Patients who "really" are allergic to NSAID's A story

[GeriatricSunshine]

This is a story I think all ER nurses need to hear. I do work in healthcare. I have aspirin sensitive asthma and I cannot take ANY NSAID's. I went to the ER with a migraine.I was diagnosed with them about 5 years ago.Thankfully I have had very few.

I went into the ER throwing up, sensitive to light and basically almost going crazy from the pain. When the nurse came in I told her and she gave me an ice pack and walked away.

The doctor was in the hall and I heard the nurse and him talking.I clearly stated I could not take NSAIDS. I heard the nurse say I was "another migrainer allergic to NSAID's" I didn't hear anything else.

The nurse came in and hooked up an IV she said that she was giving me something for pain and nausea.I thought, ok she knows what she is doing.

30 Minutes later I "came to" I had had an anaphylactic reaction to Toradol. I turned blue, my throat closed up and I blacked out.

I suggest that nurses never "assume", I almost died because someone didn't believe me.

[Multicollinearity, BSN, RN]

I have a mild case of Samter's Triad. Samter's is a combo of three things (triad). 1) Allergy to aspirin and cross reactivity with NSAIDS. 2) Nasal polyps. 3) Asthma.

I haven't been in an ER or needed pain medication for 12+ years, but so help me G-d if I were, and they gave me an NSAID despite me explaining my allergy, there would be hell to pay. But then I'm just an uppity student.

Here's a description of Samter's Triad: http://www.answers.com/topic/samter-s-triad

[NRSKarenRN, BSN, RN]

Thanks for the link re Samter's Triad---i'd forgotten about it.

[Martibear]

No you aren't an "uppity student", we've all been students. Fortunatly we don't all have allergies to NSAIDs. I couldn't imagine not being able to take my motrin when needed! I think people who have been given meds when allergies are known should REALLY take further actions! People that honestly have NSAID allergies are sterotypically given the "drug seeker" nickname but is sad. It is really sad that nurses, ER nurses or what not still give medications that people state they are allergic to. I DO see my share of known "drug seekers" but still would never, never NEVER give a NSAID!!!

[Multicollinearity, BSN, RN]

Actually I think I am an uppity student, but that's another topic for another thread LOL.

[nurse_clown]

about two weeks ago, my hubby had chest pain and was having trouble breathing. he was a perfectly healthy guy but he's a heavy smoker. i had to call 911 because he passed out. the ambulance attendants were very cruel. they said he was hyperventilating and told him to slow his breathing down. they asked me to find his health card. i did but when i returned, one of the attendants was in my kitchen searching through the cupboards, drawers and shelves. i guess she was looking for drugs or something but i don't know why because we don't do drugs and he doesn't take regular medication. anyway, they made him walk to the ambulance. they told the triage nurse he was "hyperventilating". nobody saw us. not even a nurse to assess him. so we left and went to the urgent care unit at another hospital. they did blood test, x-ray, you know, a lot of testing etc. etc. turned out he was having angina pain. his cardiac enzymes were abnormal and so was his ekg. i'm not a cardiac nurse, i work in oncology. i know my hubby very well and he did not look well. i'd hate to see what would've happened if we stayed in the er. i was not very happy about that. i was in my bed clothes so no one would take me seriously. i didn't get a good feeling about that. anyway, i lodged a complaint against the ambulance (who apparently was an advanced paramedic) attendant who felt compeled to search our house and they have launched an investigation. she was even rumaging through my daughter's room!! it didn't even occur to me that she was searching for drugs. i don't understand why she'd do that if i told her that he wasn't taking any medication. she grabbed my vitamins out of the cupboard and started shaking them. i told her they were mine.

i'm not sure why the triage nurse believed their story. i was standing right there. his blood pressure was 202/105. his o2sats were 81%. it was the weirdest experience in my life how we were treated. i don't know why er nurses get a bad rap. i know it's very very busy and they try their best. an error was made. they assumed my husband was some drug user who was high on cocaine and treated him like that. they probably thought i was some "crack head" because i was in my bed clothes (flannel pj's) now he has to carry nitro around with him everywhere and he's going to a lot of diagnosting testing. now i have to drive him 25 km to another hospital for proper treatment because i'm afraid that if he really does have a heart attack, the ems wont treat him. i was truly scared when he passed out. it's scarey when someone you love who is normally strong and healthy, complain of chest pain and says he is having trouble breathing, and pass out. i thought he was dying. very scarey.

[NurseeTee]

I would never ever give something that someone said they were allergic to. I don't need that over my head IF something were to go wrong. Better safe than sorry - if they say they are allergic, it's up to the doctors to order something appropriate.

Funny story though...there was a patient on our floor once whose patient care summary printed up with an allergy to alcohol. Reaction? "Dizziness".

[UM Review RN, ASN, RN]

I've had some doozies of allergic reactions in my time. Not fun. Now add being sick or in pain on top of that, and I'd be livid. If I actually told the administering nurse that I was allergic and she gave the med anyway?

No mercy.

To me, telling someone I'm allergic to any medication constitutes a REFUSAL to take that med, no matter what the "reaction" is. So that giving the medication crosses the line into Patient's right to refuse any medication, test, or treatment.

And Nurse Clown, I would definitely keep complaining all the way up to the top. The way your husband was treated was horrible! I do hope you can get some resolution and can be assured of getting proper, timely care without such judgmental attitudes and frightening delays in treatment in the future.

[lpnstudentin2010, LPN]

I am a nurse in the ED & I don't believe I've lost my empathy or compassion. When you see people day after day seeking narc's & saying they have a NSAID allergy you do become a bit "hardened" to certain situations. I would NEVER give any med, even to a "drug seeker" if they stated they were allergic to that med. That is very unfortunate that you had such an awful, scary experience GeriatricSunshine. All ED nurses are not that way, I would have definatley spoken to a Unit Director or someone about that situation! Something like that should never have happened. Also I express empathy & compassion to my patients I see in the ED. Why do ED nurses get such a bad rap?

I love ER nurses. I am a recurrent patient in many areas of a hospital. I had been to the ER of my (as i like to call it) hospital. I was going for some checkup (dont remember what) and an ER nurse who was going toward the ER said "O you are not coming here are you?" she was really conserned. Another time i WAS in the ER she was getting off shift and when walking past a room saw either me or my name on a chart or something...she came in and stayed with me while i was there.

Also this scares me that this would happen. As a patient and someone alergic to pain meds that is given after surgery for pain (thank god for new meds) this is scary. I only get a rash but it could be worse and if it was then i would not be happy if this was me.

[smk1, LPN]

THis thread is truly frightening to me as a potential patient. I just assumed that when you stated you have an allergy to a certain drug, that drug would automatically NOT BE GIVEN! Who in the world do those people think they are playing russian roulette with someone else's health? THese people deserve SEVERE consequences for their actions. As someone with drug allergies myself, reading this made me scared and madder than a hornet!

[Multicollinearity, BSN, RN]

I can only attribute it to ignorance + arrogance = dangerous practice. I'm sure that a nurse who gave an NSAID after being told of the allergy would blanche upon being informed of the existance of Samter's Triad.

Frankly, I find it to be a form of assault.

[rjflyn, ASN, RN]

The key is accurate documentation of a persons allergies. We tend to hurry and just write down what the patient says they are allergic to and go no further. We really should be documenting what a persons specific reaction is. Take the original posters case, more than likely this was not done and NSAIDs was all that was documented. Pretty vauge if you ask me. Personally I would have asked what drugs specificly are you allergic to and what kind of reaction have you had. To go further we need to teach the patients the same- that if the nurse or doctor does not ask you refuse medicatons until it is done.

Rj

[clee1]

I'd sue the everlovin' SNOT out of them; The MD, the Nurse (personally) AND the hospital.

This kind of stereotyping of people d/t their c/o's and statements is just plain wrong! Until they have to pay the price for their insufferable ARROGANCE, they'll never learn their due lesson.