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👍

493 Upvotes

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572

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.

431

u/[deleted] Feb 02 '25

Nice person and family? CANCER

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 …

59

u/descendingdaphne RN Feb 02 '25

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

38

u/VioletEMT EMT Feb 02 '25

But did he finish the fence?

56

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