Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory distress, SARS-CoV-2 test, Stridor, Vomiting, Wheezing
Clinical narrative: 9/23/21:  Patient presents to ED from clinic with respiratory distress.  She was receiving a neb in the clinic when ED nurses arrived to bring her to ED.  Mom is here with patient.   Chest pain, unspecified type -     XRAY CHEST PA AND LATERAL; Future -     SARS COVID ANTIGEN; Future -     INFLUENZA A AND B NUCLEIC ACID DETECTION; Future -     XRAY CHEST PA AND LATERAL; Future -     cefTRIAXone diluted with 2.1 mL lidocaine 1% inject 1,000 mg 2.86 mL -     azithromycin (ZITHROMAX) 500 mg tablet; Take 1 tablet (500 mg) by mouth 1 time per day  Dispense: 5 tablet; Refill: 0 -     methylPREDNISolone sod succ (SOLU-medrol) injection 125 mg   Moderate persistent asthma with (acute) exacerbation -     XRAY CHEST PA AND LATERAL; Future -     SARS COVID ANTIGEN; Future -     INFLUENZA A AND B NUCLEIC ACID DETECTION; Future -     XRAY CHEST PA AND LATERAL; Future -     cefTRIAXone diluted with 2.1 mL lidocaine 1% inject 1,000 mg 2.86 mL -     azithromycin (ZITHROMAX) 500 mg tablet; Take 1 tablet (500 mg) by mouth 1 time per day  Dispense: 5 tablet; Refill: 0 -     methylPREDNISolone sod succ (SOLU-medrol) injection 125 mg -     albuterol-ipratropium (DUO-NEB) 2.5-0.5 mg/3 mL inhalation solution; Inhale 1 unit-dose (3 mL) by nebulization Every 4 hours as needed for shortness of breath  Dispense: 300 mL; Refill: 12 -     predniSONE 20 mg tablet; Take 2 tablets (40 mg) by mouth 1 time per day for 5 days, THEN 1 tablet (20 mg) 1 time per day for 2 days.  Dispense: 12 tablet; Refill: 0   Body aches -     XRAY CHEST PA AND LATERAL; Future -     COMPLETE BLOOD COUNT WITH DIFFERENTIAL; Future -     COMPREHENSIVE METABOLIC PANEL; Future -     C-REACTIVE PROTEIN (INFLAMMATION); Future -     SARS COVID ANTIGEN; Future -     INFLUENZA A AND B NUCLEIC ACID DETECTION; Future -     XRAY CHEST PA AND LATERAL; Future -     cefTRIAXone diluted with 2.1 mL lidocaine 1% inject 1,000 mg 2.86 mL -     azithromycin (ZITHROMAX) 500 mg tablet; Take 1 tablet (500 mg) by mouth 1 time per day  Dispense: 5 tablet; Refill: 0 -     methylPREDNISolone sod succ (SOLU-medrol) injection 125 mg   SOB (shortness of breath) -     XRAY CHEST PA AND LATERAL; Future -     COMPLETE BLOOD COUNT WITH DIFFERENTIAL; Future -     COMPREHENSIVE METABOLIC PANEL; Future -     C-REACTIVE PROTEIN (INFLAMMATION); Future -     SARS COVID ANTIGEN; Future -     INFLUENZA A AND B NUCLEIC ACID DETECTION; Future -     XRAY CHEST PA AND LATERAL; Future -     cefTRIAXone diluted with 2.1 mL lidocaine 1% inject 1,000 mg 2.86 mL -     azithromycin (ZITHROMAX) 500 mg tablet; Take 1 tablet (500 mg) by mouth 1 time per day  Dispense: 5 tablet; Refill: 0 -     methylPREDNISolone sod succ (SOLU-medrol) injection 125 mg -     albuterol-ipratropium (DUO-NEB) 2.5-0.5 mg/3 mL inhalation solution 3 mL   Light headed -     COMPLETE BLOOD COUNT WITH DIFFERENTIAL; Future -     COMPREHENSIVE METABOLIC PANEL; Future -     C-REACTIVE PROTEIN (INFLAMMATION); Future -     SARS COVID ANTIGEN; Future -     INFLUENZA A AND B NUCLEIC ACID DETECTION; Future   Uncontrolled persistent asthma -     albuterol (PROVENTIL) (2.5 mg/3mL) 0.083% inhalation solution; INHALE 1 VIAL VIA NEBULIZER EVERY 4 HOURS AS NEEDED FOR SHORTNESS OF BREATH, WHEEZING OR COUGH  Dispense: 90 mL; Refill: 0   Nausea -     ondansetron (ZOFRAN ODT) dispersible tablet 4 mg   Wheezing -     albuterol-ipratropium (DUO-NEB) 2.5-0.5 mg/3 mL inhalation solution 3 mL     Plan: XR, swabs and lab work today in clinic. Solu-medrol and rocephin today in clinic.   She started getting nauseated, vomiting and begining to wheeze with stridor. Color changed, BP lowered and she was diaphoretic. Zofran and Nebulizer treatment given.   Patient sent to ED after going into respiratory distress.  Return in about 1 day (around 10/1/2021) for Recheck. Multiple clinic/pulmonology/infectious disease visits:  9/30; 10/1, 10/13, 11/10, 11/29  has been started on Fasenra on 10/13 for her asthma