Emergency Dept Case StudiesEmergency Dept Case Studies

C-med radio reports a 27 yo female with h/o allergy to nuts. After eating at a Chinese Restaurant she developed SOB. BLS noted + wheezes and hives. How would you prepare for this patient’s arrival?

Prepare for IV placement

Meds: benadryl IV, solumedrol IV, zantac IV, sq epi (0.3cc of 1:1,000)

Inform ED attending of patient’s arrival

?Allergic Reaction

 Patient arrives c/o throat tightness, SOB. She is flushed. VS are 120/74.120.28. O2 sat on RA 94%. LS reveal + I/E wheezes. What is your top priority?

Hi-flo O2

Call physician into room

Prepare for nebulizer treatments

Anticipate IV benadryl, IV steroids, IV zantac and possible SQ epi

You have administered 50mg IV benadryl and 80mg IV solumedrol. Respiratory is finishing patient’s 2nd nebulizer treatment. Patient’s symptoms have improved, RR 18, O2 sat (during neb) 99%. SOB and wheezing resolved. What do you anticipate?

Observe for approximately for usually 3-4 hours.

Patient teaching for epi-pen, po benadryl and possible steroid course.

Patient should receive prescription for epi-pen

Discharge teaching- return for s/s of allergic reaction

Remind to avoid nuts