Clinical Case Database / Category: Patient Management
Treatment of anaphylaxis
Hannah R Brown, Michael Vassallo PhD FRCP
Foundation Years Journal, volume 3, issue 1, p.30 (123Doc Education, London, February 2009)
You are called to see a 28-year-old man on the medical admissions unit. He is a type 1 diabetic in hospital with a community acquired pneumonia. The nurse tells you that he is looking increasingly unwell and has just been given IV amoxicillin as treatment for the pneumonia. He is not known to have any drug allergies but has not had amoxicillin before. You advise that the antibiotics are stopped immediately and you assess Mr D. On arrival, Mr D does not look well â€“ he is having difficulty speaking to you and appears slightly confused. His respiratory rate is 25 breaths/minute and oxygen saturations are 85% on air. Examination of his chest demonstrates a marked wheeze throughout. Further examination shows him to have cool peripheries and you record a blood pressure of 80/55 and feel a weak, thready pulse, rate 124bpm. His capillary refill time is 3 seconds and he is becoming increasingly drowsy during your assessment. You suspect a diagnosis of anaphylaxis to the IV amoxicillin. How should you manage this patient?
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Hannah R Brown
Bachelor of Medicine 2007
University of Southampton
Foundation Year 2 Doctor
The Royal Bournemouth and Christchurch Hospitals NHS Trust
Michael Vassallo PhD FRCP
Consultant Physician and Honorary Senior Lecturer
The Royal Bournemouth and Christchurch Hospitals NHS Trust
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The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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