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...giving Epi for an undiagnosed allergy. Just after getting my standing Epi orders. Student presented with hives on face and arms. Rash has been occurring on/off for a couple of week on different parts of student's body. Was given benadryl by doctor. Got benadryl from me, but rash spread and student started reporting trouble swallowing and that throat felt "weird." Wasn't taking any chances. Hives disappeared and vitals stable after Epi when EMS arrived. Transported for work up. We shall see what happens after the ED visit.
I feel like I just gave my first Epi-pen all over again.
It's not uncommon for the hives to show up in multiple places. I'm interested to hear how this turns out...hives doesn't always equate anaphylaxis, to the best of my knowledge.
I'm fairly certain it was the throat feeling "weird" and trouble swallowing PLUS hives that triggered the Epi-pen administration. Not just the hives themselves.
I'm fairly certain it was the throat feeling "weird" and trouble swallowing PLUS hives that triggered the Epi-pen administration. Not just the hives themselves.
You are correct. The rash and (rotating) hives triggered the Benadryl administration. This is all part of my school's Allergic Reaction Action Plan, which follows guidelines set by several sources, including NASN.
Further update: student still experiencing rash with what appears to be a hive or two occasionally. No further symptoms (thankfully), but I will be very curious when the allergy testing is complete.
JenTheSchoolRN, BSN, RN
3,035 Posts
Update: Student back in school today. Now has prescription for Epi and EpiPen in backpack. Was seen by allergy. No idea what allergen is yet, but tests done and significant swelling seen in her throat. I feel even better that I used my stock epi now.
(Student also wrote me the sweetest thank you email. I'm going to print it and look at it when I need to remember how important being a school nurse really is.)