Just Plain Ruff Posted December 28, 2007 Share Posted December 28, 2007 Mobey, does she have any pustules or lesions on her hands? Link to comment Share on other sites More sharing options...
Eydawn Posted December 28, 2007 Share Posted December 28, 2007 Yes, 'skeeters bite through shirt and bra.. been there. Has she had any recent illness, or has there been any recent illness in the family? Other than the pneumonia? Has she had pneumonia before? Did they give her any meds for it? If so, when did she quit taking them? Can I see the shampoo bottle and any other substances she might have had in the shower with her, just to verify they're good ol' herbal essences and not contaminated with something? Thinking devious little brothers here on this one. My brother has done more stupid stuff than I care to name... Any molds or moldy substances in the barn? The hx of allergy to penicillin makes me wonder. Since penicillin is in fact a mold in origin... Ah hah! Lunch at the chinee restaurant. What did she eat? Any family history of allergy to shellfish perhaps? This sounds actually suspiciously similar to what happened to my soon to be father-in-law... came home from PF Chang's, anaphylactic reaction soon afterwards. Turns out his body decided to randomly sensitize to shellfish and lo and behold, there was clam juice in the sauce... So, I want to know what she ate, if she shared entrees with anyone else, and if anyone in the family has any sort of food allergy. What was her running route? Did she go by any chemical sheds or recently fertilized/pesticide sprayed fields? Did she run a different route than she had before? That should do for now. Wendy CO EMT-B Link to comment Share on other sites More sharing options...
mobey Posted December 28, 2007 Author Share Posted December 28, 2007 Just appear to be welts. None on her hands. No pustules. You give a dose if IM Epy and IV diphenhydramine. Sorry no solumedrol in the ALS kit (gotta love rural services) A few minutes pass and she begins to cough less, and is starting to talk. Resps seem to be deeper now. Reasess AE, Wheezes throughout and still some stridor....A vast imrovement though. Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted December 28, 2007 Share Posted December 28, 2007 When you put in the horse exposure that morning I was leaning towards equine passed Anthrax which had she have had pustules on her hands then that would have cinched the diagnosis but my original allergic rxn choice was right. take care. Link to comment Share on other sites More sharing options...
mobey Posted December 28, 2007 Author Share Posted December 28, 2007 Yes, 'skeeters bite through shirt and bra.. been there. Has she had any recent illness, or has there been any recent illness in the family? Other than the pneumonia? Has she had pneumonia before? Did they give her any meds for it? If so, when did she quit taking them? Can I see the shampoo bottle and any other substances she might have had in the shower with her, just to verify they're good ol' herbal essences and not contaminated with something? Thinking devious little brothers here on this one. My brother has done more stupid stuff than I care to name... Any molds or moldy substances in the barn? The hx of allergy to penicillin makes me wonder. Since penicillin is in fact a mold in origin... Ah hah! Lunch at the chinee restaurant. What did she eat? Any family history of allergy to shellfish perhaps? This sounds actually suspiciously similar to what happened to my soon to be father-in-law... came home from PF Chang's, anaphylactic reaction soon afterwards. Turns out his body decided to randomly sensitize to shellfish and lo and behold, there was clam juice in the sauce... So, I want to know what she ate, if she shared entrees with anyone else, and if anyone in the family has any sort of food allergy. What was her running route? Did she go by any chemical sheds or recently fertilized/pesticide sprayed fields? Did she run a different route than she had before? That should do for now. Wendy CO EMT-B No recent illness, Can't remember the name of the pneumonia med, it's been gone for 2 weeks. The brother fetches the shampoo, Pert Plus she has used it for years...Smells like pert plus. She did not enter the barn, just grab some bales off the stack, put them in the half ton drive to the pen and dispence. At the restaurant the family had "Meal for 5" included everything you can imagine, Ribs, Chicken balls, Rice, Deep fried shrimp, noodles etc etc. No family alergy Hx. Her running route is the same as always, through the yard, down the lane, down the road 1/2 mile and back. She came in contact with a few plants along the side of the lane...But she says she always does. No chemicals being used on thier farm right now. Neighbors could have been spraying although it is not too likely because it had rained yesterday and now it is too hot to spray. Link to comment Share on other sites More sharing options...
emt322632 Posted December 28, 2007 Share Posted December 28, 2007 Continue high flow O2 and reassess q 5-10. Monitor patient for return of symptoms. Maybe toss in some albuterol for good measure to open her up a bit more. Have her sats improved much from the 90% they were? Link to comment Share on other sites More sharing options...
mobey Posted December 28, 2007 Author Share Posted December 28, 2007 When you put in the horse exposure that morning I was leaning towards equine passed Anthrax which had she have had pustules on her hands then that would have cinched the diagnosis but my original allergic rxn choice was right. take care. Holy crap that never even crossed my mind.....Thanx Ruff Link to comment Share on other sites More sharing options...
mobey Posted December 28, 2007 Author Share Posted December 28, 2007 Continue high flow O2 and reassess q 5-10. Monitor patient for return of symptoms. Maybe toss in some albuterol for good measure to open her up a bit more. Have her sats improved much from the 90% they were? You start a neb of Salbutomol and the chest loosens right up. Pt is getting more and more comfortable as time passes. Sats are up around 96 now. You load the patient and start the trip to the hospital 1 hour away. This patient is heading to mongolia in 2 days to go on a horseback expedition. You feel a moral obligation to get to the bottom of this episode. You have an hour....Let the detailed history begin. Oh ya she says there is another lump in her throat about 5 mins down the highway. Same feeling of swallowing "Around" something as before. Link to comment Share on other sites More sharing options...
emt322632 Posted December 28, 2007 Share Posted December 28, 2007 Alright, let's ask the stupid question. Does she have a foreign object stuck in her throat? lol Link to comment Share on other sites More sharing options...
mobey Posted December 28, 2007 Author Share Posted December 28, 2007 Alright, let's ask the stupid question. Does she have a foreign object stuck in her throat? lol LMAO.... No there is no object. This "Lump" was there then left after the meds, but just came back. And she seems to be breathing faster again. Link to comment Share on other sites More sharing options...
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