Pre-hospital Management of Severe Anaphylaxis Assignment

University Durban University of Technology (DUT)
Subject Pre-hospital Management of Severe Anaphylaxis

CASE DETAILS

Case Information:
  • Name: Shesha Kancane ; Age: 18; Gender: Female; Weight: 60 kg

You have been called to the premises/rooms of a GP in a rural residential area to transport a patient in respiratory distress after being given a Penicillin injection for flu symptoms. You arrive on scene within 10 minutes of the call.

Medical History: Chronic asthma since childhood

Daily Medications: Seretide (beta-2+steroid) inhaler; Salbutamol inhaler, methylprednisolone tablets when necessary

Signs & Symptoms:
  • Sore throat with difficulty swallowing after receiving penicillin injection
  • Patient presents with severe difficulty in breathing
  • Generalised hives and wheals with swollen lips and tongue
Vital Signs:
Resp rate 40 per minute SpO2 82% on room air
Heart rate 130 per minute Temp. 37.5 °C
BP 80/60 mmHg EtCO2 36 mmHg
BGL 7 mmol Cap refill <3 sec
AVPU Pain response only Skin Cool & clammy

Initial presentation:

Chief Complaint: Severe shortness of breath and chest tightness

History: The patient has been experiencing worsening shortness of breath over the past 30 minutes, despite using her prescribed inhalers. She used her Salbutamol inhaler multiple times with no relief. The GP’s receptionist called emergency services when the patient could no longer speak in full sentences. The GP had left the rooms after he had attended to the patient, and is not currently available.

Upper airway: Patent but patient is having difficulty inhaling and complains of difficulty swallowing her saliva.

Breathing:

  • Auscultation: Bilateral severe inspiratory and expiratory wheezes
  • Accessory muscle use, unable to speak in full sentences

Circulation:

  • ECG: Sinus tachycardia
  • Delayed capillary refill
  • Flushed skin
  • Weak, rapid peripheral pulses

Other

  • Patient initially had flu-like symptoms i.e. dry cough, body aches and nasal congestion. Developed itchy skin and sore throat about 5 minutes after receiving penicillin injection.
  • The patient received penicillin injection only once before, 2 years ago.

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ASSIGNMENT:

  • Use ChatGPT to draft patient management of this patient. This must include intext references. (2)
  • Give a rationale for each management step. (18)
  • Critique chat GPT the patient management of this patient in terms of your training and HPCSA guidelines. (10)

Suggested areas to consider:

Is the treatment the best option? Can you improve it? If so, how?

Are the references correct? Do they say what ChatGPT says that they say?

Despite treatment, the patient’s condition continues to deteriorate. She becomes increasingly tachypnoeic and anxious, with audible wheezing and difficulty speaking, deteriorating into a state of unconsciousness.

Vital Signs:
Resp rate 10 per minute SpO2 89%
Heart rate 135 per minute Temp. 37.5 °C
BP 100/60 mmHg EtCO2 36 mmHg
BGL 10 mmol Cap refill 3 sec
AVPU Less responsive Skin Cool & clammy
  • Use ChatGPT to draft patient management of this patient. This must include intext references. (2)
  • Give a rationale for each management step. (10)
  • Critique chat GPT the patient management of this patient in terms of your training and HPCSA guidelines, as per Q3. (8)

The patient suddenly goes into pulseless ventricular tachycardia cardiac

arrest, immediately after ET tube is secured.

Vital Signs:
Resp rate 10 per minute SpO2 0%
Heart rate Pulseless VT Temp. 36 °C
BP 0 mmHg EtCO2 28à 0 mmHg
BGL 10 mmol Cap refill Undetermined
AVPU Unresponsive Skin Cool & clammy
  • Use ChatGPT to draft patient management of this patient. This must include intext references. (2)
  • Give a rationale for each management step. (10)
  • Critique chat GPT the patient management of this patient in terms of your training and HPCSA guidelines, as per Q3. (8)

Accurate referencing must be used throughout the assignment.

DUE DATE: 22 September 2025

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