C10031408 / invoice 10000

Appointment Notes: ate two fish at the beach just now'Reason: Ate 2 fish at beach approximately 1 hour ago - sardine-like fish washed up on shore. O concerned re: possible puffer fish ingestion.Subjective: EDDU normally, No V+ or d+Ate 2 dead fish at beach ~1 hr ago. One fish identified as sardine-like, other fish unknown. Multiple dead fish washed up on beach at time of ingestion. PMHx: multiple previous foreign body ingestions requiring emesis. Recent dental prophylaxis 2 days ago.Objective: BARHR/PR/Cardio: pulse normal and synchronous, CV normal, no audible murmurTemp: neMM/CRT/Hydration: pink, moist CRT 1 sec, hydration normalRESP/RR: NAD normal rate and effortGIT/UG: NAD comfortableSkin/Ears: NADM/S: NADEyes: NADDental: cleanLymph Nodes: wnlBCS: 5/9Assessment: Foreign body ingestion - 2 dead fish (sardine-like). Risk of tetrodotoxin ingestion if puffer fish consumed.Treatment: Induce emesis to remove gastric contents. Monitor response and administer antiemetic if persistent vomiting occurs.Diluted 0.2mL apomorphine with saline to make 5mL solution, gave 2.8mL slow IV Plan: Administer apomorphine to induce emesis. Monitor for successful expulsion of fish. Administer antiemetic PRN if persistent vomiting. Discuss tetrodotoxin risk and clinical signs with O. Discharge if stable post-emesis with home monitoring instructions._______________INSURANCE HXInitial Assessment > ate fish at the beach, induce emesis  Suspected cause >  ate fish at the beach Date of first clinical signs >14/3/26Any other conditions / treatments > no    Vital Signs    Weight: 27.7;