So note for a lady called tina hayes I can't remember her hospital number I think she was born on the 1961 hospital number is 00001 documentation from a peri arrest or met call patient is a member of staff 1 of the hcas on ella rowcroft ward peri arrest call put out at approximately 07:45 07:30 on arrival patient laying on the floor supported by 4 or 5 nursing staff airway appears patent conversing with the nursing staff but appears tremulous a to e assessment reveals patent airway normal breathing with clear chest bilaterally saturations a 100% on 8 l via face mask circulation reveals blood pressure 180 over 105 with heart rate 120 ecg undertaken reveals sinus tachycardia heart sounds normal and good regular peripheral pulses glucose 5.3 gcs 15 tremulous in the legs and arms abdomen soft and not tender patient reassured mobilized to wheelchair taken into the staff room for further assessment on arrival in the staff room further history taken patient suffers with anxiety central tremor and asthma for which she takes several inhalers including a salbutamol inhaler has been feeling particularly anxious over the last 24 hours did not sleep well at home last night and this morning awoke feeling tremulous and much more anxious than usual of note she has a background of a central tremor as well she hasn't had any fevers has been feeling generally well over the last few days and has no exacerbation of her asthma currently she took her inhalers as usual this morning but subsequent to taking them felt very tremulous and shaky and felt her heart beating very quickly experiencing palpitations when she took her inhalers when she was at work stood in the corridor she felt palpitations and her heart racing and so she used a portable observation machine to take her pulse rate which she found to be very high and then she reports feeling the room was spinning her vision was darkening that she her breathing was incredibly fast and her heart was fast and she felt the need to lie on the floor during the assessment she was breathing very fast tremulous both in the arms and the legs consistent with anxiety on examination heart sounds normal chest clear asthma is soft and nontender no peripheral edema impression anxiety attack exacerbated by use of salbutamol inhaler and subsequent tachycardia plan to be transferred to the acute medical unit for further assessment including blood tests full blood count using these lfts thyroid function testing and crp observation until patient feeling better and review with 1 of my day team colleagues subsequent to that if discharged for a patient to go home and not return to work today I will hand over this patient to the medical registrar on call so they are aware of this lady and hand it over to doctor bartlett approximately quarter past 8