r/emergencymedicine • u/Asleep-Palpitation43 Nurse Practiciner • Feb 02 '25

Advice Allergy Olympics

Is it wrong that if I see a patient has more than 10 allergies I IMMEDIATELY assume she's (bc it's always a she) a psych case?

In 24 years I've never been wrong.

You'll never read this in a textbook but add it to your practice today and thank me later👍

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571

u/AppalachianEspresso Feb 02 '25 edited Feb 02 '25

Dyed hair over the age of 30? Borderline personality disorder.

Patient pulls out the cell phone charger in the room? They aren’t having an emergency.

Seizure + stuffed animal upon arrival? PNES

Non English speaking belly pain + never in the department before? Appendicitis or cancer

Contrast allergy? Liar or actually has the PE and that VQ will be equivocal.

Psychotic malingering patient that is there everyday? Will one day actually have badness someone will not believe, will die, someone gets sued

John Boy who comes in drunk every day will be dangerously hypoglycemic or have a head bleed inevitably.

If you’re ever going to have a bad outcome, it’ll be in the last hour of your shift when you’re trying to leave.

The laws of ER.

104

u/the_taco_belle Feb 02 '25

Or pregnancy for the non-English speaking belly pain. And never any prenatal care.

110

u/An_Average_Man09 Feb 02 '25

Had a 17 year old non English speaking patient come in with belly pain, get placed in the equivalent of our urgent care section of the ER. PA comes out and says “this bitch is in labor.” Lo and behold she’s was in fact in labor and didn’t know she was pregnant. Baby birthed 30 minutes later.

29

u/nurseymcnurserton25 Feb 02 '25

Same, but she was 14😩

2

u/[deleted] Feb 04 '25

“This bitch is in labor.” 😂

33

u/the_taco_belle Feb 02 '25

My first field delivery was a non-English speaking pt, we were dispatched for non-emergency abd pain. Husband tried to translate (very poorly) and initially I was thinking UTI as he acted out lower abd/back pain, until I took off her massive puffy winter coat and saw the belly. Baby delivered full term and healthy along the highway, no prenatal care, hospital had no record of her. Fortunately both (to my knowledge) were fine

60

u/Edges8 Feb 02 '25

had a non English speaking woman with belly pain deliver from her wheelchair while wheeling back to triage once. I'll never forget the splat as it hit the ground

22

u/[deleted] Feb 02 '25

Define “it”

36

u/OverallEstimate Feb 02 '25

Giblets

4

u/pushdose Nurse Practitioner Feb 02 '25

💀

1

u/crash_over-ride Paramedic Feb 03 '25

Not what I wanted to read while eating yogurt. Thank you for that.

2

u/Edges8 Feb 02 '25

he/she

12

u/DocBanner21 Feb 02 '25

He/she/it, pronounced in the south as Heee Shiiiiitt.

10

u/AppalachianEspresso Feb 02 '25

Definitely an ectopic.