I'm allergic to.....(laundry list)!

[AOx1]

I just had a patient who listed about a million allergies. Among them was "oxygen" lol! When asked about this "allergy" she reported "it dries my nose." Here lately, it seems every must have multiple "allergies" many of which are just side effects. It makes me worry that those with true allergies might not have them taken as seriously. For example, a frequent flier boy's mom listed a zillion allergies, and her son actually had an anaphylactic reaction to nuts. But I fear this gets lost in all the other "allergies" he has. Anyone else worry about this?

[mamamerlee, LPN]

I just spent 2 days in the hospital - I listed my allergies as Sulfa drugs ( turned bright red and swelled up last time I took Bactrim), Versed (actually adverse effect, but please don't ever give it to me again) and eggs (bad headaches from RAW eggs, can't take flu shots).

I was served eggs both mornings -even after I called dietary the first day, and they LISTED it on my menu!!!

Talk about your poor communication.

And, yes, I have seen people allergic to benadryl, most pain meds, strange food items and many other things. And even though a side effect is not a true allergy, if they shouldn't be given the med ever again, then allergy it is!

My husband will never be given Versed again - he became combative during a procedure, and was trying to hit everyone. Not a good scene, they were unable to complete the procedure.

[epinephRN]

I agree with the above (wtbcrna); I also have several true allergies leading to anaphylaxis, but the problem with treating the patient as if all listed allergies are equally valid can lead to lack of appropriate care. For example, if I accepted the patient's "allergy" to oxygen that I mentioned in the initial post, this would have been quite problematic as the patient required a vent after surgery, not to mention that if the allergy was real, she would already be dead.

I am also not referring to people who have not been educated about the nature of an allergy vs. an intolerance vs. "I just don't like it." I am referring to those who continue to say they have an "allergy" despite education. I have discussed why this is not a good idea and re-educated the mom of the frequent flier multiple times, but she continues to state the allergies unchanged. Also, it drives me crazy when people just don't like a food and claim they are allergic. Ex- a close friend hates onions, but tells others she is "allergic" instead of just saying at a restaurant "Don't put any onions in my food!" and sending it back if they do. To me, this really discounts those with true allergies that will DIE or become quite ill from exposure (such as my niece, who has a severe peanut allergy). My concern is that the people who exagerrate are like the "boy who cried wolf"- and I fear that those without a medical background will be less likely to take real claims seriously when this happens.

[eriksoln, BSN, RN]

I just spent 2 days in the hospital - I listed my allergies as Sulfa drugs ( turned bright red and swelled up last time I took Bactrim), Versed (actually adverse effect, but please don't ever give it to me again) and eggs (bad headaches from RAW eggs, can't take flu shots).

I was served eggs both mornings -even after I called dietary the first day, and they LISTED it on my menu!!!

Talk about your poor communication.

And, yes, I have seen people allergic to benadryl, most pain meds, strange food items and many other things. And even though a side effect is not a true allergy, if they shouldn't be given the med ever again, then allergy it is!

My husband will never be given Versed again - he became combative during a procedure, and was trying to hit everyone. Not a good scene, they were unable to complete the procedure.

IDK about your neck of the woods, but at my hospital..............its not a lack of communication. Its an apathetic dietary dept. that causes this to happen frequently.

Our allergies are split up into two groups, food and drug. Anything not falling into either of these is simply placed according to nursing judgement. The reason for the two categories............everything listed under the food allergy list shows up in the dietary dept. They are fully aware of all the allergies they need to be aware of.

They do not pay any attention to it though. They are short staffed, underpaid and get yelled at by the dietary dept. head from the time they enter the building until they leave. If someone gets eggs and shouldn't, no concern of theirs, they are completely apathetic to the whole process. One that rounds on our unit on weekends jokes in the open about how proud the whole dept. is of the low PG scores associated with her dept. "They are getting what they paid for".......meaning the administration of the hospital.

[realnursealso/LPN, LPN]

I'm allergic to citrate, in blood drawing tubes. My platelets clump together and my CBC comes back with too few platelets. I never want to think I'm ill again like that. It was simple enough when the hematologist figured it out, but was way scarey at first. It's written all over my chart at my drs.

[happy2learn]

I agree with the above (wtbcrna); I also have several true allergies leading to anaphylaxis, but the problem with treating the patient as if all listed allergies are equally valid can lead to lack of appropriate care. For example, if I accepted the patient's "allergy" to oxygen that I mentioned in the initial post, this would have been quite problematic as the patient required a vent after surgery, not to mention that if the allergy was real, she would already be dead.

I am also not referring to people who have not been educated about the nature of an allergy vs. an intolerance vs. "I just don't like it." I am referring to those who continue to say they have an "allergy" despite education. I have discussed why this is not a good idea and re-educated the mom of the frequent flier multiple times, but she continues to state the allergies unchanged. Also, it drives me crazy when people just don't like a food and claim they are allergic. Ex- a close friend hates onions, but tells others she is "allergic" instead of just saying at a restaurant "Don't put any onions in my food!" and sending it back if they do. To me, this really discounts those with true allergies that will DIE or become quite ill from exposure (such as my niece, who has a severe peanut allergy). My concern is that the people who exagerrate are like the "boy who cried wolf"- and I fear that those without a medical background will be less likely to take real claims seriously when this happens.

I 100% agree with the first part and the main point of your post, however...

My husband despises tomatoes. It doesn't matter how many times he tells them to not put in tomatoes, they do 95% of the time. But he found if he told them he was allergic, they were more likely to not put it in. He is also a chef. He knows how the kitchen works. A server is more likely to communicate to him an allergy vs a "picky" patron, which in turn causes less hassle for the kitchen and restaurant in the end. So either tell them he's allergic, or spend forever waiting for them to refire a meal.

I don't think speaking of a food allergy (lying or not) in a restaurant is the same as listing allergies in a medical setting.

[wtbcrna, MSN, DNP, CRNA]

I just spent 2 days in the hospital - I listed my allergies as Sulfa drugs ( turned bright red and swelled up last time I took Bactrim), Versed (actually adverse effect, but please don't ever give it to me again) and eggs (bad headaches from RAW eggs, can't take flu shots).

I was served eggs both mornings -even after I called dietary the first day, and they LISTED it on my menu!!!

Talk about your poor communication.

And, yes, I have seen people allergic to benadryl, most pain meds, strange food items and many other things. And even though a side effect is not a true allergy, if they shouldn't be given the med ever again, then allergy it is!

My husband will never be given Versed again - he became combative during a procedure, and was trying to hit everyone. Not a good scene, they were unable to complete the procedure.

So, with the Versed there was nothing else given at all that way you absolutely know it was the Versed and not another drug or a combination of drugs?.... IMO it often isn't so much the drug but the patients personality that causes the problems. Many anesthetic drugs actually work on the same receptor(s) so what you are seeing most of the time is what happens to that particular patient when they become disinhibited. The same thing can happen with propofol, valium, ativan, ketamine, thiopental or any drug that is used for sedation.

If it isn't an IgE mediated reaction then it isn't an allergy, and I take it off the patients allergy list. I list meds/food that the patient has had side-effects below the allergies with an explanation of what the reaction was, and note usually the patient requests not to be given these medications/foods.

Listing allergies that aren't true allergies is poor practice and can lead to all sorts of problems.

[Leelee2]

IDK about your neck of the woods, but at my hospital..............its not a lack of communication. Its an apathetic dietary dept. that causes this to happen frequently.

Our allergies are split up into two groups, food and drug. Anything not falling into either of these is simply placed according to nursing judgement. The reason for the two categories............everything listed under the food allergy list shows up in the dietary dept. They are fully aware of all the allergies they need to be aware of.

They do not pay any attention to it though. They are short staffed, underpaid and get yelled at by the dietary dept. head from the time they enter the building until they leave. If someone gets eggs and shouldn't, no concern of theirs, they are completely apathetic to the whole process. One that rounds on our unit on weekends jokes in the open about how proud the whole dept. is of the low PG scores associated with her dept. "They are getting what they paid for".......meaning the administration of the hospital.

I have witnessed this apathetic attitude with nursing also. Mistakes being made and staff shrug and say "oh well, we are not perfect, we all make mistakes" Hopefully karma kicks in for these staff, and then they can have some clueless staff person standing over them saying "oh well..."

[wtbcrna, MSN, DNP, CRNA]

I'm allergic to citrate, in blood drawing tubes. My platelets clump together and my CBC comes back with too few platelets. I never want to think I'm ill again like that. It was simple enough when the hematologist figured it out, but was way scarey at first. It's written all over my chart at my drs.

This should be real interesting if you ever have to get a blood transfusion since PRBCs units have citrate in them. I think I would goto to an allergist and get further testing on that one.

[LisaDNP]

During one of my clinicals I had a chance to shadow a nurse in the PACU. The nurse asked the patient if she had any drug allergies, she said that she was allergic to ACE-Is; the nursed asked what happened when she took them and the pt said "they make me cough." The nurse said immediately that was a typical reaction to an ACE-I, the pt's response was "Well I told my doctor and he said I shouldn't take it anymore." I don't know if there was a different reason for the pt to stop taking the med, but it was very eye opening to me as a student to see the need to educate pts on the meds they are taking and teach them the difference between an allergic reaction and a side-effect.

I agree, if every side effect is counted as an "allergy" then real allergies may be over looked.

Hey Kerry,

While an ACE cough is not an allergy it is a very annoying side effect some patients have from taking ACE-I. Another class of medication should be prescribed for HTN if an ACE causes a cough.

[Asystole RN]

To some of those who say, "You can't be allergic to potassium or such and such drug, doesn't make sense???"

You have to consider that many times it is not the drug itself that the patient is allergic to but the binders, preservatives, coatings, coloring, and anti-caking agents used in the manufacture of those drugs.

I have had patients that were allergic to the brand name of the drug but not the generic or visa versa just do the the different manufacturers using different additives.

Just an FYI.

[eriksoln, BSN, RN]

To some of those who say, "You can't be allergic to potassium or such and such drug, doesn't make sense???"

You have to consider that many times it is not the drug itself that the patient is allergic to but the binders, preservatives, coatings, coloring, and anti-caking agents used in the manufacture of those drugs.

I have had patients that were allergic to the brand name of the drug but not the generic or visa versa just do the the different manufacturers using different additives.

Just an FYI.

It was IV.

Unless she was allergic to D5 1/2...................................well.............you know.

The theory was it burned no matter what was done (run it slow, ice, even pain meds) and she hated it so (like saying you are allergic to tomatoes at Denny's I guess) she just said she was allergic in hopes of the doctor finding a different way to solve the problem. She half heartedly admitted this.

[mamamerlee, LPN]

WBTCRNA - - I was given Versed just before having an outpatient bunion reduction. I never even dozed, I can tell you everything that happened, and, even worse, I cried uncontrollably through the entire procedure. People in the waiting area could hear me, including my husband. He became very nervous and upset that I was crying so hard.

Even if it is not an allergy, I do not ever want to have it again. NEVER.