but it is your responsibility to call your allergist’s office to schedule a pick-up time for the new serum. We can provide you with a list of local allergists if you are unable to see your allergist while at school. Since we do not recommend mailing serum, the BSU SHC is not responsible for postage, or for mailed materials that are lost, un-refrigerated, or otherwise damaged. The BSU Allergy Shot Clinic patient is responsible for adhering to the schedule outlined by his/her physician. If you are leaving campus for breaks and injections are due, you must pick up your shot record and serum. You are responsible for making appointments with your allergist at home. We recommend the use of a cooler for extended travel/transport of your serum. Unclaimed vials will be discarded upon expiration. The BSU will not mail serum to you if you forget to take it home.
Administration of Extracts Under Protocols from Allergists Not Privileged at Bluefield State University Student Health Center
Purpose:
Allergy Immunotherapy is used to alter the immunologic response in allergic patients. The extracts used are individually prepared solutions supplied by allergists not privileged at the Bluefield State University (BSU SHC). It is the intent of BSU SHC to provide patients the service of administering these extracts under protocols written and provided by outside allergists.
Policy:
- Patients requesting administration of immunotherapy extracts will complete a consent and request form titled Allergy Shot Clinic Informed Consent.
- Allergists not privileged at BSU SHC will complete a referral agreement indicating they have reviewed BSU SHC procedures for administering extracts and protocols for treating reactions and agree that they are acceptable for care of their patient. They further agree to be available to BSU SHC nurses for questions related to patient care and dosage adjustment.
- Referring Allergists will provide:
- Allergen extract for injection
- Detailed protocols for dosing and dose adjustments including schedules for: escalation and maintenance dosing, the use of new vials, during seasonal exposures, if the constituents of the allergen immunotherapy extract have changed, missed doses, and when reactions occur
- Protocols from referring Allergists will be reviewed and approved by the BSU SHC Consulting Provider (Physician or Nurse Practitioner) to ensure that the protocol is consistent with the current standards of care and consistent with the current capabilities of BSU SHC. If the protocol does not meet these criteria, the patient will be given an appropriate referral, either to the original Allergist or to an Allergist in the community.
- The referring Allergist is responsible for the management of the individual immunotherapy and modification of dosing schedules. BSU SHC will periodically send updated treatment history back to the referring Allergist if outlined per the protocol provided by the referring Allergist.
- Administration of immunotherapy extract will be performed by a licensed BSU SHC provider.
- Allergen immunotherapy will not be administered unless an BSU SHC attending provider (Physician or Nurse Practitioner) is present and readily accessible in the office.
- Treatment of reactions will be done under BSU SHC protocol.
- BSU SHC will provide the service of storing allergen extracts for patients between injections are described in the following procedures. BSU SHC is not liable for the compromise in the integrity of the medication due to handling before BSU SHC receives the medication or for loss or compromise of integrity due to power outage, storage equipment failure, or catastrophic event.
- Consents and referral agreements expire at the end of each academic year in April.
BSU SHC expects the referring Allergist to reevaluate the patient at least annually.
Procedures
Allergy Clinic Visit
The patient is seen by a provider who is privileged to administer immunotherapy extract. The patient must have:
- Referral agreement signed by the referring Allergist.
- “Request and Consent for Administration of Allergy Immunotherapy” signed by the patient.
- Protocols for dosing and dose adjustment form from the referring Allergist and approved by the BSU SHC consulting Provider.
- Allergen extract from the referring Allergist.
Storage of Extract
- The extract is to be stored in containers clearly indicating the patients name and labeled to identify the contents of the vial.
- The extract is to be stored, refrigerated, and kept between 3°C and 6°C (37.4°F and 42.8°F).
- If the extract is exposed to heat or frozen, BSU SHC will contact the referring Allergist for instructions and document the contact and instructions.
Administration of Extract
- A BSU SHC provider must be present in the office and readily available during the entire allergy injection and observation period before extract can be administered.
- Injections are given subcutaneously using a 1-mL syringe with a 27-gauge half-inch non-removable needle.
- Injections should be given in the posterior portion of the middle third of the upper arm.
- The patient must remain and be observed for 15 minutes after an injection. After 15 minutes the site is checked and any reaction is documented.
Dosage and Dose Adjustment
- Dose changes are indicated 1) during escalation and maintenance dosing, 2) the use of new vials, 3) during seasonal exposures, 4) if the constituents of the allergen immunotherapy extract have changed, 5) missed doses, and 6) if reactions have occurred. Detailed dose and dose adjustment for the above-mentioned scenarios are per the schedule provided by the referring Allergist.
- Any questions or clarifications will be addressed to the referring Allergist.
Contraindications
- Injections should be postponed if the patient is ill, febrile, has symptomatic asthma, or has sunburn or irritation at the injection site.
- Injections should not be given to patients taking beta-blockers or monoamine oxidase inhibitors (MAOI’s).
- Caution advised- appropriately revised dosage schedules must be obtained from the referring Allergist in order to continue injections during pregnancy.
Every visit is to be charted in the BSU SHC allergy chart documenting the following information:
- Current health status (document recent illnesses); include a statement attesting to whether the patient’s asthma is stable or not (e.g. albuterol usage in the week before injection, nocturnal symptoms, hospitalizations or ER visits, compliance with medications).
- Record if the patient felt any reaction occurred with the most previous injection (local swelling, local itching, wheezing, hives, delayed reaction, systemic, large local, etc.)
- Current medications and allergies
- The patient’s baseline peak flow is listed for reference (if the patient is asthmatic).
- Pre-injection peak flow if clinical concern for possible asthma symptoms or exacerbation (e.g. if Albuterol use in the last week, recent asthma flare, or recent illness).
- Post-injection peak flow (if systemic reaction symptoms occur)
- Missed or late dose
- Injection information (extract, concentration, volume, local of injection)
- Documentation that the patient was observed for 15 minutes of that patient left early
- Inspection and description of injection site after 15 minutes (e.g. negative, inflammation, swelling, wheal and flare size in mm of longest diameter, etc.)
- The treatment record provided by the referring Allergist is to be completed for each visit.
- Post-injection treatment (e.g. ice, topical steroid, oral antihistamines, resuscitation, etc.)
- The treatment record provided by the referring Allergist is to be completed for each visit.
- Usually, no treatment is required for local reactions other than the application of an ice pack and adjustment of future doses.
- For local reactions greater than 2 inches, topical steroids may be applied.
- For local itching, redness, and large swelling, an oral antihistamine such as diphenhydramine 50 mg may be given.
Immediate Treatment of Systemic Reactions by the Provider
- If a systemic reaction is suspected, assess the airway, breathing, and circulation. EMS should be summoned urgently.
- The provider can administer a dose of 0.3 mL epinephrine 1:1000 intramuscularly into the Deltoid or thigh near the injection site.
Provider management of systemic reactions is per the protocol Provider Management of Anaphylaxis and Systemic Reactions.
Provider Management of Anaphylaxis and Systemic Reactions
Definition
Anaphylaxis is an acute systemic allergic reaction following antigen exposure in a sensitized person and is considered a medical emergency. Anaphylactoid reactions are thought to reflect a release of inflammatory mediators by non-immunologic mechanisms. Most reactions will occur within 5 – 30 minutes following administration of a specific antigen, but may be prolonged or may be recurrent (biphasic) within 8 to 12 hours (J Allergy Clin Immunology, Sept 2002).
Manifestations
- General – Patients often report sudden anxiety, morbid fear, and a sense that “something is very wrong.” Palpitation may occur as well as dizziness or “graying out”.
- Cutaneous Reactions – intense itching; especially of scalp, palms, and groin areas; erythema +/- hives
- Laryngeal Edema – may be experienced as a “lump” in the throat, hoarseness or stridor
- Angioedema – sensed as fullness, numbness or other awareness of the swollen part.
- Lower Airways – feeling of tightness in the chest, cough or wheezing; shortness of breath
- Gastrointestinal/Visceral – nausea, vomiting, or diarrhea; abdominal and uterine cramping
- Cardiovascular – lightheadedness, palpitations, hypotension with or without syncope and/or cardiac arrhythmias
Assessment
The identification of an anaphylactic reaction depends largely upon an accurate history revealing the onset of one or more of the following:
- Cutaneous Reactions – diffuse or localized erythema, pruritis, urticaria and/or angioedema
- Upper Airway – laryngeal edema with possible dysphoria, stridor; rhinitis symptoms
- Lower Airway bronchospasm – respiratory distress, cough, wheezing, dyspnea
- Cardiovascular system – hypotension with or without syncope possibly progressing to vascular collapse, cardiac arrhythmias, cardiac arrest
- Gastrointestinal system – gastrointestinal spasm and edema leading to nausea, vomiting, and/or diarrhea
Plan
Local Reactions – Usually no treatment is required other than the application of an ice pack and adjustment of dosage for subsequent allergy shots. If an unusually large reaction is noted before the patient leaves the office, a tablet or capsule of an antihistamine such as Benadryl, Claritin, or Zyrtec may be given.
Mild Systemic Reactions – (itching of palms, scalp, roof of mouth or groin areas, mild hay fever or asthma): Administer aqueous epinephrine 1:1000 dilution 1 mg/ml, 0.2-0.5 ml, (0.1 mg/kg in children; maximum dose, 0.3 mg dosage) intramuscularly (*preferably initially into the arm that received the allergy shot), every 5 minutes, as necessary, to control symptoms and blood pressure. Diphenhydramine 25 to 50 mg may be given (parenterally). Consider giving an oral corticosteroid (e.g. prednisone 0.5 mg/kg) to prevent recurrent and protracted reactions.
Severe Systemic Reactions – (anaphylactic shock, hypotension with or without lightheadedness, bronchospasm, worsening angioedema with or without laryngeal edema, visceral spasm):
- If a suspected offending antigen is being given, immediately stop administration; if feasible apply a tourniquet above the implicated injection site.
- The nurse should immediately contact the provider.
- For a severe reaction, the nurse may administer one dose of aqueous epinephrine 1:1000 dilution (1 mg/ml.), 0.2 – 0.5 ml, (0.01 mg/kg in children; maximum dose, 0.3 mg. dosage) intramuscularly into the arm (deltoid)or thigh before arrival of the provider.
- The provider will perform an initial assessment as above and will consider anaphylaxis as well as other possible diagnoses (hypoglycemia, vasovagal reaction, seizure, PE, myocardial dysfunction, etc.). If the assessment is consistent with anaphylaxis, proceed as follows:
- Administer aqueous epinephrine 1:1000 dilution (1 mg./ml.), 0.2 – 0.5 ml (0.01 mg/kg in children, maximum dose, 0.3 mg. dosage) intramuscularly into the arm or thigh every 5 minutes as necessary and assess response.
- Place the patient in a recumbent position if hypotensive.
- Initiate oxygen at 2-4 liters/minute per nasal cannula or mask for patients in respiratory distress. Monitor pulse oximetry at frequent intervals. Monitor the airway closely.
- Assess clinical response to treatment.
- Immediately for laryngeal/pharyngeal edema
- Immediately for significant hypotension
- Immediately for cardiac arrhythmia
- For respiratory distress not responsive to epinephrine
- For symptoms that recur or worsen during observation after treatment
- Observation – length of time and setting individualized depending on severity of reaction.
- Administer diphenhydramine 25 to 50 mg. orally every 4 – 6 hours as needed.
- Consider hospital admission for 24-hour observation for patients who have manifested significant systemic reactions.
- If the patient is being discharged home after a significant systemic reaction:
- Prescribe an Epi-pen auto injector. Instruct patient on the use of Epi-pen and discuss the possibility of recurrent/biphasic reactions, the signs and symptoms thereof, and self-treatment.
- The patient should not be alone for the first 24 hours after the reaction.
- Consider giving an oral corticosteroid (e.g. prednisone 0.5 gm./kg.) to prevent recurrent or protracted reactions.
Birth Control Start
The Student Health Center offers services, by appointment, for birth control start and counseling as well as abstinence support. While we counsel on all forms of contraceptives, we can provide, pills, rings, patches, injections and insertions of Nexplanon. A referral list of providers will be given as appropriate, to those requesting another form of contraceptive. We will also give a referral list to those in need of an extensive work up related to underlying circumstances. We ask that you allow 30 minutes for an appointment and come 10 minutes early to fill out a Women’s Health Pre-visit Form: Sexual Health and History Pre-visit Form
Routine Gynecological Exam
Annual PAP smear before the age of 21 is no longer recommended by ACOG (American College of Obstetrics and Gynecology). If you are 21, you may schedule a routine women’s health examination with one of our providers. This involves breast and pelvic exams, Pap smear, and Gonorrhea/Chlamydia screening. This exam is by appointment only. If you are experiencing symptoms, please call the BSU SHC to speak with the provider. You will be advised over the phone or scheduled appropriately for an appointment.
If you are sexually active, we recommend annual Sexually Transmitted Infections (STI) testing. BSU SHC provides the following at no charge.
- Complete women’s health exam (PAP)
- Chlamydia and Gonorrhea testing (urine or cervical swab)
- Birth control pills from Our Pharmacy. We carry a limited amount of birth control options. (Students wishing to obtain birth control through the Health Center Pharmacy must receive their care and exams through the BSU SHC provide a complete exam from their provider).
- Emergency contraception and counseling (Plan B )
- Pregnancy testing and counseling
- Nurse visit for birth control
- Nexplanon insertion or removal
The Student Health Center works closely with the BSU SHC. If you are having mental health issues, make an appointment with either us or the BSU SHC or the Counseling Services so we can help you.
The University provider has prepared an FAQ about antidepressant drugs. If you have an appointment to discuss medication for depression, you may want to read this before your visit.
All links to websites may be accessed by clicking on resources in the left column.
Crisis Text Line: Text HOME to 741-741
National Institute on Drug Abuse: https://www.nih.gov/about-nih/what-we-do/nih-almanac/national-institute-drug-abuse-nida
National Institute of Mental Health https://www.nimh.nih.gov/health
National Suicide Prevention Lifeline: 988 https://988lifeline.org/current-events/the-lifeline-and-988/
Suicide Prevention Resource Center: https://www.sprc.org/
Alcohol Poisoning: Facts about alcohol overdose https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-dangers-of-alcohol-overdose
Alcohol Addiction Center: Resources for alcoholics and problem drinkers https://www.addictioncenter.com/alcohol/
Substance Abuse and Mental Health Services Administration: Find treatment facilities and programs in the United States or U.S. Territories for mental and substance use disorders
https://www.samhsa.gov/find-help/national-helpline
LGBTQ+ HELPLINE: TEXT: 988 or 741741
https://afsp.org/lgbtq-crisis-and-support-resources
In-person or online counseling are available:
- Cravor Jones 304-3274016
- Jessica McDaniels 304-327-4424
- Southern Highlands https://shcmhc.com/ 18006150122
- Better help (online therapy) https://www.betterhelp.com/
- LARKR (app store for iphone for self-care and video therapy)