3. Anaphylactic shock
Anaphylactic shock is a severe, potentially life-threatening
allergic reaction. It can occur within seconds or minutes of
exposure to allergen.
12. Sara is a 22 year old female who is brought into the ER by ambulance after
sudden changes in her level of consciousness and difficulty speaking when
talking to friends at a party. Her friends called 911 when she became
increasingly agitated and incoherent.
Vital signs on admit were:
B/P 80/62
Resp: 8 with difficulty
Pulse 120
Temp 39.2
O2 sats: 82
Patient was still conscious on admit but confused and disoriented and unable to
speak. Patient was very restless and anxious. A few of her friends arrived at
the emergency room and it was discovered that she had eaten some cookies
that were thought to have peanuts in them right before the event occurred.
Family could not been contacted to determine if Sara had a previous
documented allergy to nuts/peanuts. Her friends were unaware of such an
allergy in her history but never remember seeing her eating nuts of any kind
13. A previously healthy 12-year-old boy is brought to the emergency
department after being stung by a bee on his right forearm. He
initially complained of localized pain and swelling. Fifteen minutes
later, he began to complain of shortness of breath and was
observed by his parents to be wheezing. He reported feeling weak
and dizzy.
In the emergency department, VS: T=37.1 C, P=120, R=39, BP=
69/45.
Exam: He is drowsy and pale, but able to answer questions.
Generalized urticaria is present. He has no conjunctival edema and
his lips and tongue are not swollen. His voice sounds normal. He is
tachycardic and hypotensive. Respiratory examination reveals mild
wheezing, with fair aeration and mild subcostal retractions.
Abdomen is soft and non-tender. His capillary refill time is delayed.
14. ◦ UptoDate, Anaphylaxis symptoms and diagnosis (Beyond the Basics); 2016
◦ Anaphylaxis and Other Acute Allergic Reactions ,University of Hawaii, Brandon O. Takase,
MD Jessica S. Kosut, MD;2013.
◦ Anaphylactic Case Study; Rowan Cabarrus community college; 2014.
◦ Journal of Emergency Medicine, 2015-11-01
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