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/heytheremoustache ED Attending Feb 02 '25

Seen that as a listed allergy. Along with "fresh fruits & veggies" in a 250 kg man.

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u/Heavy-Waltz-6939 Feb 02 '25

Ok so I never believed this either until a coworker told me it was only fresh fruits and vegetables. If they had cooked either, they were totally ok. Apparently it was a protein that was denatured during cooking. She also proved it to me over the course of a few weeks by eating small bits of fruit and I watched a rash develop in real time. I used to think it was the same BS but there may be some truth to that one in some patients.

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u/dbbo ED Attending Feb 02 '25

I don't think anyone doubts the potential for food protein induced allergy. The problem is the allergy section of the patient chart is intended for severe adverse reactions that might alter care decisions.

In reality, when people list every single thing that ever gave them a rash or an upset tummy, it just creates more warning boxes for me to click through before I can treat them.

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u/Heavy-Waltz-6939 Feb 02 '25

Of course, agree with that, especially when they list side effects to medications that are commonly known