Anaphylaxis

A 24 year old Asian male presents to the ER with tachypnea, shortness of breath and generalized urticaria. Patient has no known maintenance medications to relieve the symptoms he is currently experiencing prior to coming to the ER. A physical examination revealed the following: HR 110bpm, RR 40 with signs of accessory muscle use.

Brief history of the patient reveals that he has been trying to patch things up with his partner of 8 months – after a whirlwind dating phase that lasted only roughly two weeks. Patient discloses that he was not aware that things would have gone out of hand, and symptoms of said event manifested abruptly one Saturday evening, after receiving one too many messages from the other person.

Accumulation of said allergen in the system may have caused this allergic reaction to the patient, causing him to lose motivation and feel irritability at the mere thought of this person.

An aerosol treatment was ordered and given with 0.5 cc albuterol with 3.0 cc normal saline in a small volume nebulizer for 10 minutes. Peak flows done before and after the treatment were 125/250 and ausculation revealed loud expiratory wheezing and better airflow.

Symptoms began to  resolve, and the patient was advised to resolve his current ordeal with his partner, and if they would accept their excessive neediness of one another, come into terms with this so as to prevent his reexposure to this allergen, as well as to refrain from whirlwind relationships because, you know what? Things that are taken too fast just to achieve something is just.. it’s just not right. It’s crap.

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