أثناء تسريب فانكومايسين وريدي، احمرّ وجه المريض ورقبته وصدره وصار يحس بحكة، والضغط والتنفس طبيعيان ولا يوجد صفير. ما التصرف الصحيح؟

During an IV vancomycin infusion, the client’s face, neck and chest flush and itch; BP and breathing are normal, with no wheeze. What is the correct action?

1. Give IM adrenaline now, as this is anaphylaxis
2. Continue at the same rate, as flushing is a minor symptom
3. Stop it for good and record vancomycin as a permanent allergy
4. Pause the infusion, notify the provider and restart it more slowly

Answer: D) Pause the infusion, notify the provider and restart it more slowly. This is a vancomycin infusion reaction (red man syndrome) caused by rate-related histamine release, not true allergy. The infusion is paused, an antihistamine given per order, and it is restarted over 60 minutes or longer. Adrenaline is for anaphylaxis, and labelling it an allergy deprives the client of an important drug.