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Not a zebra....History taking practice


mobey

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Interesting. Recurrence of symptoms is always a bummer! Any changed laundry detergent recently? How about personal hygiene products, like deodorants, etc.?

New towels perchance? How about removing the gal's shirt completely (if you haven't already done so) and wiping down the skin with wet wipes or dampened gauze? Let's try to remove the allergen if it's a contact type thing. If it's an inhaled thing... not so much luck there.

I'm still leaning towards "Mr. Wong's Fry Pan Dinner Family Combo 5" as part of our culprit here... for this to be coming back like this with her in a different environment, I'm leaning towards an ingested allergen.

Did she manage to stick herself on any of those plants she encountered? Any puncture marks noticeable at all on her? Could she really and truly be freakin' allergic to mosquitos and be having issues from a large quantity of bites?

Wendy

CO EMT-B

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Holy crap! I didn't even know that EXISTED... wow. The human body is a strange thing indeed. Here's a link for y'all in case you want to know what it is... thank you google...

Overview of Exercise Induced Anaphylaxis

Could this really be her problem? If so, not much we can do for her except treat symptoms. I'm still leaning towards the chinese food link and maybe hypersensitivity to mosquitos. That would really suck for her, since she runs a lot, if she's got EIanaphylaxis...

Wendy

CO EMT-B

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Interesting. Recurrence of symptoms is always a bummer! Any changed laundry detergent recently? How about personal hygiene products, like deodorants, etc.?

New towels perchance? How about removing the gal's shirt completely (if you haven't already done so) and wiping down the skin with wet wipes or dampened gauze? Let's try to remove the allergen if it's a contact type thing. If it's an inhaled thing... not so much luck there.

I'm still leaning towards "Mr. Wong's Fry Pan Dinner Family Combo 5" as part of our culprit here... for this to be coming back like this with her in a different environment, I'm leaning towards an ingested allergen.

Did she manage to stick herself on any of those plants she encountered? Any puncture marks noticeable at all on her? Could she really and truly be freakin' allergic to mosquitos and be having issues from a large quantity of bites?

Wendy

CO EMT-B

You remove her shirt and pants and inspect her for bites or rashes. Dammit nothing. The welts are clearing up and you don't notice a bunch of mosquito bites. You pay careful attention to her ankles but see no abraisions or needles of any sort. No Hx of detergent or deodorant changes.

Re-read your third paragraph. You really have to think outside the box for this one.

Remember she ate lunch 2 hours ago, and she has had chinese before, even at that restaurant.

You now have a young girl down to her underwear, feeling uncomfortable in your presence. Since you are a 27 y/o male. haha.

I got very frusterated on this call and ended up asking a very open ended question to which her responce gave me the answer that probably saved her life in the future with the mongolia trip coming up fast.

Another hint: The allergen has been specificaly mentioned more than once in this scenario.

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exercise induced anaphylaxis...

i had heared of that prior to this call and thats what I had stuck in my head. Except that she excersises every day, and this has never happened before. And now the symptoms are recurring and she is lying down.

Good thinking.....But not this time :D

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Well, you're obviously saying it ain't the food... but here's where I'm coming from. My future father-in-law loved seafood his WHOLE LIFE. Ate the stuff like there was no tomorrow. Never had a reaction to it- EVER. Red Lobster was his FAVORITE restaurant... no problems until that random night after eating at PF Chang's.

He didn't develop symptoms until about 45 minutes after returning home... so there was indeed a time delay. That's why I got stuck on that one for a bit.

Hmm... she's allergic to horses! I'll bet she is... and the allergens are all over her clothes and hence in the back of your rig now. Ergo, your recurrence of symptoms.

I'm allergic to horses... and got triggered by a friend who worked at the corral at my camp... I picked up her sweatshirt and lo and behold... coughy wheezy time!

Maybe?

Wendy

CO EMT-B

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Hey, wait a minute! If she's a good catholic girl and you recognize the land as belonging to the MINISTER, she must be a rebel! Catholic priests don't have kiddos! LOL.... sorry, couldn't resist. I'm now changing my differential diagnosis to possession by an evil spirit...

Wendy

CO EMT-B

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... and the allergens are all over her clothes and hence in the back of your rig now. Ergo, your recurrence of symptoms.

Maybe?

Wendy

CO EMT-B

Gettin warmer...run with this, what else can we do?

What kind of questions can you ask?

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Could have a latex allergy as well. Which will make the next hour of your life real fun. :D

Has this every happened before?

Is she taking any pills for her trip to Mongolia? If so, what, for how long, ever taken any of them before?

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Could have a latex allergy as well. Which will make the next hour of your life real fun. :D

Has this every happened before?

Is she taking any pills for her trip to Mongolia? If so, what, for how long, ever taken any of them before?

Awesome question...but nope no pills. This has never happened before.

What would set off the latex allergy during a run?

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