Questionable Allergies?

Trauma Columnist · May 23, 2006

Yep - all the time. I just put it down and go on.

Antikigirl, ASN, RN · May 23, 2006

Yes, in fact...getting the reaction to any allergies is part of the assessment process and should be documented as such.

I have people that are allergic to certain medications that a doctor feels is totally necessary if it can be given...and they look for the type of reaction to see if it is bad enough for withholding treatments...most times we can premedicate for certain s/sx and still give the med!

So document the reactions...I always ask what type of reaction they get and write it down!

pricklypear · May 23, 2006

Well, there are allergies, and there are adverse reactions. Most people don't know the difference, and it doesn't really matter. Being "allergic," to most people just means it causes some kind of unpleasant reaction.

My personal favorite: "I'm allergic to Go-Lytely - it gives me terrible, watery diarrhea." :lol2:

Or - "epinephrine makes my heart race"

Creamsoda, ASN, RN · May 23, 2006

Haha, ive heard some strange ones.

Had a patient who on the chart it said allergic to morphine, so we werent sure what pain meds to order. So we asked her what kind of reaction she has, and she said that it "gives me nightmares". Sorry lady, thats NOT an allergy.

rjflyn, ASN, RN · May 23, 2006

Generally it is easier for the patients if the keep medications they are allergic to and have undesired reactions to in the same class. As one other poster noted its our job to ferret out the details. As an example myself for instance am not alleric to any medications but state Biaxin and e-mycin's due to the severe exacerbation of my GERD symptoms if I take them- my doctor said to just call them allergies.

Also as another poster mentioned in certain instances a patient needs to recieve a substance they are truely allergic to. The biggest example here is the allergy to IV contrast dye. One cant do a cardiac catheterization without it. These patients get premedicated for various lengths of time with steriods and benadryl.

RJ

Multicollinearity, BSN, RN · May 23, 2006

I answer yes to allergies with Phenergan, but then quickly explain that it's not an actual allergy but rather a very bad reaction. When I was given Phenergan in an ER once for nausea due to pneumonia and promptly discharged I had a bizarre reaction. I got dizzy and strangely restless. I almost climbed over the car seat it was so bad. I can't quite explain it. Anyway, I have no problems with Compazine and indicate that.

Could someone clue me in about Phenergan? I'm a student. I have heard RN's refer to Phenergan as problematic for "the little old ladies" but I don't know specifically what they meant and why?

Gompers, BSN, RN · May 23, 2006

I believe I'm allergic to CT contrast, but two radiologists have tried to tell me otherwise. Okay, fine - if they think it's just a bad reaction, that's fine with me, but I just need them to KNOW about it before they give it to me!

The first time I had the contrast, my tongue and throat started itching as soon as they pushed the IV contrast. I flagged down the CT tech and started freaking out a bit. She got the radiologist, who told me it wasn't an allergic reaction if I wasn't having trouble breathing. I told him that itching in my throat and tongue brought on by the contrast was enough of a reaction to me, and I was scared swelling would come next. I pictured myself getting an emergency trach in the middle of the CT room! He basically told me he was humoring me, but that he'd give me IV Benadryl. As soon as that was flushed in, the itching went away immediately.

The next time I needed a CT with contrast, a different radiologist was working. I explained it to him, and he said he'd give me half a dose of contrast and watch me. I still got itchy, but he said to just wait and see how bad it got. It went away a short while later. The last time I had the procedure done (darn kidney stones!) I premedicated myself with 50mg of Benadryl by mouth and didn't have any itchiness.

Just in case, whenever I have a scan done, the techs won't do it without a radiologist very close by. They also don't do my scans in the basement - they put me in the CT room that is just off the ER bay.

mandana · May 23, 2006

I believe I'm allergic to CT contrast, but two radiologists have tried to tell me otherwise. Okay, fine - if they think it's just a bad reaction, that's fine with me, but I just need them to KNOW about it before they give it to me!
The first time I had the contrast, my tongue and throat started itching as soon as they pushed the IV contrast. I flagged down the CT tech and started freaking out a bit. She got the radiologist, who told me it wasn't an allergic reaction if I wasn't having trouble breathing. I told him that itching in my throat and tongue brought on by the contrast was enough of a reaction to me, and I was scared swelling would come next. I pictured myself getting an emergency trach in the middle of the CT room! He basically told me he was humoring me, but that he'd give me IV Benadryl. As soon as that was flushed in, the itching went away immediately.
The next time I needed a CT with contrast, a different radiologist was working. I explained it to him, and he said he'd give me half a dose of contrast and watch me. I still got itchy, but he said to just wait and see how bad it got. It went away a short while later. The last time I had the procedure done (darn kidney stones!) I premedicated myself with 50mg of Benadryl by mouth and didn't have any itchiness.
Just in case, whenever I have a scan done, the techs won't do it without a radiologist very close by. They also don't do my scans in the basement - they put me in the CT room that is just off the ER bay.

I'm no doctor, but that sure sounds like an allergy to me.

I think I'd stick with the self-medicating ahead of time!

Amanda

Marie_LPN, RN, LPN, RN · May 23, 2006

I've had a LOT of people attempt to convince me that i'm not allergic to a certain type of tape, that i'm allergic to all adhesives, till i finally get annoyed, put a piece of the bad tape on, and the next day show them the oozing blisters where it used to stick.

Multicollinearity, BSN, RN · May 23, 2006

I've had a LOT of people attempt to convince me that i'm not allergic to a certain type of tape, that i'm allergic to all adhesives, till i finally get annoyed, put a piece of the bad tape on, and the next day show them the oozing blisters where it used to stick.

Marie, do you mean that you are allergic to ALL adhesives or just one type?

I get the blisters but without oozing with my hormone patch. My doc says it is an irritation from the adhesive, but not an actual allergy. I tend to trust this doc more than most. He said to hold the patch in the air for 45 seconds after removing the backing then apply and the irritation would be reduced. It has for me, somewhat. Oh, and yes, I do have little patch-shaped red blisters all over my rear all the time because I must use the patch and not oral hormones.

Marie_LPN, RN, LPN, RN · May 23, 2006

I'm allergic to a particular tape, but people are always trying to tell me i'm allergic to adhesives. Others tapes don't bother me, just one kind