Phone Visit
Narrative: SPRUCE MESSAGE VISIT Date: 2026-05-09 Encounter: Spruce text message followed by in-person home visit (2026-05-09) CC: Worsening breathing difficulty, lethargy, and persistent cough with fever requiring frequent albuterol nebulizer use. HPI: Malcolm (age not specified) had been coughing with wheezing since at least 5/6, at which time it was noted as less severe than Hendricks. By 5/9, parent reported worsening breathing described as worse than Hendricks had been. Albuterol nebulizer had been administered every 4-6 hours, including at 4am on 5/9. Respiratory rate measured at 41 breaths/minute by parent on 5/9. Temperature was slightly elevated (99°F on 5/9, over 100°F the prior day). He had been lethargic when picked up from school the previous day, though energy appeared more normal by 5/9 morning. Hendricks and Nelly were noted to be recovering. Assessment: Respiratory rate of 41 breaths/minute flagged as concerning, prompting escalation to in-person evaluation. Initially planned office visit, but Dr. Hobbs ultimately conducted a home visit after logistical challenges with office timing. Plan: Attempted in-person office visit at 11am on 5/9. When the parent was unavailable at the office, Dr. Hobbs offered to conduct a home visit instead and called the contact number provided (Courtney). Further clinical details of the home visit assessment and plan are not captured in the transcript. Medications: - Albuterol Nebulizer, every 4-6 hours as needed (adjust) Key clinical quotes: "can you tell me more? how's he doing right now? does he have a fever? Henny wasn't breathing badly, he just had that gnarly cough when I examined him." "I'll msg you back shortly and we can make a plan, need to figure out the plan here" "I'm out. I'll just run by the house" Source: Spruce conversation t_27C02FVS44O00