Phone Visit
Narrative: SPRUCE MESSAGE VISIT Date: 2024-07-07 Encounter: Photo review (image sent by parent via Spruce text message) CC: Severe local reaction to bug bites at the cabin, recurring issue for Penelope and Hendricks. HPI: Penelope, age approximately 6, had a significant local reaction to insect bites at the family cabin, a pattern that reportedly recurred for both her and her brother Hendricks at this location. A photo was sent showing the reaction. Parents had been using cortisone cream and Benadryl for prior episodes but were asking about preventive options. Assessment: Hypersensitivity insect bite reaction, recurring at cabin exposure. Preventive antihistamine therapy indicated given the pattern. Plan: Benadryl for acute flares. Start Zyrtec 2.5 mL daily for the summer as preventive therapy. Dr. Hobbs asked for her current weight. Medications: - Cetirizine (Zyrtec) 2.5 mL daily (new) - Diphenhydramine (Benadryl) OTC, for acute flares (new) Key clinical quotes: "Poor kiddo. For sure. Start Zyrtec 2.5ml daily for the summer" "Benadryl will help the most acutely and then get the Zyrtec started now" Source: Spruce conversation t_27C02FVS44O00