Urgent Care patient Highlights (Urgent care is a step down from ED. It is same day appointments reserved for acutely ill children).
Ultimate favorite!
16 y/o female with intermittent neck pain that's been bothering her for the last 12 months. She made an urgent same day appointment because, well, she's just tired of her neck occasionally hurting. Exam was consistent with musculoskeletal origin of pain. Diagnosis: Pain in neck (ICD 9 code 723.1) likely muscle strain. Treatment: Motrin, heat, and passive stretching exercises and follow up with primary care physician for well child check.
Second place:
11 y/o male with chief complain of sore throat. I walk in the room. Hello John (not real name) how are you doing. What brings you to the urgent care today? John: "I don't know." Me: "You don't know? Well, are you sick?" John: "No." Me: "Were you sick?" John: "Oh yes, about a month ago." Me: "Do you still have a cough, sore throat, or congestion." John: "Oh no, those went away weeks ago, my mother just wanted me to come in and make sure I'm all better." Me: "Well, do you feel better?" John: "Yes." Me: "Go tell your mom you are all better!" Assessment: Pharyngitis, likely viral, resolved. Plan: F/U PRN.
Third place:
Chief complaint: Asthma exacerbation
Setting:
Small exam room, small resident (I'm 5'2"), one LARGE dad (at least 300 lbs), one medium sized mom, two LARGE 15 year old identicle twins (180 pounds each) sitting like petrified hunks of humanity. Their names (I kid you not) Rob and Bob.
Me: Hi! What brings you in today! Rob: "my cough." Me: "Tell me about your cough." Rob: "well, it's a cough and I cough a lot." Me: "How long have you had your cough." Rob: "ever since I had my runny nose." Me: "when did you get your runny nose. Rob: "I dunno, I think it was when I got my cold." Me (this isn't working): How LONG ago did you get your cold? Rob's mom: "I guess it was when he started opening his window at night." Me: "When did he start opening his window at night?" Mom (a little incredulous): "When it started getting cold!" I finally just decided to forget the history and rely on my physical exam. His O2 sat was 96%, and he was barely moving air. After a med neb treatment, his sats had jumped and he was moving air. Diagnosis: asthma exacerbation. Treatment: albuterol and steroid burst.
-Rachel Nelson
Ultimate favorite!
16 y/o female with intermittent neck pain that's been bothering her for the last 12 months. She made an urgent same day appointment because, well, she's just tired of her neck occasionally hurting. Exam was consistent with musculoskeletal origin of pain. Diagnosis: Pain in neck (ICD 9 code 723.1) likely muscle strain. Treatment: Motrin, heat, and passive stretching exercises and follow up with primary care physician for well child check.
Second place:
11 y/o male with chief complain of sore throat. I walk in the room. Hello John (not real name) how are you doing. What brings you to the urgent care today? John: "I don't know." Me: "You don't know? Well, are you sick?" John: "No." Me: "Were you sick?" John: "Oh yes, about a month ago." Me: "Do you still have a cough, sore throat, or congestion." John: "Oh no, those went away weeks ago, my mother just wanted me to come in and make sure I'm all better." Me: "Well, do you feel better?" John: "Yes." Me: "Go tell your mom you are all better!" Assessment: Pharyngitis, likely viral, resolved. Plan: F/U PRN.
Third place:
Chief complaint: Asthma exacerbation
Setting:
Small exam room, small resident (I'm 5'2"), one LARGE dad (at least 300 lbs), one medium sized mom, two LARGE 15 year old identicle twins (180 pounds each) sitting like petrified hunks of humanity. Their names (I kid you not) Rob and Bob.
Me: Hi! What brings you in today! Rob: "my cough." Me: "Tell me about your cough." Rob: "well, it's a cough and I cough a lot." Me: "How long have you had your cough." Rob: "ever since I had my runny nose." Me: "when did you get your runny nose. Rob: "I dunno, I think it was when I got my cold." Me (this isn't working): How LONG ago did you get your cold? Rob's mom: "I guess it was when he started opening his window at night." Me: "When did he start opening his window at night?" Mom (a little incredulous): "When it started getting cold!" I finally just decided to forget the history and rely on my physical exam. His O2 sat was 96%, and he was barely moving air. After a med neb treatment, his sats had jumped and he was moving air. Diagnosis: asthma exacerbation. Treatment: albuterol and steroid burst.
-Rachel Nelson
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