Age: 17.0
Sex: M
Vaccine: TYP
Symptoms: Skin abrasion, Tremor
Clinical narrative: RN left exam room and went to get client's Typhoid injection. When RN returned to exam room, client was sitting on the exam table with his feet dangling off and his mother and brother sitting next to the bottom of the exam table. Client was asked if he was going to lay down on the table and he said "no, I am good" and this RN said "are you sure you don't want to lay down" and once again the client stated "I am okay." Client was then asked which arm he would like the Typhoid shot in and he indicated his right arm. Right deltoid was cleaned with an alcohol wipe and injection given. After injection was given, client was again asked if he was okay and if he wanted to lay down on the exam table, as this RN put a bandaid on the injection site. Client again stated he was fine. This RN then walked around the office table and put the saftey needle and syringe in the sharps container and then walked back to the client. The client was again asked if he was okay and he said yes. Client was then instructed to stay sitting down and not try to get up for a few minutes. Client and client's mother were told by this RN that she was going to step out of the exam room and go into the main office and get the client's itinerary to bind it and to document his Typhoid injection in his immunization records. RN went right to the office and grabbed clients paperwork and walked back to the office table just outside the exam room so that client could be observed. As RN leaned over the table to document the immunization on the client's record, RN heard client's mother gasp, and then state he is having a seizure and then a thump. Client had fallen face first off of the exam table. RN unsure if client was just sitting or if he tried to stand up. RN quickly went into exam room and helped his mother roll client onto his back. The mother was hysterical and kept saying her son had a seizure. Client was bleeding and was doing some shaking of his whole body and so RN grabbed some tissues and gave them to the mother to put pressure on the bleeding sites while RN went and called 911. While on the phone with 911, RN went and grabbed some 2x2 gauze and returned to the room to exam the client and his sustained injuries. As the client started coming around, he asked what happened and why he was on the floor. The mother kept telling him he had a seizure. While RN was on the phone with 911 at client's side, RN answered 911's questions and was evaluating the injuries. Client's mother had called her husband and was explaining what just happened and the client kept telling her to let him talk to his dad. From what this RN could tell, client had 3 lacerations on his face. 2 on the right side of his upper lip and lip and 1 on the left side of his left upper lip. There was also notable rug burns present to his right side of the face by his eye and to his upper nose and below his nose, above his lip. Client had also broken his glasses. As RN kept pressure on the lacerations, EMS showed up and started asking questions and evaluating client. Client's blood pressure was approximately 142/80 and client told EMS that this has happened before with a blood draw. EMS told client that this is not normal and that he needs to be seen by a doctor and then they asked the mom where to transport him. Clients mother stated she would take him because they don't have insurance and she didn't want to be charged with an ambulance bill. EMS indicated that he was okay to be transported by his mom. Client was helped up by EMS and client then put pressure on the lacerations himself. Client walked out the door with EMS helping him.