Mommy Call What Do I say?

1. Mommy CallWhat Do I say? Pediatric Noon Conference Kami Larsen MD, FAAP

2. Chiefs Guide Need to get a copy from the Chiefs All the rules and regs about logistics Weekdays from 5pm to 8 am Weekends are 24 hours Mainly calls from parents and labs, occasionally pharmacy

3. Who do we cover? Dr. Denton, Dr. Jain, Dr. Heintz, Dr. Snavely, Dr. Neyland, Dr. Larsen, and all of the pediatric residents patients Occasionally will get calls for Dr. Fricke of some of the other subspecialists

4. Who don’t we cover? Typically you should not get calls regarding the pediatric sub-specialists, even if they are on the faculty Leid clinic non-faculty staff (Dr. Hart, ect.) Never take calls for unaffiliated general pediatricians in the community

5. Documentation! Always, Always, Always document your conversation with parents Forms available in the chief’s office Fax to appropriate clinic the next morning

6. Resources Yourself! Barton Schmidt Phone triage book UNSOM attending on call Chief residents The faculty member that sees the patient in clinic

7. Typical calls Parental concern Lab values Pharmacy calls

8. Parental Concern Reassurance Management Advice Follow up in clinic in AM Go to ED Hang up and dial 911

9. Lab Values Should have been signed out if a STAT order ALL CRITICAL VALUES should be dealt with Call the family Ordering or attending MD Go to ED if needed

10. Rx Refills Should never need to refill over the phone If child is sick enough to need meds now, needs to be seen in ED All patients need to be seen in order to make sure meds are appropriate

11. Remember We are not house call doctors, families need to address issues in the office Only answer questions for our patients Try not to call in medications

12. Remember Have your pager with you Speak so the family will understand you Call through the service when available, Beware caller ID Call the attending if you are uncertain It’s OK to send kids to the ED

13. Fever What do you want to know?

14. Fever Get a good history Did the family take the temperature? Have they tried cooling measures Is the child under 3 months Are they otherwise well

15. Cough What do you want to know?

16. Cough Again, History Can you hear the child over the phone Any signs of respiratory distress Are you worried Any other symptoms

17. Rash What do you want to know?

18. Rash History Any other symptoms Does it blanch Is it itchy Distribution What have they tried

19. Vomiting/ Diarrhea What do you want to know?

20. Vomiting/ Diarrhea History Signs of significant infection, blood, mucous ect. Signs of dehydration Fever, mental status Clears, BRAT, no meds

21. Newborn Care Anticipatory Guidance

22. Newborn care Umbilical cord care Circ care Congestion Rash Poor PO

23. Feeding Commonly called about nursing or lactation issues What can mom take Cracked sore nipples Weight gain, wet diapers, ect

24. Jaundice Use clinical judgment If bili levels look at your graphs

25. Colic What do you want to know?

26. Colic Again history is important When are they crying Can they be consoled at all Feeding related Signs of reflux Signs of infection

27. Other calls Swallowed FB Constipation Bites/stings Tummy pain UTI Ingestion Diaper Rash Headache

28. Practice!!!!