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Society for Pediatric Urgent Care

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Society for Pediatric Urgent Care

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RUNNY NOSE

DIFFERENTIAL DIAGNOSIS

  • Allergic Rhinitis
  • URI
  • Foreign Body- Nose
  • Sinusitis
  • CSF Rhinnorhea
  • Medication withdrawal or side effect
  • Systemic Illness (Hypothryroidism,Wegener’s, CF, Sarcoidosis)

AGE/GENDER CONSIDERATIONS

  • Allergic Rhinitis can begin at any age.
  • Nasal fractures are uncommon under age five.

DIAGNOSIS

HISTORY

  • General health-fever
  • Seasonality to symptoms (Allergic Rhinitis)
  • Nasal Itching (Allergic Rhinitis)
  • History of asthma or eczema/ Family history of atopy (Allergic Rhinitis)
  • Medication cessation (Nasal decongestion withdrawal)
  • Duration (Sinusitis, Nasal polyps, Nasal tumor)
  • Foul smelling (Foreign Body)
  • Facial trauma (CSF Rhinorrhea)
  • New Medication (Oral contraceptive, Anti-Hypertensive)

PHYSICAL EXAM

  • Allergic Shiners/Allergic salute (Allergic Rhinitis)
  • Nasal Polyps
  • Septal deviation/perforation
  • Foreign body

Tests

  • None are generally needed. CT Scan if concern for facial fracture/CSF leak.

MANAGEMENT

Transfer/Admit considerations

  • Urgent evaluation by ENT if CSF leak is suspected.

REFERRAL

PEARLS AND PITFALLS

REFERENCES

ALLERGIC RHINITIS

TREATMENT

  • Analgesics (Tylenol, Ibuprofen),

DISCHARGE CRITERIA

  • Pain controlled with PO medications
  • Able to tolerate PO

FOLLOW UP

  • Primary care physician
  • Encourage fluids
  • Medications as indicated

PROGNOSIS

  • Generally very good

ANTICIPATORY GUIDANCE

SINUSITIS

TREATMENT

  • Analgesics (Tylenol, Ibuprofen),

DISCHARGE CRITERIA

  • Pain controlled with PO medications
  • Able to tolerate PO

FOLLOW UP

  • Primary care physician
  • Encourage fluids
  • Medications as indicated

PROGNOSIS

  • Generally very good

ANTICIPATORY GUIDANCE

UPPER RESPIRATOR INFECTION

TREATMENT

  • Analgesics (Tylenol, Ibuprofen),

DISCHARGE CRITERIA

  • Pain controlled with PO medications
  • Able to tolerate PO

FOLLOW UP

  • Primary care physician
  • Encourage fluids
  • Medications as indicated

PROGNOSIS

  • Generally very good

GROUP BILL MEMBERS ENJOY DISCOUNTS

GROUP BILLING
10% or 15% discount on membership dues. Receive a 10% discount on member dues in the group billing program for groups of 34 members or fewer for your practice or institution. Groups of 35 or more members will receive a 15% discount. The Society will send one comprehensive renewal notice to include all the SPUC members in your practice or institution. Contact Greg Leasure, Membership Director, at [email protected] or 804-565-6393.

Copyright © 2023 · Society for Pediatric Urgent Care

2209 Dickens Road, Richmond, VA 23230-2005 · Phone: 804-565-6393 · Fax: 804-282-0090 · [email protected]

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