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.
Had a patient tell me he was allergic to oxygen once...
Had a parent tell me that. The Babe was a left heart and docs did not want sats going above 90%. Parents were young and did not understand. So they said their son was allergic to O 2
No, some of those are not allergies...okay...maybe none of them are. But devil's advocate...once you have a real allergy, you may shy away from anything that gives you a small bump in the road. That said, non-medical people don't always understand what a true allergy is...granted! lol
I've had a few patients with angio edema so bad that they end up intubated until we can get the swelling down to normal size.
Um yeah... This is an obstructed airway, just like with anaphylaxis. A mite different than benadryl making one sleepy.
A while back I had a pt who was already intubated and got angioedema after lisinopril. Her tongue was so swollen she got pressure ulcers from the ETT (we rotate it q 2 hrs, and we did what we could, but her tongue was so huge the ETT didn't have much ROM.) Her teeth were also cutting into her tongue. I tried to stick 2x2s in between her teeth and tongue, but couldn't get ANYTHING in there--not even 1 ply.
I usually stay pretty cool at work, but my eyes teared up then. Of course part of that sad feeling was this woman happened to be one of those who needed comfort care, but her next-of-kin didn't agree.
I usually stay pretty cool at work, but my eyes teared up then. Of course part of that sad feeling was this woman happened to be one of those who needed comfort care, but her next-of-kin didn't agree.
Why I will never work ICU. You're a better nurse than I.
We had a patient once who developed angioedema at home in the early morning hours. Rather than calling 911 or even going to an ER, he drove himself to the outpatient clinic at my hospital. My hospital has inpatients, and a 24h hospitalist- but no ER, and no 24h OR staff. He sat in the clinic waiting area and waited for clinic to open- 2 hours from when he arrived.
A housekeeper found him blue and unconscious about an hour after he arrived and called a code. The hospitalist gave epi and high dose steroids and tried to tube him to no eval.
Thankfully, head and neck surgery loves to round on their patients obscenely early, and they responded as well and criched him on the clinic waiting room floor, then took him to OR to clean it up once they had an airway.
He went to ICU for a few hours post op then came to us. His trach was removed within 48 hours and he was discharged within 72 hours. He was on no high risk meds for angioedema, but they got rid of any meds that he could possibly do without. They never did figure out what caused it as far as I know. They sent him home with an epipen and a rescue medrol dose and instructions to call 911 if his tongue so much as tickled.
We had a patient once who developed angioedema at home in the early morning hours. Rather than calling 911 or even going to an ER, he drove himself to the outpatient clinic at my hospital. My hospital has inpatients, and a 24h hospitalist- but no ER, and no 24h OR staff. He sat in the clinic waiting area and waited for clinic to open- 2 hours from when he arrived.
A housekeeper found him blue and unconscious about an hour after he arrived and called a code. The hospitalist gave epi and high dose steroids and tried to tube him to no eval.
Thankfully, head and neck surgery loves to round on their patients obscenely early, and they responded as well and criched him on the clinic waiting room floor, then took him to OR to clean it up once they had an airway.
He went to ICU for a few hours post op then came to us. His trach was removed within 48 hours and he was discharged within 72 hours. He was on no high risk meds for angioedema, but they got rid of any meds that he could possibly do without. They never did figure out what caused it as far as I know. They sent him home with an epipen and a rescue medrol dose and instructions to call 911 if his tongue so much as tickled.
That Einstein is lucky he's not a vegetable from anoxic brain injury.
We had a patient once who developed angioedema at home in the early morning hours. Rather than calling 911 or even going to an ER, he drove himself to the outpatient clinic at my hospital. My hospital has inpatients, and a 24h hospitalist- but no ER, and no 24h OR staff. He sat in the clinic waiting area and waited for clinic to open- 2 hours from when he arrived.
A housekeeper found him blue and unconscious about an hour after he arrived and called a code. The hospitalist gave epi and high dose steroids and tried to tube him to no eval.
Thankfully, head and neck surgery loves to round on their patients obscenely early, and they responded as well and criched him on the clinic waiting room floor, then took him to OR to clean it up once they had an airway.
He went to ICU for a few hours post op then came to us. His trach was removed within 48 hours and he was discharged within 72 hours. He was on no high risk meds for angioedema, but they got rid of any meds that he could possibly do without. They never did figure out what caused it as far as I know. They sent him home with an epipen and a rescue medrol dose and instructions to call 911 if his tongue so much as tickled.
Appreciate the story...feel bad for the patient. He was very lucky though...that's a "happy" ending. Thank goodness for the head & neck peeps! Yay!
CamillusRN, BSN
434 Posts
Allergic to oxygen: "It makes my nose dry"