Posted by Dr. Marc Mickiewicz at March 9, 2019 8:43 pm Blogs, urgent care
Most Common Pediatric Urgent Care Illnesses & Injuries

Most Common Pediatric Urgent Care Illnesses and Injuries

As we mark our return to warmer and (hopefully) drier weather, children will soon be back to doing what do they best: acting like kids and getting hurt. In this post, we will review some of the most common reasons children visit our Nashville urgent care clinic. We will also provide some information which will hopefully result in a smoother urgent care experience for you and your child.

According to a 2016 study published in the journal Pediatrics, the three most common diagnoses for children who visited an urgent care or walk in clinic were upper respiratory infection, fever, and otitis media. Let us begin by examining each of the conditions in detail.

Common Respiratory Infections: Flu, Strep Throat, Colds

An upper respiratory infection is an infection of the nose, sinuses, throat, and/or larynx (voice box and vocal cords). What we think of as the common cold definitely fits into this category, but influenza, strep throat (streptococcal pharyngitis), and bacterial sinusitis are also included. Many times these infections are caused by viruses, but not always. 

Flu

At our urgent care clinic we offer rapid point of care testing for influenza. Antiviral medications such as Tamiflu (oseltamivir) work to shorten duration of symptoms. They also have been shown in studies to reduce complications and lessen the risk of death from influenza. Antiviral therapy is recommended by the Centers for Disease Control and Pediatric Infectious Diseases Society of America for many patients, including all patients under the age of 2. Does everyone with influenza have to take Tamiflu?  Clearly the answer is no but we are happy to discuss the pros and cons with every patient/family to help make the decision which is best for your child. 

Strep Throat

Strep throat (bacterial or streptococcal pharyngitis) is typically treated with antibiotics, and can be diagnosed with a rapid swab or throat culture if the swab is negative. Often a child with persistent runny nose and congestion (especially for more than 7-10 days) has rhinosinusitis, a sinus infection that may be caused by a bacterium which will improve dramatically with the correct antibiotic. 

Colds

It is clear that the majority of upper respiratory infections are caused by simple viruses that need to run their course. However, if your child appears quite ill, isn’t improving or you have concerns, our urgent care providers may be able to confirm that nothing more serious is going on (such as pneumonia) from a careful physical exam or additional testing such as a chest x-ray. Even if we don’t feel that antimicrobial therapy will help your child, we can provide reassurance and discuss the expected time course of the illness.  We can also possibly recommend some adjuvant non-antibiotic therapy which can speed along your child’s recovery.

Fever

Fever is another very common diagnosis for children who present to our urgent care walk in clinic. All of the conditions discussed above commonly cause fever, as do ear infections (discussed below). In addition, there are many viruses which infect the gastrointestinal (GI) tract and cause fever along with nausea, vomiting, and diarrhea. These children frequently benefit from an antiemetic (such as Zofran or ondanestron) which can break the cycle of vomiting, aid in rehydration and prevent the need for an IV catheter. Infections of the skin, such as cellulitis or an abscess may present with a fever and require therapy with an antibiotic or incision and drainage to remove pus from beneath the skin. 

A special population to mention with regards to fever are young infants (especially less than 90 days old). Due to the development of their immune systems, it can be very difficult to distinguish between a minor viral illness and a life-threatening bacterial infection in these patients. As a result, these children are best evaluated in an Emergency Department or primary care provider’s office. For children older than 6 months, we can often confirm the cause of a fever in a child by the history and physical and point of care testing, and provide any additional therapies which might be needed in an urgent care setting.

Ear Infections

Otitis media is the clinical term for a middle ear infection. Many cases of otitis media are caused by viruses but due to the proximity of the middle ear to important structures, such as the mastoid air cells and brain, managing these infections appropriately is very important. It is presently recommended that all children less than 6 months be treated with antibiotics, as well as all double ear infections in children aged 6-23 months and essentially any child who appears seriously ill (high fever and severe ear pain). With some milder ear infections, a wait-and-see approach is appropriate, especially in older children. Therefore it can be reasonable to withhold antibiotics initially in certain cases. Re-evaluation either in the urgent care or primary care office in 48-72 hours is critical to insure that these infections are improving appropriately.

That’s a brief overview of pediatric illness, let’s us our remaining space to talk about injuries: a very common cause of visits to the urgent care, especially during the warmer spring and summer months. 

Lacerations

Lacerations are cuts that extend through the various layers of the skin. Sometimes they heal well on their own, but depending on the size and location, stitches, staples, or tissue adhesive (Dermabond) may be needed to properly close the wound and give your child the best functional and cosmetic outcome.  Some wounds need irrigation and cleansing or removal of foreign bodies. Lacerations need to be properly cleaned initially to reduce the risk of infection. This can be difficult for parents of older children to perform by themselves. Older children may need a tetanus booster.

The providers at our urgent care clinic are happy to evaluate any wound and give our opinion on the best way to close it.  If you need a referral to a specialist such as a plastic surgeon, we have great relationships with all of the local hospitals and can refer you to the best provider for your need.

Fractures

Fracture is the medical term for a broken bone. We have x-ray available on site if you are concerned that your child may have broken a bone. Some clues to watch for are painful swelling, bruising, pain, and reluctance/refusal to move an extremity or bear weight on an injured leg. Pediatric bones have growth plates, so it is critical to properly treat a fracture to insure unimpaired growth and development of the injured bone.  If we do diagnose a fracture, we have the necessary splinting and orthotic materials for proper immobilization and we will ensure that your child sees the appropriate specialist in follow-up.

When to Visit an Urgent Care Clinic with Your Child

We encourage all families to manage their children’s health care at the pediatrician’s office, but we understand that illnesses don’t take weekends, don’t follow a 9am-5pm schedule, and can’t always wait for a pediatrician’s appointment to open up.  For this reason, we are glad to care for children age 6 months and older 7 days a week at our Nashville urgent care walk in clinic.  Beyond the common illnesses and injuries mentioned above, we also evaluate burns, bites, scratches, abrasions, or any injury your child has the back luck to sustain.

If you have any questions as to whether we can help your child, just give us a call.  A human (not a phone tree!) always answers the phone in our office, and our walk in clinic doors are open 9am to 7pm everyday for our Nashville community.  For prompt care & easy online scheduling visit our Complete Health Partners Urgent Care/Walk in Clinic homepage.  Our urgent care clinic is located at 6746 Charlotte Pike near the Nashville West Shopping Center. Our clinic serves patients from all parts of our Nashville community – from Green Hills to Kingston Springs and from Germantown to Hillsboro – we are Nashville’s partner in complete health. 

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