Age: 25.0
Sex: M
Vaccine: COVID19
Symptoms: Epistaxis, Fall, Head injury, Loss of consciousness, Nervousness
Clinical narrative: Last week Monday - June 14 I worked 1pm-9pm. My opening pharmacist left around I'd say 2pm, or 2:15pm~ish and hadn't witnessed the incident. So somewhere around that approximate time I was inside the pharmacy working on a back computer by drive thru and I heard someone yell for help in the waiting area. It was the kind of help you just know means something really drastic has just occurred. I quickly entered the waiting area via the pharmacy consultation door and saw patient face down between two chairs and his nose had a consistent drip of blood that was apparent on the floor.   My technician who was in the consultation room told me he had received a Johnson and Johnson Covid vaccine probably within 5 minutes of the incident. With the combination of that information and the visualization of an active bleed, I made eye contact with another staff member inside the pharmacy at will call and told him to call 911 which he turned around immediately and did. The man was alone, but the woman who yelled for help was also calling 911 I believe. At this point I'd say approximately every 3 seconds, a new drop of blood would emerge. There were a couple people nearby including the customer and I asked everyone to stay back a little, I surveyed the scene and it appeared to be safe and I approached patient as I tried to verbally get a response of some sort.  I asked if he could hear me, if he knew where he was and what happened, both with no response. The bystander recommended turning him on his side but with the unknown cause of the bleed and the recent vaccination I didn't know if it could be CNS or spinal related and since we were on the phone with EMS, we could get their recommendation of whether to move him or not.   Within 15-30 seconds probably, he started regaining consciousness and he was scared at first and rightfully so. He jolted up and back and looked at me like, "why am I face down in my own blood (and probably in a lot of pain i'm sure)", and it scared me a little to be honest. I told him what we had observed, and I saw the bridge of his nose stuck out beyond what was normal but I'm not sure what normal is to him..?? I saw two small lacerations on the side of his nose and a pair of glasses on the floor. I couldn't determine if they were broken or not but surmised, he must have fainted and fallen off the chair and landed on his glasses which cut and may have even broken his nose. Or maybe the ground broke his nose. Either way it looked bad. There were several store team members around at this point (those listed in this report), and the patient was given paper towels for the bleeding and bottled water. There was a store use wheelchair we put him in when he was ready and wheeled him into the consultation room where he could be monitored until EMS arrived.  While speaking with the patient before EMS arrived, he rendered all the following information:           Never had a reaction to a vaccine before           Never had any knowledge of high or low BP issues           Doesn't recall ever feeling lightheaded or dizzy upon quickly erecting           Might have low blood sugar issues                   Reasonings for the above response:                             Hadn't eaten that day yet before his shot and was feeling a little anxious about it                            Last time he gave blood he hadn't eaten breakfast and passed out after that                                         This was the only other fainting history mentioned                                        He did say it was within the last 6 months  EMS arrived within another 2-3 minutes I'd say at which time we had already began the cleaning process. We blocked off the area to other customers, we halted the vaccination process until the issue was resolved, I printed the Biohazard Spill procedures, we obtained the bio-hazard spill kit, and proceeded to clean with all the PPE and sanitization materials included within the kit. After the entire process was completed the store team even ran the cleaner over the area to go above and beyond.   The patient refused the ride to the hospital via ambulance due to costs and signed a medical waiver I believe..??