Phone Visit
Narrative: SPRUCE MESSAGE VISIT Date: 2024-03-19 Encounter: Spruce text message CC: Known peanut-allergic child ingested trail mix containing peanuts approximately 45 minutes prior to messaging. HPI: Malcolm, approximately age 3 with known peanut allergy, inadvertently consumed trail mix containing peanuts. Approximately 45 minutes after ingestion, he had been crying but had settled and was watching TV. He was itchy with red, swollen eyes. Breathing appeared normal. Parents administered 5 mL of Benadryl. EpiPen was available but not yet used. He vomited later that night, which parents noted was consistent with a prior reaction to eggs. Assessment: Allergic reaction to peanut exposure, manageable without epinephrine given stable breathing and improving symptoms after Benadryl. Vomiting the following morning was noted as a potentially more serious reaction sign to watch for in the future. Plan: No EpiPen needed at this time. Shower to remove allergen. One parent to stay with and sleep near Malcolm overnight. Monitor per existing allergy action plan. Use EpiPen and go to ER if reaction escalates. Follow-up check-in the next morning confirmed he slept well and was doing better. Medications: - Diphenhydramine (Benadryl) 5 mL (new) Key clinical quotes: "You don't need to do the epi pen." "I'd rinse him off in the shower to get any lingering allergen off of him." "If you do use the epi pen, go down to the ER" Source: Spruce conversation t_27C02FVS44O00