HISTORY:
for
Onset: , after exposure to
Treatments tried: ,
Other elements:
EXAM:
General appearance:
Vital signs: , BP , HR , RR , SpO2 %, Temp °
Throat:
Neck:
Heart: ,
Lungs: ,
Abdomen: , , ,
Skin:
Extremities: , , cap refill , pulses ,
Musculoskeletal: joints ,
Mental status: , , speech , mood , thought process , , judgment
ASSESSMENT:
, due to
DDx:
PLAN:
-
-
-
-
-
- IV fluids
- Monitor vital signs every 15 minutes
- Epinephrine autoinjector
- Avoidance of suspected allergen
- Education on anaphylaxis management
- Referral to allergist
- Follow-up in
- Go to ER if symptoms reoccur