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.
Getting all huffy about how colleagues choose to address these things seems more self serving to me than actually in the patient's best interest.
Actually, "getting all huffy" when licensed people who (should) know what they're doing do their job incorrectly seems like a perfectly logical reaction to me. I get pissy if the person before myself hasn't done their job correctly. That creates double the work for me. I have to take their incorrect information out and then put the correct information in. It'd be a lot easier if people would just do their job correctly the first time.
One cannot be allergic to iodine, as well as to any other chemical element.
Iodine (as well as other chemical elements and other small molecules ) can make chemical complexes with certain proteins in the body, usually with "sitting" IgA or IgE. It is named "haptenization" and causes subclass of allergic reactions. The most common example of it is poison ivy contact dermatitis. The good news is that hapten-related reactions almost never become more severe with time, as opposed to "classical" IgE- mediated anaphylaxis. The bad one is that treatment is the same: avoidance of affecting substances.
You need to watch your pills as well, as quite a few of them colored orange or pink contain povidone as colorant, and povidone is a potent source of iodine.
Thank you for your guidance. You've given me a starting point for my research to find out what I'm *really* allergic to.
Okay, so what are people's thoughts on amoxicillin rashes?
When my youngest was 2, he received amoxicillin and on day 7 or 8, he broke out into an itchy swollen rash over his entire body. In my reading, that seems to be a not-uncommon reaction and not a true allergy. But his physician at the time said "Let's just be safe and put it as an allergy; there are plenty of other antibiotics out there to use." But I don't want to tell him all his life that he has an allergy to cillins if he doesn't.
Amoxicillin rash is generally not swollen and itchy. Sounds more like hives or erythema multiforme. I think your pediatrician made the safest call. There really are plenty of antibiotics out there to choose from.
Actually, "getting all huffy" when licensed people who (should) know what they're doing do their job incorrectly seems like a perfectly logical reaction to me. I get pissy if the person before myself hasn't done their job correctly. That creates double the work for me. I have to take their incorrect information out and then put the correct information in. It'd be a lot easier if people would just do their job correctly the first time.
Meh. If I got irritated for every little thing someone else did incorrectly, life would be pretty miserable. Either fix it or don't, but spending so much time worrying about what other people are doing rather than focusing on your own practice is just a lot of wasted energy. Life is much too short. Save it for the big stuff.
What I've discovered with the epi "allergy" is the fault of a dentist. Pt goes to the dentist, gets some lido with epi, and has a reaction. Dentist tells pt "you're allergic to epi and can never have it again" so pt believes that. When I tried to explain that the allergy is most likely to the lidocaine and epi is adrenaline that your body produces, I got argued with and told that I was flat wrong because Dr. Dentist said no epi. Did I mention I was an allergy nurse and we rx epipen/adrenaclick/auvi-q daily? Yeah, we know a thing or two about epi.
Flu shot--allergy to eggs. FYI, it has been proven safe for an egg-allergy pt to receive the flu shot, and only if you've reacted to the flu vaccine itself should you proceed with caution.
I try to clarify the difference between allergy and s/e
My favorite--asking parent if child has any allergies, parent says allergy to PCN, I ask what reaction pt has, parent says they don't know but parent is allergic to it so they keep the child away from it too. So, pt has never had a reaction to it? No.
Specializes in Complex pedi to LTC/SA & now a manager.
IThe MAs at my former PCP insisted on adding codeine & Percocet as allergies to any physical forms I needed completed. It's not an allergy, it's an adverse effect. After one or two doses I get horrible cramping stomach spasms at sphincter of odi due to altered GI anatomy after major surgery. It's not an allergy. It's a known adverse effect. Painful? Absolutely Life threatening? Not at all. It's. Not. An. Allergy.
I can just say no. No reputable medical professional is going to crush up a Percocet or OxyContin & try and inject me with the stuff.
On the other hand, for me Sulfate/sulfacetamides & Demerol cause hives, angioedema, wheezing etc. that's an allergy. But no one needs Demerol. The funny part the same MA that wanted to add codeine & Percocet to the physical form "forgot" to add sulfacetamides (a documented witnessed reaction with an epipen prescribed by that office) because she couldn't spell the word!
Let me see. All my diabetics are allergic to peanut butter. All my muslims are allergic to pork and pretty much everyone is allergic to sunlight/grass/pollen/ or whatever reason they dont want to work outside.
Anna Flaxis, BSN, RN
1 Article; 2,816 Posts
Or maybe they chuckled about it and shook their heads realizing how ridiculous it was.