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👍

497 Upvotes

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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.

425

u/[deleted] Feb 02 '25

Nice person and family? CANCER

329

u/pyyyython Feb 02 '25

Colossal douchebag and general menace to society? INVINCIBLE

44

u/SunshineSugarLips Feb 02 '25

As Lewis Black said, “The good die young but pricks…live forever”

30

u/Asleep-Elderberry260 MSN, RN Feb 02 '25

Ugh yes

19

u/treylanford Paramedic Feb 02 '25

Holy shit, this is spot on.

4

u/harveyjarvis69 RN Feb 02 '25

They live, forever.

172

u/[deleted] Feb 02 '25

Farmer who hasn’t seen a doctor, ever, and has to get back home to finish his work but felt off for a week …. Trop over a million, Huge anterior stemi, ekg with a widow maker that makes your jaw drop, and you still have to convince him that the pain is real and his heart is about to explode. But he’s got work to do so …

57

u/descendingdaphne RN Feb 02 '25

Just in case you haven’t seen Glaucomflecken’s take on farmers 😂

37

u/VioletEMT EMT Feb 02 '25

But did he finish the fence?

54

u/descendingdaphne RN Feb 02 '25

“I’m here, ain’t I?”

1

u/Megaholt Feb 03 '25

Call Texaco Mike and tell him to fire up the fan boat!

2

u/rache6987 Feb 02 '25

Oh, this is hilarious!! Can't wait to show my coworkers

39

u/Stepane7399 Feb 02 '25

My agency works with a lot of farmers. One of our clients came in walking with a cane a few weeks ago. He told my co-worker that he’d had surgery a tumor removed from his brain just days before. Like, how is he getting along so well? He’s well into his 70s.

18

u/JHRChrist Feb 02 '25

I think farmers just prove that constant physical activity & a determined mindset throughout your entire life makes you sturdy as hell and prevents an insane amount of health issues. My husband and his family (all farmers) rarely eat a vegetable but are all fit and live into their 90s. They’re legitimately inspirational to me.

7

u/Stepane7399 Feb 02 '25

Oh yeah. They, I feel, have to live longer than average. Many of our farmers are up there in age and still plugging away.

24

u/Gomzon Feb 02 '25

Someone’s gotta feed them hogs!!

24

u/[deleted] Feb 02 '25

Our local council got onto the urgent care department due to the number of GSWs coming in related to the level of local gang activity. Turns out it was almost all farmers that had shot their own toes off

62

u/Screennam3 ED Attending Feb 02 '25

Can confirm, we are okay people and our toddler has cancer

31

u/organicvibes ED Attending Feb 02 '25

Man, I’m so sorry to hear that. Sending love and good wishes your family’s way. Really hope your toddler pulls through.

11

u/Nurseytypechick RN Feb 02 '25

Fuck cancer. All the good juju to your baby and your family.

10

u/Burnt-Out-Chica Feb 02 '25

I’m sorry 😞

1

u/Megaholt Feb 03 '25

Oh God I’m so sorry. Sending love to you & your family. Give your little one lots of hugs for me.

8

u/ObiDumKenobi ED Attending Feb 02 '25

The saddest of all the ER laws. It never fails, and I hate having to deliver the news to them but they remain so nice about it

8

u/SolitudeWeeks RN Feb 02 '25

And the prognosis is not good.

2

u/Megaholt Feb 03 '25

This was my husband back in March/April. Came in for a right MCA stroke. Found the PFO and stage 3A metastatic testicular cancer as a result of that.