Round 16 (Allergic Reaction)


Case Introduction

You are sitting at your computer on an otherwise beautiful Friday afternoon when a mother brings her 16 year old son to the ED with chief complaint of allergic reaction.  

Initial Vitals

  • Temp 98.7
  • HR 155
  • RR 28
  • BP 125/85
  • O2 99%

Critical Actions

  • Interpret ECG
  • Interview patient alone (and identify trigger)
  • Perform vagal maneuver
  • Administer Adenosine
  • Discharge patient

Final Diagnosis

Supraventricular Tachycardia

Tips and Tricks

  • Interview pediatric patients without family members in the patient’s room
  • Escort family out of patient room during invasive procedures
  • Ask about / rule out potential triggers (caffeine use, drugs, ischemia, electrolyte abnormalities, etc)

Further Reading

The REVERT Trial (RebelEM)


  1. Joly

    I really appreciate your podcast !! I just listen to this whole series from round 1 and its amazing how mike grow clinically I just love it. He is a smart guy. Thanks and wish me luck in my exam this week.

    • Zack

      Thank you for the comment! Good luck on your exam!

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