Thursday 15th April 1993 After lunch 13:18
When Harriet pressed the alarm, Dr Lewis was the first to arrive in the treatment room. We crowded in behind her.
Mr Thomas was lying on the couch looking pale and frightened.
“His eyes are puffy,” said Dr Lewis. “His lips are swollen. Look at his neck!” There was a flush of red that seemed to be spreading up from under his shirt. Dr Lewis quickly checked the patient’s pulse. A red rash started to appear on his hands.
“It looks like anaphylaxis, Harriet.”
“He’s on amoxicillin, Dr Lewis.”
“I took one just before I left the house,” said Mr Thomas. His swollen lips made his speech slightly slurred. Dr Lewis asked him to stick out his tongue. It was beginning to swell. Mr Thomas coughed.
“Can I have some adrenaline, Harriet?”
Harriet nodded. While she got the adrenaline ready, Dr Lewis checked Mr Thomas’ blood pressure.
“That’s quite low, she said. Dennis, can you get a drip ready. Dilys, can you set up the oxygen. Will you phone an ambulance for me, Dylan? 999, please.”
Dylan rushed out towards reception.
“Thanks, Harriet. Alright, I am giving 0.5 ml of 1 in 1000 adrenaline intramuscularly into his right upper arm. It’s 13:20.”
“Do you want to get me another dose ready?”
“Yes please, Harriet.”
Dilys put the oxygen mask on and asked Mr Thomas to breathe slowly but steadily in and out.
“How’s that drip, Dennis?”
“It’s ready, Dr Lewis. Do you want me to put the cannula in? Mr Thomas’ veins look quite good.”
“Please, Dennis. I’ll check his blood pressure again.”
“Do you want hydrocortisone, Dr Lewis?”
“Not yet, Dilys. It’s 13.25 and his blood pressure is still low. I will need to give him another dose of adrenaline first.”
“His lips are starting to improve and his eyes are less puffy, Dr Lewis.”
“Excellent. Thanks, Harriet. Right, that’s another 0.5 ml of adrenaline given at 13:27. It’s a bit later than I wanted but he is improving.”
“How are you, Mr Thomas?” Dilys shouted.
I feel better. Mr Thomas’s speech was already clearer.
“The drip’s in, Dr Lewis.”
“Well done, Dennis! Do you want to run 500ml of normal saline through? Once Dennis has done that, Dilys, you can give 200mg hydrocortisone intravenously. I will give him some piriton.”
“The ambulance will be here in 6 minutes, Dr Lewis.” Dylan announced excitedly as he arrived back.
“I’m feeling much better,” said Mr Thomas. “Do you really think I should go in?”
“You will still need to be admitted for observation,” Dilys explained. “Sometimes, these severe reactions can flare up again after a few hours.”