C09978949 / invoice 10000

Reason: Allergic ReactionHistory:Presented to ARH ECC this morning with angioedema and pruritis of the face and muzzle.No previous hypersensitivity reactions.O reports no CS of allergic reaction prior to going to bed, was awoken by Bruno frantically scratching face. Noted ocular and muzzle angioedema which prompted vet visit. No lethargy. No vomit or collapse. No other emergent concerns noted by O. Is otherwise well - BAR and EDDU as per normal.See previous re PLN, IMTP & hypoalbuminaemia. Currently managed by internal medicine team. Currently only on telmisartan 12mg SID. Subjective: BARObjective:Temp: 39.1          mm: p + m         CRT: <2s        HR: 88             FP: SS            RR: 20BCS:   5/9            Wt: 14.8 kgPain score (CSU):   0/4CV: WNL. No murmur or arrhythmia noted on cardiovascular auscultation. BP - 147/92 (110). Wriggly, could only get 1 reading. RESP: WNL. Normal respiratory rate and effort. Normal bronchovesicular sounds.GIT: WNL. Abdomen soft and comfortable on examination. No discomfort or abnormalities on deep abdominal palpation.U/G: WNL. No discharge or abnormalities noted.Neuro: WNL. Mentation is normal.M/S: WNL. Ambulating well with no gait abnormalities.Integ: Moderate ocular angiodema (R>L), mild to moderate muzzle andioedema. No urticaria. Ophth: WNL. Eyes are clear with no discharge, inflammation or blepharospasm.LNs: WNL. Superficial lymph nodes of normal size and consistency.Imaging:Mild GB halo present, no free fluid.Assessment:Hypersensitvity reactionGB halo - clinically well and stable.Ok for outpatient monitoring unless any decline or concerns.Plan:Discussed hypersensitivity and anaphylaxis with O.Advised of likely causes and potential for escalation on repeat exposure. Angioedema much improved after anti-histamine given.O comfortable to monitor at home and return if any concerns or repeat CS. Treatment:IM chlorpheniramine 0.5mg/kg @ 0400    Vital Signs