What should be the personalized plan of care for someone who has had a reaction to the flu vaccine?

  

nitial Post
Clinical Experience
Several years ago a flu shot clinic was being held for employees of the facility. It had been going on for several hours without any issues. If any issues did arise, the team would call for the non-patient rapid response team. In that case, the ER would respond. A RRT was called over head to the flu shot clinic. I responded and found a female patient lying on the floor in mild respiratory distress. She was anxious, diaphoretic, and stating like she felt like her throat was swelling, We quickly assessed her and did a set of vitals and felt it was safe to transport her to the ER down the hall.
In the ER, the patient was placed on the cardiac monitor and vital signs were obtained. The provider ordered for an IV to be placed and medication given. Some of the meds first included Benadryl, Pepcid, and a steroid. IV fluids were started as well and the patient was placed on oxygen. After a short period, the patient symptoms had not improved. The provider ordered for epinephrine to be given. The patient was observed for some time after to make sure they did not rebound.
Pharmacokinetics and Pharmacodynamics
Pharmacokinetics is the movement of drugs in the body. Pharmacodynamics is the affects of the drug on the body and mechanism of action “Dose, indications, adverse effects, interactions… from PDR.net,” n.d.).
The influenza vaccine works by causing the body to produce its own antibodies against the virus. Several medications can interfere with the flu vaccine. In total, 268 medications can cause a severe reaction (“Influenza virus vaccine, inactivated interactions,” n.d.).
A questionnaire should have been done prior to giving the vaccine. This is to make sure there has not been a previous reaction to the vaccine, eggs, or any ingredient to the vaccine. An anaphylaxis reaction would have to be caused by the virus or a component of the vaccine.
Personalized Plan of Care
I’m not sure of the patient’s prior health history before the event but I do know there was not a previous anaphylaxis event to a flu shot prior. The patient was being seen to rule out Lupus but no official diagnosis was given yet. As far as a plan, no further flu shots will be received. The patient should follow up with an allergist to see where the sensitivity lies. If any vaccine is approved, the patient should be pre-treated with Benadryl, Pepcid, and a Zyrtec prior to administration.
References
Dose, indications, adverse effects, interactions… from PDR.net. (n.d.). PDR.Net. https://www.pdr.net/drug-summary/Fluvirin-influenza-virus-vaccineLinks to an external site.
Influenza virus vaccine, inactivated interactions. (n.d.). Drugs.com. https://www.drugs.com/drug-interactions/influenza-virus-vaccine-inactivated.htmlLinks to an external site.
Kinman,T. (n.d.). What are the side effects of a flu shot? Healthline. https://www.healthline.com/health/flu-shot-side-effectsLinks to an external site.
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Clinical experience is critical in ensuring that patients receive personalized care and attention when seeking medical services. It is through these experiences that medical practitioners are expected to make informed decisions that cater to the needs of their patients. In this post, we shall discuss a clinical experience that took place during a flu shot clinic that required the intervention of a non-patient rapid response team.

Description:

During the flu shot clinic, a female patient presented respiratory distress symptoms, accompanied by anxiety and profuse sweating. Initial assessments indicated that it was safe to transport the patient to the ER. In the ER, she was given medication, which included Benadryl, Pepcid, and steroids, but the patient’s symptoms did not improve. Epinephrine was administered, and the patient was observed for some time.

Pharmacokinetics and pharmacodynamics affect how drugs move through the body and their effects on the human body. In the case of influenza vaccines, several medications could interfere with the vaccine, leading to severe reactions. Patient information, including previous drug reactions, should be collected before administering drugs.

In conclusion, for patients with reactions to the flu vaccine, a personalized plan of care should be established. Future vaccines for patients with allergies should follow a pre-treatment process with Benadryl, Pepcid, and Zyrtec to avoid similar reactions.

Objectives:

1. To understand the pharmacokinetics and pharmacodynamics of influenza vaccine and its possible interactions with other medications.
2. To recognize the signs and symptoms of anaphylaxis caused by the influenza vaccine.
3. To develop a personalized plan of care for patients with a history of anaphylaxis to the influenza vaccine.

Learning Outcomes:

1. Explain the meaning of pharmacokinetics and pharmacodynamics and its importance in understanding the effects of drugs in the body.
2. Identify the medications that can cause severe reactions with influenza vaccine.
3. Demonstrate the ability to assess patients who experienced respiratory distress after receiving flu shot and perform appropriate interventions.

4. Recognize the signs and symptoms of anaphylaxis and understand the mechanism of action.
5. Develop a comprehensive care plan for patients with a history of anaphylaxis to the influenza vaccine, including pre-treatment medications and follow-up with an allergist.

Solution 1: Conduct Screening Questionnaire and Allergy Testing Prior to Flu Shot

To prevent any future anaphylactic reactions, it is recommended that a screening questionnaire be implemented before administering a flu shot. This will help assess the patient’s risk for allergic reactions and make necessary arrangements to pre-treat with medications if required. Additionally, allergy testing should be done to identify the specific sensitivities of the patient.

Solution 2: Personalized Pre-Treatment Plan for Future Vaccine Administration

After a thorough assessment and evaluation of the patient, it is recommended to develop a personalized plan for future vaccine administration. The pre-treatment plan should include administering antihistamines, steroids, or other medications to prevent anaphylactic reactions. The patient’s plan should be discussed with an allergist who can help identify the patient’s specific allergy triggers and develop a personalized treatment plan. Overall, proper pre-screening and individualized pre-treatment plans will help prevent anaphylactic reactions and ensure patient safety during flu shot clinics.

Suggested Resources/Books:
1. Pharmacokinetics Made Easy by Donald Birkett
2. The Anaphylaxis Handbook by Dr. Lynda Mitchell
3. The Vaccine Book by Robert W. Sears
4. Clinical Immunology and Serology: A Laboratory Perspective by Christine Dorresteyn Stevens
5. Handbook of Adverse Drug Reactions: A Guide for Healthcare Professionals by Jeremy J. Webb

Similar Asked Questions:
1. What are the symptoms of anaphylaxis?
2. What precautions should be taken before administering a vaccine?
3. What is the mechanism of action of the influenza vaccine?
4. What are the common interactions of the flu vaccine with other medications?
5. What is the personalized plan of care for a patient experiencing anaphylaxis due to a vaccine?

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