Received Feb 17, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| HPV9 | HPV (GARDASIL 9) | MERCK & CO. INC. | 2 | Y005835 | IM / LA |
Patient is here for her well-child check. She was given her HPV vaccine at the start of the visit approx. 8:56 am. She was sitting on the bench next her mom said I feel tired, slumped to the right and had brief loss of consciousness. She came to and we transferred her up onto the exam room table. An urgent response was called. We reentered the room mom noticed that her eyes were fluttering, she is holding her head turned to the right. She was minimally responsive, but able to identify where she is at and answer simple questions. Her speech is quite dysarthric. She seemed to have a slight droop of her right face, and tongue deviates to the right when protruded. Pupils are equal round reactive to light, but she has a lagging gaze with some horizontal nystagmus. Initially when she smiled there was drooping on the right but that has subsequently resolved. She continues to hold her head turned to the right. Decision was made to activate EMS for transport to the hospital. On their arrival, she still had dysarthric speech but was starting to joke and asked to go to school. She was able to stand and transfer to the stretcher with some support, though still seems weak. Continues to have a slight rightward head tilt, but has a symmetric smile now. We are approximately 40 minutes out from vaccine administration.
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Peanut , Egg
Blood sugar 104, repeat 94. Head CT was normal. Component Ref Range & Units 4 d ago (2/13/25) 12 yr ago (8/21/12) 12 yr ago (3/26/12) WBC 4.5 - 13.5 K/uL 5.0 8.1 R 30.5 High Panic R RBC 4.10 - 5.10 M/uL 4.54 4.21 R 4.94 R HGB 12.0 - 16.0 g/dL 13.3 11.3 R 17.4 R HCT 36.0 - 46.0 % 39.7 MCV 78.0 - 102.0 fL 87.4 80.5 R 102.6 R MCH 25.0 - 35.0 pg 29.3 26.8 35.2 R MCHC 32.0 - 36.5 g/dL 33.5 33.3 R 34.3 R RDW 11.5 - 14.2 % 12.7 12.4 16.7 High Platelets 150 - 450 K/uL 287 503 High R 329 R MPV 8.5 - 12.4 fL 9.5 10.5 10.4 R Neutrophils % % 44.0 14.0 Low R 65 R Immat Gran % % 0.2 0.1 R, CM Lymphocytes % % 40.2 65.8 R 20 R Monocytes % % 9.5 9.4 High R 10 High R Eosinophils % % 5.5 10.3 High R 3 R Basophils % % 0.6 0.4 R 0 R Neutrophils # 1.5 - 8.0 K/uL 2.2 1.1 R 19.8 R Immat Gran # 0.0 - 0.1 K/uL 0.0 Lymphocytes # 1.5 - 6.5 K/uL 2.0 5.3 R 6.1 R Monocytes # 0.2 - 1.0 K/uL 0.5 0.8 R 3.1 R Eosinophils # 0.0 - 0.6 K/uL 0.3 0.8 High R 0.9 R Basophils # 0.0 - 0.1 K/uL 0.0 0.0 R 0.0 R nRBC HCT 33.9 R 50.7 R Method AUTO MANUAL Meta/Myelo% 2 High R NRBC%-autodiff 1 High R RBC Morphology NORMAL Resulting Agency PHLab 710 HX MULTISITE HX MULTISITE Specimen Collected: 02/13/25 10:15 PST Last Resulted: 02/13/25 10:31 PST Component Ref Range & Units 4 d ago (2/13/25) 12 yr ago (3/26/12) 12 yr ago (3/26/12) Sodium 136 - 145 mmol/L 137 Potassium 3.4 - 4.7 mmol/L 4.0 Chloride 98 - 111 mmol/L 103 CO2 21 - 32 mmol/L 28 Anion Gap 3 - 12 mmol/L 6 Glucose 70 - 99 mg/dL 105 High BUN 9 - 23 mg/dL 8 Low Creatinine 0.40 - 0.80 mg/dL 0.61 GFR (CKD-EPI) Comment: For patients <18 the creatinine-based equation is recommended. Protein, Total 5.7 - 8.2 g/dL 7.4 Albumin 3.4 - 5.0 g/dL 4.2 Globulin 2.2 - 3.5 g/dL 3.2 Calcium 8.7 - 10.4 mg/dL 9.8 Bilirubin, Total 0.3 - 1.2 mg/dL 0.5 5.2 R 3.7 R Alkaline Phosphatase 128 - 420 U/L 303 ALT 9 - 54 U/L 19 AST 13 - 40 U/L 28 Resulting Agency PHLab 710 HX MULTISITE HX MULTISITE Specimen Collected: 02/13/25 10:15 PST Last Resulted: 02/13/25 10:39 PS