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<h1><a name="Managing_Allergies_and_Intolerances"></a> Managing Allergies and Intolerances </h1>
<p></p>
In GNUmed three aspects of allergy in a patient are tracked: Allergy state, any actual allergies with details, and date of last reconfirmation of either.
<p></p>
<a name="foswikiTOC"></a><div class="foswikiToc"> <ul>
<li> <a href="#Concepts"> Concepts </a>
</li> <li> <a href="#Reviewing_allergies"> Reviewing allergies </a>
</li> <li> <a href="#Editing_allergies_and_allergy_state"> Editing allergies and allergy state </a>
</li></ul>
</div>
<p></p>
<h2><a name="Concepts"></a> Concepts </h2>
<p></p> <dl>
<dt> Allergy Status </dt><dd> The (suspicion of) presence or absence of allergies and/or intolerances in a patient.
</dd> <dt> Reconfirmation </dt><dd> The event of ascertaining oneself of the correctness of the allergy state in a patient. Akin to <em>signing</em> the allergy state.
</dd> <dt> Allergy </dt><dd> Any <a href="http://en.wikipedia.org/wiki/Hypersensitivity" target="_top">hypersensitivity</a> in the Gell/Coombs sense. In other words an undesirable reaction produced by the normal immune system. Often also called a <em>sensitivity</em>.
</dd> <dt> Intolerance </dt><dd> Any undesirable bodily reaction to a voluntary agent exposure <em>not</em> mediated by the immune system.
</dd> <dt> Therapeutic Precaution </dt><dd> Any condition of the patient which may influence therapeutic decisions, such as <em>"undergoing antiocoagulation"</em>.
</dd> <dt> Caveat </dt><dd> Any attribute or condition of the patient being aware of which is relevant to considering deviation from the standard care process, such as <em>"tends to be aggressive"</em> or <em>"low compliance"</em>.
</dd></dl>
<p></p>
Conceptually there is a tree-like structure of <em>noteworthy conditions</em> (which are not yet fully implemented in GNUmed, however):
<p></p> <ul>
<li> Caveats <ul>
<li> Therapeutic Precautions <ul>
<li> Allergies and Intolerances
</li> <li> anticoagulation
</li> <li> pacemaker in situ
</li> <li> ...
</li></ul>
</li> <li> Unhelpful behaviour <ul>
<li> aggression
</li> <li> low compliance
</li> <li> ...
</li></ul>
</li> <li> Unhealthy substance use <ul>
<li> nicotin
</li> <li> alcohol
</li> <li> ...
</li></ul>
</li> <li> ...
</li></ul>
</li></ul>
<p></p>
<h2><a name="Reviewing_allergies"></a> Reviewing allergies </h2>
<p></p>
Whenever a potentially allergenic action is commenced (such as administration of a drug in a treatment regime) allergy status should be ascertained. To this end GNUmed offers therapeutic precaution information at various places in the workflow:
<p></p> <dl>
<dt> the top panel <em>Cave</em> field </dt><dd> This field is always visible within the client and displays either a notification on the allergy state or, if any, a list of abbreviated allergenic agents. A tooltip reveals more complete details. Double-clicking inside the field starts the allergy manager.
</dd> <dt> the EMR tree </dt><dd> In the tree view of the EMR allergy information is included with the top level node EMR summary displayed on the right hand side.
</dd> <dt> the substance intake edit area </dt><dd> when adding/editing a substance intake entry allergy information will be displayed at the top
</dd> <dt> the substance intake list </dt><dd> the tooltip for entries displays a warning if there's an allergy recorded for that entry
</dd> <dt> documents </dt><dd> documents can include a list of known allergies via a placeholder
</dd> <dt> the prescription generator </dt><dd> not implemented yet
</dd></dl>
<p></p>
Various symbols are used to denote certain allergy states and absence/presence of details and/or comments:
<p></p> <ul>
<li> <strong><a href="http://www.fileformat.info/info/unicode/char/2300/index.htm" target="_top">diameter sign</a></strong>: patient does not have any allergies to the best of our knowledge
</li> <li> <strong>?</strong>: the allergy state is unknown <ul>
<li> unasked
</li> <li> asked but still unknown (for any number of reasons)
</li></ul>
</li> <li> <strong>!</strong>: can appear added to any of the above to denote the existence of a comment over and above the state itself
</li></ul>
<p></p>
<h2><a name="Editing_allergies_and_allergy_state"></a> Editing allergies and allergy state </h2>
<p></p>
Double-clicking the <em>Cave</em> field in the top panel opens the allergy manager for the active patient. Within the manager it is possible to modify the relevant allergy information.
<p></p>
Within the <em>Medication</em> plugin (Substance intake) it is possible to turn a documented substance intake entry into an allergy by the click of a single button. Also, from within the edit area for substance intake one can discontinue the entry and mark it allergenic.
<p></p>
<hr />
<a href="AllergyAndIntoleranceStatus.html">material</a>
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