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.
being a new graduate, i always seem to get the patients that are allergic to TORADOL... with q2 dilaudid in "severe pain" admitted for "weakness." hey doc... patient must have some awesome insurance, huh? :smile.
Jesus. This drives me nuts! I had a patient today who told me he's allergic to aspirin. When I asked him what happens he said; "It makes my stomach hurt." Seriously? God bless America.
Thank to people like this my mom who is truly allergic aspirin and NSAIDS (facial swelling, and hives) a pharmacist over rode her allergy in the system and she got a med she was allergic to.
Thankfully she was ok after she took some benedryl. It just pisses me off that the pharmacist didn't call her directly to ask about the allergy and assumed it was just nausea or the like.
I had a doctor put in an allergy for me due to sweating after taking a med. Known side effect but not an allergy. I just clarify with another provider now that I am not allergic, but the side effect of sweating was intolerable to me.
A couple of years ago I was in and out of the hospital for several months. I was steroids and they were doing accuchecks on me. They gave me aspart insulin for a high blood sugar, and I had a major reaction to it. Within about 3 minutes post injection my heartrate went into the 140's and my bp hit about 210/130, O2 sats droppped into the 80's. Thank god I was on tele. They rushed into my room and rapid responsed me. My doc comes in later and tells me in no uncertain terms to always list insulin as an allergy from now on. I am one of the rare people out there now that are allergic to insulin.
I ended up back in the ER shortly after that with complications and they called in some other doc other than mine. He asks about allergies and I say insulin. He looks at me and says that is impossible. You cannot be allergic to insulin. I immediately kicked him out of the room. People can be allergic to insulin I found out after researching it. He was an idiot if he did not know that.
So now when someone says they are allergic to something, I take it as the truth.
If the decrease in blood pressure that occurs in anaphylaxis dropped your BP to 210/130 then maybe some anaphylaxis is just what you needed.
Since your body produces insulin it is actually pretty unlikely you are allergic to insulin in general, if you have an allergy it is to pharmaceutical insulin preparations, and since they vary it might actually be wise to determine if you are actually allergic and to what specific insulins, since an inability to ever administer you insulin might negatively affect your health at some point.
That is the main reason to properly assess for and document allergies; I think a lot of people don't realize that what they list as allergies could potentially cause them harm by limiting their treatment options in the future, sometimes life-dependent treatment options. In addition, excessive and unjustified labeling of things as allergies can create 'boy-who-cried-wolf' effect, where true allergies which should be taken very seriously, aren't.
I had a doctor put in an allergy for me due to sweating after taking a med. Known side effect but not an allergy. I just clarify with another provider now that I am not allergic, but the side effect of sweating was intolerable to me.
I have my doctor do the same thing with phenobarbital. It makes me puke. Severely. Not an allergy, but not something I really want to do in response to a med.
True story: Little old man told me he was allergic to Lasix. "How unusual - never had anyone allergic to that before" says I.
Little old man, "Yeah, when I take that pill all I do is pee!" When I explained that it was the desired effect, he got agitated and responded, "Why in the WORLD would anyone make a pill like that?"
Specializes in Oncology; medical specialty website.
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.
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.
Specializes in Oncology; medical specialty website.
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!
No words. Well, actually I do have words. Start hiring real nurses (LPN/RN) instead of MAs for doctor's offices. Yes, the doctors will have to pay them more, but the likelihood of this boneheaded move happening is much less.
I guess where this bugs me most is when ACTUAL allergies get downplayed in the giant pile of self-described "allergies". I've seen medical professionals so desensitized to seeing "allergies", that when they hear it's an actual, honest-to-goodness anaphylactic reaction, they almost panic. A little patient education might help shorten the list of "allergies" to actual allergies (vs adverse reactions).
I remember years ago when I was working in Day Surgery, we got this woman who had so many stated allergies it took three allergy bands.
I have this corollary that states that the greater the number of stated allergies, the greater the probability that the patient has a mental health history.
You mean like the patients with allergies to Lasix, tomatoes, MOM , and Tylenol?
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?
I also have a sensitivity to iodine. If I get topical iodine on me, it makes my skin look like someone poured battery acid on it, needless to say, I avoid having iodine touch me like the plague.
I am not allergic to seafood or shell fish in the medical sense of the word allergy. I can eat it without dying, throat closing or tongue swelling. But I have noticed when I do eat either, I do end up breaking out in an itchy rash (more like it flares up my eczema and much worse than a common flare up. Last much longer, affects bigger area and itches much worse than a common flare up). I've never had contrast dye but I'd be a little leary of having it. My doc also said there is some component of iodine that I am reacting to. So, I avoid eating seafood/shell fish, I'll refuse contrast dye if it is ever an issue and I NEVER let iodine touch my skin.
Specializes in Oncology; medical specialty website.
You mean like the patients with allergies to Lasix, tomatoes, MOM , and Tylenol?
I had to try to write as small letters as possible to get them all sown. There were some that I just didn't include; after a while you just give up.
I actually know someone who has an honest-to-goodness gallery to tomatoes. She'll break out in hives if she eats them. That would really stink...I love good tomato sace.
wanttonurse7
14 Posts
being a new graduate, i always seem to get the patients that are allergic to TORADOL... with q2 dilaudid in "severe pain" admitted for "weakness." hey doc... patient must have some awesome insurance, huh? :smile.