Author: James Rowley / Editor: Fiona Mendes / Codes: AP3, MaP2, RP2, SLO1, SLO3Published: 21/12/2022

You are working in adult resus as the lead doctor and the triage nurse calls you to urgently review a patient that they are assessing.

A 45-year-old female has presented with gross upper and lower lip swelling. The triage nurse is concerned about the potential of a compromised airway.

Upon your assessment, the patient has gross lip swelling, but seems otherwise well. She is a refugee from the Ukraine and speaks limited English. Her lip swelling started a few hours ago.

There was no trauma, and the patient has not been exposed to any known allergens. The patient has a document saved on her phone which is written in characters you do not recognise except for one word: ‘Berinet’.

The patient’s initial A-E assessment is as follows:

A – Patent, no sign of airway issues. Talking.

B – Respiratory rate 12 breaths/minute, oxygen saturations 98% in room air, no audible wheeze or respiratory distress.

C – Heart rate 85 beats per minute, Blood Pressure 145/67 mmHg 

D – Alert, able to follow simple commands. GCS 15/15.

E – Gross lip swelling. No other visible swelling, rashes or bruises.

The patient keeps pointing to her phone and requests a translator.

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