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Scenario — Urticaria with severe reaction
Patient Information
Dispatch
Liam has come to the First Aid stand during an Australia Day event.
Incident History
After being stung by a bee.
Emergency Contact
Julie James (Mother) 0454040041
Initial Rapid Assessment
Response
Alert
Airway
Patent. Nil airway obstructions. Nil airway swelling or stridor.
Breathing
Shortness of breath.
Circulation
Rapid and weak pulse. Skin left arm — red welts that are itchy.
Disability
Orientated to Time, Place and Person.
Exposure
Bee sting still on his left forearm. Red welts on left forearm that are itchy.
Vitals
Time SpO2 Resp Dist RR Pulse BP CRT GCS PERL Temp BGL Pain
Initial 94% (RA) Mild 20 100 70 <2s 15 3 3 ++ 37.2 5.3 3
10 mins 98% (RA) Nil 16 84 98 <2s 15 3 3 ++ 36.9 – 2
History Taking
Signs/Symptoms
Mild respiratory distress. Dizzy and pale. Red welts on the skin that are itchy.
Onset
Fast
Pain
Sudden
Quality
Itchy
Radiates
Nil
Severity
As per vitals
Allergies
Nil
Medications
Multivitamin
Pertinent History
Nil
Last Oral Intake
Lunch — hot dog and chips with a coke, 2 hours ago.
Treatment
Nil
Events Leading
Having fun at Australia Day.
Scenario Progression and Treatment Objectives

(If second body system not found — start to vomit.)

This patient is suffering from urticaria with severe reaction.

  • Officers must gain consent as not life threatening at this stage.
  • Officers should perform a rapid primary survey and recognise potential life threatening circulation after blood pressure — then EpiPen (patient admitted he is 55kg).
  • A full vital sign survey should be conducted following initial assessment.
  • Salbutamol MDI 12 sprays due to shortness of breath with a wheeze.
  • Scenario ends on arrival of ambulance and IMISTAMBO handover.
  • Attention to hand hygiene throughout the scenario.

Clinical references: CPG — Anaphylaxis · CPG — Urticaria