Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Presyncope, Syncope, Vomiting
Clinical narrative: Nurse Notes:  Patient came in today for first covid vaccine. I went through all side effects and information for patient prior to administering vaccine. Patient voiced he was nervous about getting the vaccine. I assured patient we were here to help him and to let me know how he was feeling with every change. After a few minutes of receiving vaccine, patient stated he was feeling faint. I was able to get him to a chair safely before patient passed out. Patient was out for approx 2 minutes and returned to an alert state. Patient was diaphoretic, slightly confused, and fatigued. I applied cold pack, cool wash cloth, elevated feet, and gave water. I checked patient's bp and got a reading of 175/95. I allowed patient to sit for a little longer and checked BP again with reading of 117/85. Patient passed out once again and was out for less then 1 minute. Once patient was stable I manually checked BP and got a reading of 118/84. Patient still reports fatigue, shows diaphoresis, fatigue, anxiety. I took patient to a room and had Dr. (PCP) come in to see him.   10:29 am- checked in on patient, no further loss of consciousness or vomiting. Patient stated he is till feeling fatigued and slightly nauseas. Patient is in Fowler's position and was given crackers to help with nausea. Patient's wife is at bedside. Wheelchair is outside of room for quick access, door to room left ajar to aid in better visualization of patient. Encouraged wife to call with any concerns, encouraged patient to remain on bed for a while longer and to notify me of any changes in status.   10:45- Checked on patient and he reported he was feeling better. The crackers given helped with the nausea. Patient's color has returned and he reported no headache, vision changes, or dizziness. Will allow patient to rest with us for a few more minutes prior to allowing him to go home.   11:00- checked in on patient, he reports he is feeling much better and feels he is ready to go home. Dr. did a final assessment and gave a work excuse for today. Patient was wheeled in wheelchair out to vehicle and assisted into the passenger side. Patient was driven home by his wife and given instructions to report to ER with any difficulty breathing or chest discomfort. Patient also encouraged to call us with any further questions.    Provider notes:  Pt presented to the office today for first Covid vaccine.  After receiving vaccine, pt experienced immediate diaphoresis and syncopal event. Pt was able to be aroused. Denied any CP, shortness of breath, nausea, trouble swallowing. Pt admits to being very anxious about Covid vaccination. He worked 2nd shift last night and woke up early to get vaccine so did not sleep well. Has not eaten anything this morning either.  On exam patient is resting comfortably on exam table. See nursing note for vitals which were stable. Heart is regular rate and rhythm with no M/R/G. Lungs are CTAB. No respiratory distress. Peripheral pulses are 2+. Skin is clammy and sweats with normal color.  After discussion with patient, it appears that he has had a vaso-vagal episode following vaccination. He is currently stable including VSS.  While monitored in the office he was given water and sprite to help with possible hypoglycemia.  Had some crackers as well. Pt reported feeling much better.  No longer diaphoretic.  Given work excuse for the day.  Pt given strict return precautions.