Scenario — Urticaria with severe reaction
intermediate Medical · Pediatric · 11yr · male
Patient Information
| Dispatch | Liam has come to the First Aid stand during an Australia Day event. |
| Patient | Liam James — 11yr (55kg) |
| 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. |
| Allergies | Nil |
| Medications | Multivitamin |
| Pertinent History | Nil |
| Last Oral Intake | Lunch — hot dog and chips with a coke, 2 hours ago. |
| Events Leading | Having fun at Australia Day. |
| Treatment Prior | Nil |
| Onset | Fast |
| Pain | Sudden |
| Quality | Itchy |
| Radiates | Nil |
| Severity | As per vitals |
Scenario Progression and Treatment Objectives
Diagnosis
This patient is suffering from urticaria with severe reaction.
Facilitator Triggers — if trainees miss a critical step
- ! If second body system not found — start to vomit.
Treatment Objectives
- 1. Officers must gain consent as not life threatening at this stage.
- 2. Officers should perform a rapid primary survey and recognise potential life threatening circulation after blood pressure — then EpiPen (patient admitted he is 55kg).
- 3. A full vital sign survey should be conducted following initial assessment.
- 4. Salbutamol MDI 12 sprays due to shortness of breath with a wheeze.
- 5. Scenario ends on arrival of ambulance and IMISTAMBO handover.
- 6. Attention to hand hygiene throughout the scenario.
Clinical references: CPG — Anaphylaxis · CPG — Urticaria
How did you go? Next scenario →
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