You are an emergency room nurse and have just clocked in and gotten report on your four patients. Which patient should you see first?

 

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Correct

- 27 year old female with a rattlesnake bite on the upper arm who needs antivenin

- 97 year old left sided weakness, CT scan showed a ischemic stroke and he was treated with TPA. He needs a neuro check again in 45 minutes

- 3 year old with a fever who got tylenol about 10 minutes ago and needs a temperature re-check

- 13 year old male with nausea, vomiting, and diarrhea for one day who needs ondansetron

Rationale

Rattlesnakes are poisonous and this patient is at risk for serum sickness, shortness of breath and allergic reaction (such as anaphylaxis). Both the sroke and the fever have been seen, evaluated, and treated. They need to have check up interventions but not right now (45 minutes for stroke guy and at least another 20 minutes before temp re-check). I would see the N/V/D kid second to give them ondansetron (Zofran).

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