Anaphylaxis

HISTORY:

‍Diffuse rashHives for ‍ ‍hoursdays

Onset: ‍gradualsudden, after exposure to ‍ ‍medicationfoodnutsfishshellfishinsect sting

‍hives

‍swelling of lips/face

‍swelling of tongue

‍swelling of throat

‍difficulty breathing

‍wheezing

‍cough

‍chest tightness

‍dizziness

‍fainting

‍nausea

‍vomiting

‍abdominal pain

‍palpitations

‍feeling of impending doom

Treatments tried: ‍noneepinephrine auto-injectorantihistamines, ‍effectiveineffective





EXAM:

General appearance: ‍well-appearing

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Throat: ‍normalrednessexudate

Neck: ‍normallymphadenopathy

Heart: ‍RRR, ‍normal S1 and S2

Lungs: ‍clearabnormal sounds, ‍retractions

Abdomen: ‍softsemi-softtense, ‍non-tender ‍, ‍non-distended, ‍

Skin: ‍no rash

Extremities: ‍edema, ‍warm, cap refill ‍< 3 sec> 3 sec, pulses ‍normal, ‍

Musculoskeletal: joints ‍ ‍normal, ‍no limited ROM

Mental status: ‍alert, ‍oriented, speech ‍clear, mood ‍normal, thought process ‍organized, ‍no suicidal ideation, judgment ‍good



ASSESSMENT:

‍Anaphylaxis ‍likelysuspectedpossible, due to ‍

DDx: ‍



PLAN:

- ‍Epinephrine

- ‍Diphenhydramine

- ‍Ranitidine

- ‍Prednisone

- ‍Salbutamol

- IV fluids

- Monitor vital signs every 15 minutes

- Epinephrine autoinjector

- Avoidance of suspected allergen

- Education on anaphylaxis management

- Referral to allergist

- Follow-up in ‍ ‍daysweeksmonths

- Go to ER if symptoms reoccur