Phone Visit
Narrative: SPRUCE MESSAGE VISIT Date: 2023-11-28 Encounter: Spruce text message with photo review CC: Child fell and hit his nose; parent concerned about possible nasal fracture. HPI: Hendricks, age unknown, sustained a nasal injury over the weekend of 2023-11-28 after a fall, described as showing off jumps. The parent noted visible swelling and was concerned about a possible fracture. No specific complaints of difficulty breathing through nostrils, eye movement abnormalities, or dental injury were reported. Photos were sent to Dr. Hobbs for review. Assessment: Visible swelling to the nose was noted on photo review. Dr. Hobbs assessed the injury as unlikely to be a fracture and did not find signs of significant structural injury at the time of evaluation. Plan: Expectant management. Parent instructed to assess symmetry, bilateral nasal airflow, teeth, and eye movements. No intervention recommended unless, as swelling decreases, the nose appears off-center. No referral or imaging ordered at this time. Parent to follow up if asymmetry develops. Key clinical quotes: "It's unlikely to be broken. It's important to check to make sure it looks symmetric, not pushed to one side or the other, that he can breath through both nostrils, that his teeth are ok and his eyes are moving equally and normally" "Yeah, he smacked it good. You can see the swelling." "Not much to do about it unless, as the swelling decreases, it's not looking centered" Source: Spruce conversation t_236OLKQGADG00