The Food and Drug Administration has issued a new guidance suggesting there should be something of a kids’ menu for imaging, one that employs the lowest dose of radiation possible when imaging younger patients (or avoids x-rays altogether, if feasible). “Pediatric patients generally require less radiation than adults to obtain a quality image from an x-ray exam, so doctors must take extra care to ‘child size’ the radiation dose,” the FDA said in a statement. …
Read MoreA 5-Month-Old with Symptoms Beyond the Presenting Complaint
Urgent message: Treating preverbal children can be challenging under every-day circumstances for pediatricians who know the child and the family. Urgent care providers who may not have the benefit of that history must be especially vigilant for all available signs and symptoms to make diagnoses based on the full scope of the presentation. Michael Weinstock, MD Case Presentation (Please note: The Case Presentation is drawn directly from the treating physician’s notes, without editing or correction, …
Read MoreWith Four Children Dead Already, CDC Warns This Flu Season Could Be Severe
It’s relatively early in the season, but the Centers for Disease Control and Prevention reports that influenza activity is already rising—and several markers are higher than normally seen this early. Four children have already died this season, and four of the CDC’s 10 regions are at or above their regional baselines. Another bad sign: Australia, whose data are often a predictor of flu severity in the U.S., just completed its worst flu season on record. …
Read MoreApproach to Ingested Foreign Bodies in Children
Urgent message: Less than one out of a hundred cases of children ingesting foreign bodies requires surgical intervention. Identifying which children that could apply to, which need endoscopic removal, and those who can wait for spontaneous passage is an essential role for the urgent care provider. Herlene Chatha, MD and Hansel Otero, MD The case: An otherwise healthy 2-year-old boy is brought to your urgent care center by his parents, who are concerned that he …
Read MoreCDC Recommends Two Flu Shots for Kids 6 Months to 8-Years-Old
In addition to reminding clinicians that all patients 6 months of age and older should receive flu shots by the end of this month, the Centers for Disease Control and Prevention is trying to get the word out that children between 6 months and 8 years of age should receive their vaccinations twice, approximately 28 days apart. Like last year, the CDC also recommends against using the nasal pump spray because it’s been deemed inefficient …
Read MoreNew Vaccines Recommended for Adults and Children in 2016
Urgent care practices that focus on helping patients stay up to date on immunization—such as occupational medicine and travel medicine providers, or those that cater to seniors and families with children—take note: The Centers for Disease Control and Prevention has made a few changes in its recommendations this year. For adults, a recently licensed meningococcal serogroup B vaccine and human papillomavirus vaccine have been added, and the recommendation for pneumococcal vaccination has been revised from …
Read MoreBoy with Leg Rash, Knee Pain, and Abdominal Pain
This photograph was taken of a 6-year-old boy who presented with a rash on his legs. Two weeks earlier, he had an upper respiratory infection. His father said that he had 2 weeks of fever and headache before the rash began. The boy also reported knee pain and diffuse abdominal pain. On physical examination, purpuric papules were apparent on his lower extremities. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreAbstracts in Urgent Care: April, 2007
Computed Tomography Coronary Angiography for Rapid Disposition of Low- risk Emergency Department Patients with Chest Pain Syndromes Citation: Hollander JE, Litt HI, Chase M, et al. Acad Emerg Med. 2007;14(2):112-116. URL: http://www.aemj.org/cgi/content/abstract/14/2/112 Key point: CT coronary angiography may safely allow rapid dis- charge of patients with negative studies. Patients with recent normal cardiac catheterization are at low risk for complications of ischemic chest pain. Computed tomography coronary angiography has high correlation with cardiac catheterization for …
Read More