Age: 27.0
Sex: M
Vaccine: HEP, HEPA
Symptoms: Skin discolouration, Tinnitus, Unresponsive to stimuli
Clinical narrative: Patient came into office at 1130 for his second dose of Hep A and third dose of Hep B. He was given demographic sheet and health questionnaire to complete. Once it was turned in the health questionnaire was checked for any allergies or health issues. All questions were answered "no."  Employee called the patient back to the exam room at around 1135 where his health questionnaire was once again checked and she asked him if he had any issues with his previous doses of Hep A and Hep B. Patient stated that he did not have any issues before and that he had done fine. Employee proceeded to administer both injections. Employee and the patient had continuous conversation during this time in the exam room. He requested a copy of his shot record and was told to have a seat in the waiting room while the record was prepared. Once employee updated his shot record and printed a copy, she called the patient?s name. He did not acknowledge that his name had been called. He was sitting in the waiting room chair with his elbows resting on his knees and his head in his hands. Employee called his name again and he looked up so she told him she had his shot record ready. As he stood up, she asked him if he was feeling okay. As he was walking toward her, he said that he felt a little ?funny? and his ears were ringing. Employee could tell he was about to pass out so she reached through the window and grabbed him by his shirt and around his neck to keep him from falling and hitting his head on the floor. His chin hit the ledge out by the front window. Employees saw that the patient getting ready to fall and they ran around out into the waiting room to help lower him onto the floor. While employees were lowering the patient to the floor and calling his name, another employee ran to grab to grab alcohol swabs for him to breathe and cool packs. He was sweating profusely so ice packs were placed on his neck, front and back. The patient then stated that he was very nervous before his shots due to not liking needles and that he had not eaten yet. Employee then gave him a sprite to drink. After several minutes, he said he was feeling much better so it was suggested that he try sitting up in a chair for a little while before standing up. A chair was then brought to him and employees helped him into it. He stated talking to us then passed out again. He came to almost immediately but then quickly passed out again. This time his color was gray and he would not respond. Employee asked if she should go call EMS and was told yes. As employee was walking to call EMS the patient began to convulse. Employees immediately began lowering him to the floor. He began sweating more profusely so more cold packs were placed on him (on front and back of neck, under both arms, and on both sides of him). Once he was able to speak coherently, he informed staff that he had an ?artificial heart valve but he didn?t have heart disease because his doctor told him that.? Employee asked him why he had the heart valve replaced and he said that he had an infection in his blood that damaged his heart valve but it did not cause heart disease. EMS arrived and took over from there.