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

85% Upvoted

369 comments sorted by

View all comments

55

u/the_taco_belle Feb 02 '25

They’re always allergic to every pain med “except the one that starts with D!”

Dacetaminophen administered promptly, works great when you tell them it’s a new one they wouldn’t recognize

13

u/reggae_muffin Feb 02 '25

“Oh you need the one that starts with D? No problem. Have some diclofenac.”

5

u/Megaholt Feb 03 '25

If I could manage to get my grubby little mitts on diclofenac patches, I would be the happiest little bitch on earth.

-15

u/C_Wrex77 Feb 02 '25

It does suck for those of us that do have a real anaphylactic rxn to all NSAIDs (except Tylenol and COX2 inhibitors), and seizures with Tramadol. I'm always looked at as suspect when I list out my allergies

9

u/eachdayalittlebetter Feb 02 '25

how did you get to know about your allergy? sounds horrible that one is in pain, takes pain med and next thing you see is they are suffocating

0

u/C_Wrex77 Feb 02 '25

It started with what my doctor called a "pseudo-anaphylactic" reaction to ibuprofen when I was a teenager. When I tried Voltaren in his office, I had the same rxn. But acetaminophen and COX2 inhibitors don't evoke the same rxn. So, he suggested I just say I'm completely allergic as to avoid any possible danger.