So we are switching to a new computer system at work. Not everything will carry over and we have to do some manual entry of certain things. Allergies is one of the items that falls onto that list. We are able to print out that info from the old system so we can put in onto the new, so the information has all been verified at some point by nursing staff or physicians. Which also means at one point it was all ENTERED by someone with a license or someone who is supposed to have enough medical knowledge to do such things.
Some of the "allergies" (complete with reaction, since it's a required field):
Nitroglycerin---"it makes my ears ring"
Tetnaus shot---"my arm hurts after I get one"
E-mycin---"diarrhea"
iron supplements---"makes my BM dark"
and my favorite:
Epinephrine---"makes my heart race"
Seriously?! I can shrug and say "meh" to many things, but truly?! WHY do trained professionals DO this? Go ahead and put some of these things down and attribute the poops after an ABX to a side effect, but not an ALLERGY. Yes, side effects, intolerances and allergies are all options to choose from.
I am not even entering the epinephrine "allergies", nope, not doing it.
I saw an epi "allergy" recently as well. The reaction also stated that it caused her heart to race. (eye roll)
Also, I'm sensitive to iodine but I don't say that I have an allergy to iodine because, naturally, I would be dead then. I have a reaction to seafood, shellfish, topical iodine, and contrast dye. I've recently been told that it is something in all these things that I am truly allergic to. Any thoughts?
Shellfish allergies are d/t invertebrate tropomyosin and aren't necessarily connected to contrast dye/iodine. The iodine allergy was debunked a billion years ago I don't know why it persists.
Specializes in Nurse Leader specializing in Labor & Delivery.
If a patient breaks out in erythema multiform, that should definitely be listed as an adverse reaction. That not just a run of the mill rash. I've taken care of kiddos who broke out with it after antibiotics; it's an angry, blister like lesion that is very painful and becomes infected easily.
Definitely wasn't that. And it wasn't hives, either. It was definitely a typical amoxicillin rash (google the phrase, look at the images, that's what it looked like) but yeah, it was all over his body, it caused facial swelling and it was itchy.
It also blows because it severely limits things in certain instances. I was on a unit for my first L&D clinical and a patient was allergic to a medication she really would have liked to have but was unable to due the allergy. I wonder if, however it was determined that this was a true allergy, this had really been discussed and explored, she wouldn't have been suffering as much as she was until the anesthesiologist order expired. Because of instances like this, I'm extremely skeptical of a patient's stated allergies, especially when they tend to be a complainer and are allergic to everything under the sun (it's almost like you have to go get Midas himself to touch the IV tubing for the patient....until they tell you they're allergic to gold as well!!!).
I get there are people with this kind of bad luck and are allergic to many things but usually they are more willing to work with it than essentially use it as a reason to make things harder for everyone around them (particularly the PP who mentioned patients saying docs 25-40 years ago told them never to take/use a certain thing).
Shellfish allergies are d/t invertebrate tropomyosin and aren't necessarily connected to contrast dye/iodine. The iodine allergy was debunked a billion years ago I don't know why it persists.
Because just....in....case...... Like pro athletes, some docs are just inexplicably superstitious.
Specializes in Med-Surg, OB, ICU, Public Health Nursing.
I can eat most shellfish, including shrimp. I got really sick on lobster once and was never sure if it was bad or if it was something else. (severe nausea/vomiting). After having anaphylactic reaction to contrast, I never tried the lobster, just in case.
However, it is not fun to be semi-awake; hear the code blue, realize anesthesia is bagging me via mask and hear the numbers heart rate 160, bp 60.
I wish it could be clarified if it is a specific contrast, because I have had surgery because they wouldn't do contrast.
I was taught in school that an allergic reaction was either integumentary or respiratory. Anything else was just an adverse reaction or a side effect.
Ok, here we go:
- "pure" anaphylaxis or primary systemic reactions. Rare, thanks God. Associated with food allergies and high circulating IgE. Without treatment, cause death within 3-5 min from heart arrest due to total circulatory collapse and hypovolemic shock. Respiratory and other symptoms just do not have time to develop.
- GI allergic reactions, which go anywhere from failure to thrive and resistant to treatment B12 deficiency (allergy to gluten) to "allergic cholera" with boody diarrhea, vomiting and cramps (infantile form of cow's milk protein intolerance associated with high level of IgA). Due to "sitting" nature of IgA, may have no systemic, respiratory and skin components at all, although usually associated with asthma, exzema and such. Diagnosis requires biopsy.
- GU allergies (cystitis, interstitial nephritis). Often caused by chemicals/drugs but resistant to treatment, in urine/kidney biopsy will be a lot of eosinophiles. Uncommon but happens more often among females and young children. Can cause CRF if left untreated/continuing contact.
- common among young children: subtle forms of respiratory rhinitis masquerading as not too acute, rather chronic/recurring otitis media. Success of treating many cases without antibiotics actually caused not by "not working with viruses" but by removing the child from either dusty surrounding (daycare) or contact with antibiotics themselves. Increased number of eosinophiles in blood/fluid, h/o the same among parent are the clues... then just stop your d***ed antibiotics and wait for a couple of weeks.
I know a couple of more things but I am back from shift and just too d*** tired.
Um, yeah, it's iodine. All of those contain significant amounts of iodine. Iodine allergy is real. ETA: referring to KatieMI's excellent post, I ought to have expanded on this to explain the complexes. Fact remains, though, that consuming those things which contain iodine bound to proteins results in allergic symptoms. I didn't know about the pink coloring in stuff being povidone, though-- thanks, that's interesting.
Not all allergies are fatal, so saying you're not really allergic to something because otherwise you'd be dead is nonsense. :)
I brought this up with my clinic's MD and ARNP today. They both told me it was not possible to be allergic to iodine. I get so many different responses to this, and as you can see from the post everyone has something different to say regarding the matter.
.thumb.gif.9c97ffa9443a5f22ff38e1eac832292c.gif){kind=avatar}
Like pro athletes, some docs are just inexplicably superstitious.
Oh'Ello, BSN, RN
226 Posts
Shellfish allergies are d/t invertebrate tropomyosin and aren't necessarily connected to contrast dye/iodine. The iodine allergy was debunked a billion years ago I don't know why it persists.