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/tturedditor Feb 02 '25

Once had a lady in afib with RVR reported allergies to every rate control medication in our armamentarium. I told her to her face I didn't believe her and we were going to push diltiazem.

She of course did not have a reaction.

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u/Sen5ibleKnave ED Attending Feb 02 '25

My rule is: anyone with more than 10 allergies has no allergies. Anyone with more than 20 allergies has a personality disorder until proven otherwise.

4

u/WriterBren Feb 03 '25

Maybe make some consideration for actual possibilities. I have lupus. I may have an allergy that lasts a month or a lifetime. The immune system loves attacking me for anything different. My allergy list is LONG. Sometimes I let the doctor risk it to see if it is still there or not. Most doctors don't want to try and THEY are the ones that put it in EPIC and I can't take it off.