Telemedicine “Virtual” Visits: Tips for a GREAT visit with us online!

Virtual Visits are Here!

To meet your needs in the time of COVID-19, and to continue to provide convenient access to your doctors, Pediatric Associates is now offering TELEHEALTH (“virtual”) visits from the comfort of your own home.  Certain visits will be appropriate for this service, but others WILL require an in person visit (such as ear pain, strep tests, or flu tests, for example).  If your child has an illness or a visit that is appropriate for a virtual visit, here are some helpful hints to make sure it is a good visit.

Your Home

  • Have the child in a well-lit room, that is quiet, and free of distractions (such as a video playing loudly).
  • We know this is your home.  Don’t be embarrassed by other kids running around (we want to say hi!), pets, or even dirty dishes.  We understand.  We have kids, pets, and dirty dishes too.

Your Equipment and Logging In

  • Smartphones are the BEST!!  Later model iPhones or Samsung Galaxy offer the best video and audio for these visits.
  • Try to log in about 5 minutes before your scheduled appointment time.
  • Please use the patient’s name (not yours) when you are asked to enter a name on the screen.
  • Do the “Pre-Call Test” (button in the bottom left corner of the screen) to help us have the best connection.

Useful Tools

  • A flashlight (or other light source) that is NOT the phone you are using for the visit
  • A thermometer (or have taken your child’s temperature before the visit)
  • Your child’s most recent weight (or a scale where you can weigh them)
  • The name and location of your pharmacy, if we need to send in a prescription
  • For ADHD medication followups, click vanderbilt-assessment-parent-follow-up to download and fill out a Vanderbilt form to complete before the visit.
  • For depression and/or anxiety visits, click GAD&PAIweb and PHQ9PAIweb to complete these forms prior to the visit.

The Visit

  • The doctor will ask you questions and ask you to help us with your child’s physical exam.
  • We may ask you to undress your child so we can see rashes, or if she/he is having a hard time breathing.
  • We may also ask you to shine a light down your child’s throat, press on his/her belly, or take a temperature.
  • NOTE: it is possible that we determine your child DOES need to come in to the office for an “in person” visit.

Relax!

  • Don’t be afraid to ask questions.  Encourage your child to do so as well.
  • If your child has a favorite toy, or wants to introduce a family pet, we want to see that!  You are ALL part of our family.

Recommended COVID-19 Resources For Families

There are many good resources for families on the Internet for COVID-19.  We’ve picked a few that we feel are reliable and reasonable, and have listed them here.

HealthyChildren.org (sponsored by the American Academy of Pediatrics)

https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/2019-Novel-Coronavirus.aspx

Ohio Department of Health

https://coronavirus.ohio.gov/wps/portal/gov/covid-19/home/Family-Activities/Resources-for-Parents-and-Families

Nationwide Children’s Hospital

https://www.nationwidechildrens.org/family-resources-education/health-wellness-and-safety-resources/covid-19

Ohio Chapter of the American Academy of Pediatrics

Ohio-AAP-COVID-19

Important Patient Flow Changes At Pediatric Associates

In order to keep with public guidelines and protect our patients, we have made the following changes in scheduling patients:

Separation of ill visits and well visits

  • All WELL visits will be moved or scheduled in the MORNINGS at each office.  This also includes non-sick visits for behavioral health concerns (ADHD, anxiety, etc.).
  • All SICK visits will be scheduled in the AFTERNOONS at each office.  If your child is severely ill and you feel needs seen earlier, please call our office to speak to a phone triage nurse who will guide you to care.

Limiting Walk-In Immunization Hours

  • We will be offering our walk-in immunization hours ONLY in the mornings (during the WELL visit time) until further notice.
  • If your child is sick, please do not bring her/him in for this walk-in service.

Spirometry and Asthma Visit Changes

  • For our asthma patients who are coming in for spirometry, we will be only scheduling these visits in the MORNING hours.

Regarding Sick Siblings during WELL visit times (mornings)

  • We realize that with the schools being closed this will be difficult, but we ask that you please DO NOT bring in any sick siblings or relatives with you and your child to any of the WELL clinic times.  We want to make sure that there are no sick children in the office during our well visit hours.  Please make other arrangements for them during these visits.
  • If you can’t make other arrangements for sick siblings, please call our office to reschedule the well visit.

THANK YOU for your patience, your trust, and your understanding!

UPDATED: Important Coronavirus Questions and Answers

Frequently Asked Questions for Coronavirus Disease 2019 (COVID-19)

(Adapted from the website of the Centers for Disease Control and Prevention–Revised 3/13/2020)

How does COVID-19 spread? 

The virus spreads mainly from person-to-person

  • Between people who are in close contact (within about 6 feet)
  • Through respiratory droplets produced when an infected person coughs or sneezes

When are people with COVID-19 the most contagious?

  • People infected with the virus are most contagious when they are the sickest
  • Symptoms may take up to 2-14 days to appear after exposure

What are the symptoms of COVID-19? 

  • Fever
  • Cough
  • Shortness of breath

Who is at risk for severe disease from COVID-19?

  • So far, most  severe disease and deaths have occurred in elderly people and in people with underlying medical disease, especially that which compromises the immune system.
  • Infection in children appears to be asymptomatic or mild.  
  • While elderly patients have more severe disease, nearly 40% of US hospitalized patients were aged 20-54.
  • There have been a small number of deaths in children.  The risk of death is much higher in the elderly.

How can COVID-19 infection be prevented?

  • Avoid close contact with people who are sick.
  • Wash hands frequently.
  • Cover coughs and sneezes with your arm, not your hands.
  • Avoid touching your eyes, nose and mouth.
  • Stay home if you are sick.
  • Avoid large gatherings of people.
  • Postpone travel.

Should I wear a mask to prevent COVID-19 infection?

  • No – masks do not protect a person who does not have the virus from getting the virus.  Some evidence suggests that people who wear masks are more likely to touch their faces more frequently which could increase the risk of infection with COVID-19.
  • People who are infected with the virus should wear masks to limit the spread of the virus when they cough or sneeze.
  • Healthcare workers who are in contact with potentially exposed patients and especially when collecting swabs from potentially exposed patients should wear eye protection and mask.

Who should be considered for testing for COVID-19?

  • The CDC has opened up testing to physician’s discretion as the virus has spread throughout the nation and travel is no longer the primary cause of exposure.
  • Priorities for testing include:
    • hospitalized patients with severe respiratory disease,
    • older adults and people with chronic medical conditions, and
    • healthcare workers who have had direct contact with a confirmed case of COVID-19 or travelled to an area of risk in the past 14 days.

What advice are we giving to our patients?

  • Stay home if you do not need medical care.
  • If you are sick enough to require medical care, call your physician’s office to schedule an appointment.
  • Proceed to the emergency department ONLY IF YOU ARE SICK ENOUGH TO REQUIRE EMERGENCY CARE.

A Message About the COVID-19 Situation

The federal and state governments have taken judicious (not panicked) measures to protect us all from the spread of the novel coronavirus (also known as COVID-19).  We agree with the principles of reducing risk by not attending mass gatherings and practicing social distancing.

We also believe at this time, it is still important for your child to keep up on well visit care, particularly as it pertains to needed immunizations.  We feel it would not be wise to postpone these visits, particularly for children under the age of two.  This could make them susceptible to other diseases.  

At Pediatric Associates, we will be doing everything we can to make sure your child is NOT put at risk by coming to our offices.  We have a protocol in place that helps us identify patients who may be at risk for COVID-19, and will isolate these patients.  We will rearrange schedules to reduce the chances that well children are not exposed to ill children.  We value the safety and health of your family, and the safety and health of our staff.

Please stay tuned to our website and social media pages for more updates as the situation is going to be rapidly changing.

Thank you,

The Pediatric Associates Family

Novel Coronavirus (COVID-19) Frequently Asked Questions ANSWERED!

The following is adapted from the Centers for Disease Control (CDC) Website.  For more detailed information, please visit the site at this web address: https://www.cdc.gov/coronavirus/2019-ncov/faq.html

Who is at risk for exposure to COVID-19?

  • People who have had prolonged and close contact with a patient who has been confirmed to have COVID-19.
  • People who have travelled in the last 14 days to countries with high rates of transmission, including China, Japan, South Korea, Iran and Italy.

How does COVID-19 spread? 

The virus spreads mainly from person-to-person

  • Between people who are in close contact (within about 6 feet)
  • Through respiratory droplets produced when an infected person coughs or sneezes

When are people with COVID-19 the most contagious?

  • People infected with the virus are most contagious when they are the sickest
  • Symptoms may take up to 2-14 days to appear after exposure

What are the symptoms of COVID-19? 

  • Fever
  • Cough
  • Shortness of breath

Who is at risk for severe disease from COVID-19?

  • To date, the majority of severe disease and deaths have occurred in elderly people and in people with underlying medical disease, especially that which compromises the immune system.
  • Infection in children appears to be uncommon and generally mild.  
  • There have been no deaths from COVID-19 reported in children.

How can COVID-19 infection be prevented?

  • Follow the CDC advice on avoiding travel to countries with high rates of transmission, including China, Japan, South Korea, Iran and Italy.
  • Avoid close contact with people who are sick.
  • Wash hands frequently.
  • Cover coughs and sneezes with your arm, not your hands.
  • Avoid touching your eyes, nose and mouth.
  • Stay home if you are sick.

Should I wear a mask to prevent COVID-19 infection?

  • No – facemasks do not protect a person who does not have the virus from getting the virus.  Some evidence suggests that people who wear facemasks are more likely to touch their faces more frequently which could increase the risk of infection with COVID-19.
  • Healthcare workers and first responders who are likely to be in contact with people infected with COVID-19 should wear N-95 respirators which are not available to the public.
  • People who are infected with the virus should wear facemasks to limit the spread of respiratory droplets when they cough or sneeze.

Who should be considered for testing for COVID-19?

At this time, the only people who will be tested for COVID-19 are those who meet one of the following criteria:

  • Fever or respiratory symptoms in a person who has had direct contact with a confirmed case of COVID-19
  • Fever AND respiratory symptoms in a person who has travelled to a country of high risk in the past 14 days, including China, Japan, South Korea, Iran and Italy
  • Severe respiratory infection requiring hospitalization with no alternate cause identified

What should I do if I meet the above criteria for testing?

  • Call your physician if you meet the criteria above.   Note that fever AND respiratory symptoms are required for testing.   Your physician can give you further instructions on how to proceed.
  • Note that test kits are not currently widely available so you will NOT be tested in your physician’s office or at a local emergency room.  All healthcare providers will work with their state’s public health department to arrange testing if appropriate.

What should I do if I have a fever but do not meet the above criteria for testing?

  • Stay home if you do not need medical care.
  • If you are sick enough to require medical care, call your physician’s office to schedule an appointment.
  • Proceed to the emergency department ONLY IF YOU ARE SICK ENOUGH TO REQUIRE EMERGENCY CARE.

Stay tuned to our social media pages (and this website) as we expect the situation and recommendations to change frequently.

Cold vs. Flu: What can you do?

Both the common cold and the flu (influenza) are caused by viruses for which there is no definitive treatment.

Colds are typically mild and do not require a visit to the doctor. Medications such as Tylenol or Advil/Motrin can be used to reduce any pain or fever that occurs. Cold and cough medicines are not very effective and are not recommended in children younger than 2 years.

The flu can be quite severe. Medication for flu such as Tamiflu does NOT cure the flu. At best it reduces the symptoms of the flu by 1-2 days if given with the first 24-48 hours from the start of illness, and therefore is only indicated for people at very high risk for complications from flu, including children younger than 2 years old and people with conditions such as asthma or immune suppression. Patients with these conditions should be seen in the office in the first 1-2 days of fever onset.

You should call our office for a same day appointment if your child experiences persistently high fever (> 101 for more than 3 days), appears to have difficulty breathing, or is unable to keep down fluids such as water or Pedialyte. Your child’s pediatrician can determine what the cause of the symptoms is and if any additional treatment is appropriate.

The most effective treatments for any viral illness including both colds and the flu are drinking fluids and getting lots of rest. Drinking fluids prevents dehydration while the body is trying to recover from illness and the body heals best when resting.

Well Visits ARE Sports Physicals

Is your child planning to play a sport in school for the next academic year?  Is your child THINKING about playing a sport next year?  If so, we recommend you do two things as the current school year winds to an end:

  1. Schedule your child’s annual well visit as soon as possible to get it in before tryouts and/or practices start for the sport(s) he/she will be playing.
  2. Tell the nursing staff and the doctor that your child will (or may) need a sports clearance, either in the summer, or later in the year.  This will assure we ask the appropriate questions and add the appropriate parts of the physical exam to clear your student athlete.

Remember that a clearance for sports is good for a full 12 months.  So if your child has a well visit this summer, he/she can be cleared for the entire school year.  An injury could require a re-clearance post-injury, but in the absence of that, a well visit will count as a sports physical, and be valid for the entire 12 months.

New! Ways to keep your child with asthma out of the ER

We’ve added a new asthma self-management tool to help patients and families avoid expensive and lengthy trips to an ER or Urgent Care.  In addition to following your asthma action plan, click here to learn more helpful hints to keep asthma patients OUT of the ER.

Spring is a common season for flare-ups of asthma.  Be prepared.  Make sure your child has his/her controller medicine and all inhalers available.  Call our office if you need help!

Important Facts about School Sports Forms

Is your 7th-12th grade child going to play a school sport during the upcoming school year?  If so, they will need to have the most recent edition the OHSAA sports clearance form completed prior to the first day of practice or tryouts.  For most fall sports, that deadline is in early August.

We can complete the sports form during your child’s regular annual physical exam.  It is very helpful to have this form completed (at least partially) prior to the checkup visit.  We will have the forms available in the office, but you can also download and print the form from here to have before the appointment.

OHSAA 2018-19

The most important health questions to have answered for the checkup are Questions 5 through 16, about heart health in the patient and family history.

We look forward to seeing you this summer and hope you ALL have a great school year this year!