A 24-year-old Asian male presents to the ER with tachypnea, shortness of breath, and generalized urticaria. The patient has no known maintenance medications to relieve the symptoms he is currently experiencing before coming to the ER. A physical examination revealed the following: HR 110bpm, RR 40 with signs of accessory muscle use.
A brief history of the patient reveals that he has been trying to patch things up with his partner of eight months, after a whirlwind dating phase that lasted only roughly two weeks. The patient discloses that he was unaware that things would have gone out of hand, and symptoms of said event manifested abruptly one Saturday evening after receiving too many messages from his partner.
Accumulation of said allergen in the system may have caused this allergic reaction in the patient, causing him to lose motivation and feel irritability at the mere thought of this peron.
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 was 125/250, and auscultation revealed loud expiratory wheezing and better airflow.
Symptoms began to resolve, and the patient was advised to resolve his current ordeal with his partner; if they would accept their excessive neediness of one another, come to terms with this to prevent his reexposure to this allergen, and refrain from whirlwind relationships, things would be better.