Age: 5.0
Sex: M
Vaccine: DTAPIPV, HEPA, MMRV
Symptoms: Dizziness, Feeling abnormal, Loss of consciousness, Pallor
Clinical narrative: CLIENT IS HERE AT THE CLINIC FOR HIS VACCINES AT 1400.  CLIENT IS DUE FOR DTAP, IPV, MMR, VARICELLA, AND HEP A.  CLIENT IS ABLE TO  RECEIVE KINRIX (DTAP/IPV), MMRV (MMR/VARICELLA), AND HEP A TODAY.  CLIENT AND STEP FATHER WERE CALLED FROM THE WAITING ROOM AND BROUGHT BACK INTO AN IMMUNIZATION ROOM.  CLIENT AND STEP FATHER SAT DOWN IN A CHAIR WITH CLIENT ON HIS LAP AT 1409.  EXPLAINED TO CLIENT'S STEP FATHER ABOUT THE VACCINES CLIENT WILL BE RECEIVING TODAY.  CLIENT'S STEP FATHER DID NOT HAVE ANY QUESTIONS AND/OR CONCERNS AT THIS TIME.  ADMINISTERED KINRIX, MMRV, AND HEP A VACCINES ON CLIENT'S LEFT THIGH IM AT 1415.    CLIENT TOLERATED VACCINES WELL.   CLIENT STOOD UP FROM THE CHAIR AND WALKED OUTSIDE OF THE ROOM TOWARDS THE CANDY BASKET AND STICKERS TO PICK OUT A LOLLIPOP.  WHILE HE WAS PICKING OUT A LOLLIPOP, CLIENT TURNED PALE AND STARTED TO SWAY.  TO AVOID CLIENT FALLING ON THE GROUND, I BRACED HIM AND CARRIED HIM ON TO THE EXAM TABLE AT 1425 WITH TWO OF MY CO-WORKERS.  CLIENT WAS LYING DOWN AND WAS UNCONSCIOUSNESS FOR ABOUT 5 SECONDS.  I SAID "ARE YOU OKAY?"  THE CLIENT THEN OPENED HIS EYES AND STARED AT ME FOR ABOUT TWO SECONDS.  I REPEATED, "ARE YOU FEELING OK?  ARE YOU FEELING SICK TO YOUR TUMMY?"  CLIENT STATED "I DON'T FEEL TOO GOOD."  THEN I ASKED THE CLIENT IF HE WANTED A COLD CLOTH FOR HIS NECK AND HE STATED YES.  BROUGHT IN A COLD CLOTH AND PLACED IT BEHIND HIS NECK AND TURNED ON THE FAN THAT WAS IN THE ROOM AT 1427.  I ASKED THE CLIENT IF HE WANTED TO SIP ON SOME WATER.  THE CLIENT ANSWERED "YES".  PROVIDED CLIENT WITH WATER.  THE CLIENT SAT UP SLOWLY ON THE EXAM TABLE AND STARTED TO SIP ON THE WATER. ASKED THE CLIENT "DO YOU FEEL LIKE THROWING UP?"  CLIENT STATED "NO, I DON'T"  A FEW MINUTES LATER, ASKED THE CLIENT IF HE WANTED A SNACK.  CLIENT ANSWERED "YES".  BROUGHT IN COOKIES, CRACKERS AND A GRANOLA BAR.  CLIENT STATED HE WANTED THE COOKIES AT 1435.  LET STEP FATHER KNOW THAT SOME CHILDREN  AND ADULTS HAVE VASOVAGAL RESPONSE AFTER RECEIVING VACCINES, BLOOD DRAWS, SEEING BLOOD OR BODILY FLUIDS, ETC.  LET KNOW THAT THE CLIENT MAY SIT IN THE ROOM FOR ABOUT 15 MINUTES TO REST AND HAVE HIS SNACK AND WATER.  I WILL CHECK BACK IN 15 MINUTES TO SEE HOW HE IS DOING.  CLIENT'S STEP FATHER VERBALIZED UNDERSTANDING.  LEFT THE ROOM AT 1445.  WENT BACK INTO THE ROOM AT 1500 TO CHECK ON THE CLIENT. BY THEN, CLIENT HAD FINISHED HIS COOKIES AND WATER AND ASKED FOR MORE WATER.  CLIENT WAS LAUGHING, JUMPING AROUND AND JOKING WITH HIS STEP FATHER.  BOTH CLIENT AND CLIENT'S STEP FATHER STATED THAT CLIENT WAS DOING WELL AND FEELING MUCH BETTER.  CLIENT'S STEP FATHER WAS ON THE PHONE WITH THE CLIENT'S MOTHER.  EXPLAINED THE SITUATION TO THE MOTHER AT 1450.  LET HER KNOW THAT IF THE CLIENT STARTS TO NOT FEEL WELL, PLEASE GO SEE HIS PEDIATRICIAN/PCP AND LET THEM KNOW THE VACCINES HE HAS RECEIVED TODAY.   CLIENT'S MOTHER STATED THAT SHE TOO HAS VASO VAGAL RESPONSE AFTER GETTING VACCINES AND/OR BLOOD DRAWS.   I WILL BE CALLING HER ON MONDAY TO SEE HOW THE CLIENT IS DOING.  CLIENT'S MOTHER VERBALIZED UNDERSTANDING.  ASKED THE CLIENT HOW HE WAS FEELING.  CLIENT ANSWERED WITH A SMILE "I FEEL GOOD NOW."  ASKED CLIENT'S STEP FATHER IF HE ANY QUESTIONS AND/OR CONCERNS AND HE ANSWERED HE DID NOT HAVE ANY QUESTIONS AND/OR CONCERNS AT THIS TIME.  HE STATED "I AM JUST HAPPY THAT HE IS FINE AND BACK TO NORMAL." CLIENT DENIED ANY NAUSEA/VOMITING, DIZZINESS, AND WEAKNESS. CLIENT WALKED OUT OF THE EXAM ROOM WITHOUT ANY PROBLEMS WITH HIS STEP FATHER.  THEY LEFT THE CLINIC AT 1510.