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Scenario: To be or not to Bee?


Please note: The users who submit scenarios have declared that all patient details are fiction. We cannot guarentee the accuracy of any suggested treatment or the realism of suggested observations. You should judge these for yourself.



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Scenario Overview:
A 12-year-old boy is brought to the First Aid stand during an Australia Day function, after being stung by a bee. He had been well until he was stung on his right forearm, while playing in the nearby playground.
Difficulty:
First Aider Easy
How the scenario should progress:
He initially complained of localized pain and swelling. Fifteen minutes later, he began to complain of shortness of breath. His parents observed him to be wheezing. He also said that he felt very weak and dizzy.
Patient 1:
Name: Levi Anderson     Age: 12    Sex: Male
Medication: Kids multivitamin daily
Allergies: No known
Past medical/family/social history: No past medical issues
Findings on examination: He is in mild respiratory distress. He is drowsy and pale, but awakens when you talk to him. He has generalized urticaria. His lips and tongue are not swollen. His voice sounds normal. He has mild wheezing. He has mild abdominal discomfort. His face is moderately pale. The bee sting site on his right forearm is unremarkable with no foreign body seen.
Possible treatment from first aiders: n the event of an Anaphylactic episode, you should: Follow the DRSABCD Call triple zero (000 or 999 or 911) Lay the casualty down or in a position which they find easiest to breathe (not standing) Ask if they have their adrenaline auto-injector on them If the casualty cannot administer the injection themselves help them 6. Record the time the adrenaline auto-injector was delivered 7. If the casualty had not been previously diagnosed and therefore does not have the appropriate medication, wait for medical assistance to arrive 8. Ensure the casualty remains lying flat. If breathing is difficult allow them to move into a comfortable position to breathe (sitting up) 9. Monitor the casualty’s breathing 10. Once five minutes has passed, if there is no response or improvement, administer another dose whilst alerting the 000 operator who will instruct you further if needed ST John Australia
Time after start: 15 min
Response: Voice
Airway: Yes
Breathing? Yes
Respirations: 39
Pulse: 120



Tips for the patient actors:
Symptoms may be mild at first but will get worse rapidly, if not treated.

Scenario submitted by: Anonymous