🎞️ View video tutorial: Recording allergies
You can record a patient's drug and non-drug allergies from the patient summary or from the Allergies section of their chart. You can edit existing allergies and delete allergies entered in error.
📌 Notes:
To record that a patient has no known drug allergies, you must use the Allergies section. See Recording no known drug allergies for more information.
When a patient has drug or non-drug allergies with a status of Active, Confirmed, Unconfirmed or no status, an allergy indicator shows in the patient chart header with the number of allergies in brackets. Additionally, a red alert appears if there are any severe allergies. Click the Allergies(x) indicator to see a summary of the allergies, including their names, severity, status and reactions. If you need to edit or add a new allergy, click Go to allergies and the Allergies section of the patient chart opens.
Steps
1. Open the patient's chart and add a new allergy:
From the patient summary, click the + icon and then click +Drug or +Non-Drug in the window that appears.
From the Allergies section of the chart (Start/Open > Allergies), click +Drug Allergy or +Non-drug Allergy.
2. Record the details of the allergy:
Field | Description |
Allergy name | Non-drug allergy: Type the allergen into the text field.
Drug allergy: You can record an allergy to a specific drug or a drug group. By default, the CHR searches by Group. To search for a specific drug, select Drug from the list. To search both specific drugs and drug groups at the same time, select All from the list.
Begin typing the name of the drug or drug group into the search field and select the appropriate allergy from the list. 📌 Note: if you select a drug with a DIN, you will receive interaction alerts when prescribing medications for this patient that are from the same allergen group. |
Reaction | Select a reaction from the list of common allergy reactions e.g. Anaphylaxis, Angioedema, Fever etc. |
Reaction Type | From the list, select whether this is an Allergy or an Intolerance. |
Other Reactions | If you selected Other as the Reaction, or if the patient had multiple reactions, type the description of the reaction in this field. |
Severity | Select the severity of the reaction from the list. |
Reported By | Select whether the allergy was reported by the Patient, Related Person, or Practitioner. |
Status | Select the allergy's status from the list e.g. Active, Unconfirmed, Confirmed etc. |
Life Stage | Enter at what point in the patient's life the allergy developed. This is useful for recording historical allergies where the patient does not know the start date. |
DIN | If you selected a drug with a DIN, the DIN is displayed here and cannot be edited. |
Started Date | If you or the patient know the specific date the allergy started, click the calendar icon and select a date. |
Recorded Date | Click the calendar icon and select the date the allergy was recorded (usually today). |
Comments | Type any other additional notes regarding the allergy that aren't captured elsewhere. You can also use this field to record the reason for any status changes; for example, why you are refuting an allergy. |
3. Click Save when you are finished.
The allergy is included in the list of patient allergies in the patient summary, the Allergies section of the chart and the patient chart header. All allergies appear in red text in the patient summary. In the Allergies section of the chart, severe allergies appear in red text, moderate severity allergies are bold, and mild severity allergies are plain text.
📌 Notes:
To edit an allergy, select it in the list and make the necessary changes.
To delete an allergy and remove it from the chart (for example, an allergy entered in error), click the trash can icon to the right of the allergy. In the Delete permanently window select the Reason For Deletion and click Delete.
When an allergy is deleted, a blue banner appears showing that something was modified. You can access the deleted allergy by clicking Open activity log in the blue banner, or via the Recent Activity widget.
For information about refuting an allergy, see Refuting an allergy.
Updated September 6, 2024