Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Chest discomfort, Electrocardiogram, Immediate post-injection reaction, Laboratory test, Malaise
Clinical narrative: Medic responded emergency reference allergic reaction at vaccine clinic Medic to find 76/f seated in drivers seat, c/o nausea immediately after receiving vaccine. EMS standby staff on scene. Pt stated she had received vaccine approx 30 minutes prior to EMS arrival and began to feel ill <15 minutes later at which time standby EMS crew were alerted and in turn alerted transport. Pt has extensive list of allergies, including many antibiotics. Pt was A&OX4, pink warm and dry w/ good ABCs/PMS upon EMS arrival. Pt had no apparent life threats/injuries, was PEARL, equal lung sounds. Upon being placed in ambulance pt began to complain of dull ex pressure 2/10. 3 lead displayed sinus rhythm w/ PVCs which pt stated was her normal per pt cardiologist and that she was medicated for same with herbal medication.12 lead obtained, no elevation or depression noted, PVCs still noted, otherwise unremarkable. R-IV access attempted x2, good flash vein blew. 3 and 12 lead obtained to rule out cardiac involvement and monitor for changes. Given reference pt statement of positive ex pressure. Zofran considered, Medic was already at hospital when last IV was unsuccessful, PO zofran not given. No further interventions. Pt moved to stairchair via stand and pivot with assistance, secured via straps and moved to stretcher, pt placed in stretcher via stand and pivot with assitance, covered for comfort, secured via straps/siderails and moved to ambulance without incident. Pt and pt vitals monitored for duration of routine transport. Pt report called for prior to arrival. Upon arrival pt offloaded and moved to bed in ER via sheet draw without assistance. Pt care report given and pt care transferred to ER RN. Medic checked back in service. 76-year-old presenting with nausea and general malaise.  Symptoms started about 15 minutes after receiving her COVID-19 vaccine around 2:30 PM.  She has been nauseous but had no vomiting.  Slight central chest discomfort with palpitations. Also feeling somewhat dizzy.  She did not receive any medications.  EMS was called and brought her to the ED.  Denies any itchy skin, abdominal discomfort, sensation of throat swelling or pain.  No wheezing or difficulty breathing.  She has had anaphylaxis to medications in the past but she is unsure exactly which ones except for codeine. 76-year-old presenting with possible reaction to the Pfizer COVID-19 vaccine.  Constellation of symptoms are not consistent with anaphylaxis but may represent a different type of allergic reaction.  Will give Zofran for nausea, Benadryl, and observe.  Basic labs and EKG. KG My interpretation of EKG Normal sinus rhythm.  Normal axis and intervals.  No acute ST elevations or depressions. Reexamination/Reevaluation Patient was observed for over an hour without any progression of symptoms.  Her nausea improved with Zofran.  No episodes of vomiting in the ED.  Discharged with plan to follow-up with her PCP, continue symptom management at home. Diagnosis/Disposition  Nausea without vomiting atient Instructions Continue your regular medications as prescribed.  Use Zofran 4 mg every 8 hours as needed for nausea.  Follow-up with your doctor within the next 1 to 2 days for recheck.  Return to the ED if you develop severe difficulty breathing, severe chest pain, intractable nausea and vomiting or have other concerns. RX Given ondansetron: 1 tab, PO/SL, TID, nausea/vomiting, # 10 tab, 0 Refil(s)