Allergy Documentation

Getting your allergy list correct is extremly important

An allergic to can be fatal.  But so can witholding a medication  because it is improperly listed as an allergy.  A side effect is not an allergy.  Make sure the allergy list documentation is correct and gives specific details of each allergy.    The chart should indicate which things you are truly allergic to and the specific reaction.  If you find something that isn’t right make sure someone corrects the chart. 

 

Why it is so important to understand the difference between true allergies and side effects?

When you list an allergy on the medical record it will stay there indefinitely.  If you list something you are not truly allergic to then health care providers won’t give it to you, even if it is critical to your health.  For example, you listed Keflex as an allergy because it gave you vomiting or diarrhea.  This is a commonly used penicillin derivative antibiotic (a cephalosporin).  Ten years later you may come to the hospital critically ill with an infection, unable to communicate, and in dire need of a penicillin-type antibiotic. This will still be on your chart.  If the chart does not specifically state what the “allergy” is they may have to give you a second-best antibiotic option.  

What is an allergic reaction?

  • An allergic reaction is an immune response to something your body comes in contact with (doctors and hospitals not included!).
  • We call the thing that causes the allergy an “allergen.”
  • It can be local, a reaction only at the body part which came into contact with the allergen, such as skin contact.
  • It can be generalized, involving the entire body, or multiple parts.
  • True allergies produce symptoms such as:
    • A rash and itching
    • nasal congestion
    • Swelling of isolated body parts such as the face particularly around the eyes, the lips, and the tongue or throat, and less commonly other body parts.
    • Rarely this can include swelling in the intestines, causing abdominal pain.
    • Wheezing or shortness of breath
    • Low blood pressure with severe reactions. 
  • ANAPHYLAXIS- This is a severe allergic reaction that involves at least 2 body systems (skin, breathing, low blood pressure, throat or tongue swelling).  Anaphylaxis starts suddenly after exposure.  It is most important for your medical record to state if you have had anaphylaxis to any medications. 

What is a side effect (intolerance)?

Side effects or intolerances are symptoms that are clearly related to a specific medication or treatment and do not have any of the symptoms listed above. Common medication side effects include. 

  • nausea, vomiting or diarrhea, or constipation
  • dizziness without other allergic symptoms
  • weakness or tiredness
  • confusion or hallucinations
  • anxiety
  • headache
  • stomach pain from the irritating effects of medication (ibuprofen and other NSAID’s)
  • Difficulty passing urine or urinating frequently. 

Penicillin allergies

Nearly 10% of people report a Penicillin (PCN) allergy.  When tested, less than 1% are actually true allergic reactions.  The facts are:

  • People who list a PCN allergy are more likely to be given other, more expensive, and less appropriate antibiotics instead.
  • Severe complications of antibiotics, such as C-Deficile colitis, are more common if a PCN allergy is listed as an allergy. This is due to the administration of overly broad-spectrum alternative antibiotics. 
  • For the same reason, they are more likely to develop antibiotic-resistant infections, kidney injury, and other side effects. 

There are a number of reasons why so many people who report a PCN allergy are not really allergic. 

  • They were told they had a reaction when they were very young but don’t know the details.
  • A parent has a severe PCN allergy so didn’t want to take a chance with their child and labeled them as allergic.  PCN allergy is NOT hereditary. 
  • They experienced a non-allergic side effect such as vomiting or diarrhea which was inappropriately listed as an allergy. 
  • They developed a rash while on a PCN but the rash had nothing to do with that medication. 
  • Allergic sensitivity to some medications decreases over time after an initial reaction. 

 

Allergy testing

There is a simple solution to this problem:  allergy testing.  This involves simple skin testing with small amounts of potential allergens.  Unfortunately in most hospitals, this is not available on an emergency basis. If you are unclear about the truth of your PCN allergy, or any other allergy,  your best bet is to see an allergist and get tested before it becomes an emergency.