[Verse 1] Dispatch drops at 03:15, lights up the night, “Possible allergic reaction, patient not feeling right.” I’m thinking through the call before I even arrive, History matters if we’re gonna keep them alive. Onset and location—what triggered this wave? Insect sting or bite, or the food that they craved? Maybe new clothing, soap, detergent in play, Or a medication exposure that started today. I ask about past reactions, did it happen before? Medical history, meds—what’s already in store? Every detail matters when the airway’s at stake, Because seconds in this job are the seconds we take. ⸻ [Chorus] It’s itching, hives, and a tightening chest, Wheezing lungs struggling just to do their best. Throat feels tight, like the air’s running thin, Nausea, swelling—now panic sets in. From mild to severe, we don’t hesitate, Epi in the muscle—don’t negotiate fate. ⸻ [Verse 2] Skin starts talking—urticaria signs, Or angioedema swelling lips and lines. Could be asthma, COPD flare, CHF stress, Or vasovagal drop in a moment of distress. Differential thinking as I’m grabbing the kit, Airway obstruction—we don’t ever quit. Shock in the vessels, pressure falling fast, This is the moment that has to outlast. Two systems hit? Now I’m going in deep, Moderate reaction—I’m breaking that leap. Benadryl 50, PO or IV, Famotidine slow drip—start therapy. ⸻ [Chorus] It’s itching, hives, and a tightening chest, Wheezing lungs struggling just to do their best. Chest and throat constricting, airway under threat, We haven’t lost this patient—we’re not done yet. From mild to severe, we don’t hesitate, Epi in the muscle—don’t negotiate fate. ⸻ [Verse 3] Severe now hits—hypotension shows, Epi 1:1,000, IM goes. 0.3 to 0.5, every five if needed, While every other step gets quickly superseded. Albuterol nebs for the lungs in fight, Maybe ipratropium if the wheeze is tight. Cardiac monitor, ETCO2 too, 12-lead ECG to see what’s true. If pressure stays low, I don’t second guess, Push-dose epi just to bring back success. Or drip it steady, titrate the flow, MAP above sixty-five—that’s the goal. ⸻ [Bridge] Airway protocol when the throat starts to close, Crystalloid bolus while the pressure still goes. 500 mL at a time, up to two liters in play, Methylpred if nothing is turning away. But I know in my hands, the rule stays the same: Epinephrine first—that’s the name of the game. Not antihistamines, not waiting for slow, It’s the drug that decides if they live or go. ⸻ [Final Chorus] It’s itching, hives, and a collapsing chest, But we move with purpose—we do what’s best. From skin to shock, we read every sign, One shot of epi can turn back the line. From mild to severe, we don’t hesitate, We don’t negotiate fate—we modify fate. ⸻ [Outro] Back in the rig, the call fades away, Another life held for another day. History, meds, and the story they bring— It’s never just calls… it’s everything.
