Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Impaired driving ability, Nausea, Retching, Vomiting
Clinical narrative: Patient received the 1st COVID vaccine (Pfizer, lot #EW0185, use by 05/23/21, expiration: 08/21) at 1411. Client notified EMT that she was feeling nauseous EMT immediately helped the patient to the anti-gravity chair. The client vomited a small amount of vomit, no blood was in the vomit and it was a light green color. The client reported eating avocado and a quesadilla prior to being vaccinated around noon. RN assessed the client who was alert and oriented to person, place, time, and situation.  The patient was offered juice and water, denied experiencing this reaction in the past with other vaccines. Vital signs were taken at 1422, BP- 125/86 (Right arm, sitting upright), HR- 82, RR- 16, oxygen saturation- 97%. The client denied experiencing a similar reaction with other vaccines in the past. Client reported, " This is what I was like when I had Covid-19 months ago, I was just really nauseous." Denied shortness of breath, chest pain, vision changes, or difficulty swallowing. The client stated, " My nausea is a lot better, I'm feeling better." Vital signs were taken at 1434, BP- 136/86 (Right arm, sitting upright), HR- 75, RR-16, oxygen saturation at 97%. Client continued to deny shortness of breath, lightheadedness, chest pain, blurred vision, or changes in vision. At 1453 the patient had another episode of vomiting, it was a small, green amount of emesis, no blood or mucous was present. The patient was given 50mg diphenhydramine at 1457 and denied Emergency Medical Services. RN educated the patient about emergency room precautions and advised the client to follow-up with her primary care provider. Vital signs were taken at 1455: BP- 140/86 (Right arm, sitting upright), HR-68, RR-16, oxygen saturation at 100%. The client was educated about diphenhydramine and that it may cause drowsiness, so the client called her brothers to pick her and her daughter up. The patient continued to report feeling nauseous, and then stated," I feel like I'm getting back to normal." Vital signs were taken at 1508, BP- 140/ 82( Right arm, sitting upright), HR- 60, RR-16, oxygen saturation- 99%. The client continued to report, " I feel like I'm getting back to normal." Vital signs were taken at 1513, BP- 136/82 (Left arm, sitting upright), HR-70, RR-16, oxygen saturation at 98%. Client denied difficulty breathing, shortness of breath, difficulty swallowing, or wheezing. The client dry- heaved and had a scant amount of green phlegm present, no blood was observed. Vital signs were taken at 1518, BP- 138/82 (Left arm, sitting upright), HR- 82, RR-16, oxygen saturation at 97%. The client reported feeling less nauseous. Vital signs were retaken at 1523, BP- 132/82 (Left arm, sitting upright), HR- 74, RR-16, oxygen saturation at 97%. Vital signs were taken at 1528, BP- 132/82 (left arm, sitting upright), HR- 63, RR-16, oxygen saturation at 97%. Vital signs were retaken at 1533, BP- 128/80 (Right arm, sitting upright), HR- 70, RR-16, oxygen saturation at 99%. RN educated the client about V-safe and gave her a handout on it, in addition to reiterating the importance of following up with the clients primary care provider, educated the client about emergency room precautions, and the importance of preventing dehydration by intaking an adequate amount of fluids and electrolytes. The client was waiting for her brothers to arrived on site, as she felt a little drowsy from the diphenhydramine. At 1552, the patient dry-heaved and had a scant amount of phlegm present, no blood present. The patient was given another emesis bag and vital signs were taken at 1554, BP- 130/ 80 (right arm, sitting upright), HR- 85, RR-16, oxygen saturation 100%. The client's brothers arrived on site at 1554, RN gave report to the brothers, educated them about following up with the primary care provider, emergency room precautions, and the importance of being adequately hydrated. The client stated, " It just comes and goes but I don't feel as nauseous right now." At 1600, the client ambulated to the car with a steady and even gait.