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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u/AnythingWithGloves Feb 02 '25

I was a school nurse for about 7 years at a big boarding school for remote Australian Indigenous kids. Not one single one of those kids had an allergy. I moved states and picked up a few casual shifts at a big posh private boarding school where there was a wall covered in photos with kids and their allergies. Guaranteed the ones with the most allergies had a super intense over involved mother.

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u/deferredmomentum “how does one acquire a gallbladder?” Feb 02 '25

And let me guess, the most common one was “the color red”?

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u/Asleep-Palpitation43 Nurse Practiciner Feb 03 '25

That's probably a big part of it. The other part, of course, is indigenous people generally don't access modern medicine

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u/AnythingWithGloves Feb 03 '25 edited Feb 03 '25

They definitely access western medicine. The first 15 years of my career was spent working with remote Indigenous folks in schools, clinics and hospitals. The past 10 years have been in regional centres where indigenous peoples are still disproportionately represented in the health system.

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u/Asleep-Palpitation43 Nurse Practiciner Feb 03 '25

Accessing healthcare disproportionately should equate to a disproportionate # of allergies. You can't be allergic to a drug, vaccine, or treatment modality you've never had.

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u/AnythingWithGloves Feb 04 '25

Over access to healthcare leads to problems as well. Kids dragged into the doctor for every niggle or little thing by paranoid parents are over diagnosed with issues as well. Parents will shop around for an ‘answer’ (sometimes rightly so). I am thinking about parents who restrict diets and medications because of reactions which fall inside the realm of normal or expected side effects and still say they are allergies.

We ran extensive school based vaccination programs. It was never the Indigenous kids who fainted or became hysterical and then claimed it was a vaccine side effect.

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u/Asleep-Palpitation43 Nurse Practiciner Feb 05 '25

Names sense. Freaked out moms make freaked out kids