You arrive on the scene and find a 38-year-old female patient at home on the steps of her house. She

You arrive on the scene and find a
38-year-old female patient at home on the steps of her house. She is sitting
upright and appears to be alert; however, she is in obvious severe respiratory
distress. She gasps after every word, and you hear obvious stridor on
inhalation. Her face, lips, and tongue are severely swollen. You note hives on
her face and neck. Her respirations are 38 per minute. Her radial pulse is 142
bpm and is very weak. Her skin is warm, dry, and flushed. Her blood pressure is
78/42 mmHg. Her SpO2 is 76%. Her husband indicates that she suddenly started to
experience
»

You arrive on the scene and find a
38-year-old female patient at home on the steps of her house. She is sitting
upright and appears to be alert; however, she is in obvious severe respiratory
distress. She gasps after every word, and you hear obvious stridor on
inhalation. Her face, lips, and tongue are severely swollen. You note hives on
her face and neck. Her respirations are 38 per minute. Her radial pulse is 142
bpm and is very weak. Her skin is warm, dry, and flushed. Her blood pressure is
78/42 mmHg. Her SpO2 is 76%. Her husband indicates that she suddenly started to
experience respiratory difficulty after taking pain medication that was
prescribed to her for dental work that she had done a few hours earlier. She
has no known allergies and takes no other medications. She has no significant
past medical history. Her last oral intake was about 15 minutes prior to your
arrival when she took her pain medication. Her husband states that she was
sitting in the recliner when the signs and symptoms suddenly appeared. She has
hives on her face, neck, and upper chest. You hear wheezing in all lung fields.
Her extremities are flushed, warm, and dry. Her pedal pulses are not palpable.

1. What is causing the airway
compromise in the patient? 2. What is causing the respiratory distress? 3. How
would you manage the airway and ventilation? 4. What would explain the low
blood pressure? 5. What emergency care would you provide to the patient? 6.
What criteria would you use to determine the need for the administration of
epinephrine? 7. What are side effects of epinephrine? 8. What type of reaction
is the patient suffering from?

»