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Many parents have a typical first aid kit with Band-Aids® and a thermometer. Helping them build a "pandemic first aid kit" can help clinicians with evaluation during virtual visits and prevent unnecessary visits to urgent care or the emergency department.
During the “lockdown” phase in the early days of the pandemic, I made recommendations to parents for treating many conditions that ordinarily we would evaluate in the office. I’d like to share my recommended “items” parents can use to treat or monitor a variety of illnesses/conditions at home - without visiting a physician’s office or emergency department. In many circumstances a “pandemic first aid kit” can help parents cope with nonemergencies even during nonpandemic times, and help pediatricians improve guidance provided at virtual visits. I have used all the products mentioned below and enthusiastically endorse them.
Smart phones and a great app for medical advice
First and foremost, any smartphone can be used for capturing videos or photos of children with rashes, sore throats, eye drainage, movement disorders, or abnormal behaviors. Reviewing the videos or photos sent by parents often enables providers to substitute virtual visits for office visits.
I always recommend that parents install PediatricSymptomMD1 on their smartphone. This is an outstanding application derived from Dr. Barton Schmitt’s telephone triage protocols. Its use can significantly reduce the need for unnecessary medical visits. The application provides guidance for innumerable symptoms that may confound and worry parents. Parents are instructed how treat minor illnesses, and most importantly are given advice regarding what conditions can be monitored at home and identify those symptoms that warrant a call to their physician or a visit to the emergency room. Drug dosages are provided as well as first aid advice for injuries including how to perform cardiopulmonary resuscitation. It also includes a section on COVID-19 that is updated frequently to reflect current guidance regarding symptoms, and prevention strategies.
For new parents
Pediatricians often see newborns frequently during the first weeks of life for issues relating to feeding. To reduce the number of in-office visits for newborns, I recommended that parents purchase an inexpensive baby scale. Often these are available for $50 or less on Amazon, and many can be delivered next day. I have found that the “Redmon Weight and Grow”2 battery powered baby and toddler scale works well. By correlating the measurements of the baby scale with the weight recorded by your office scale, you can see babies for virtual “weight check” visit and make recommendations regarding feeding based on the trends in the weight.I also recommend that parents have a digital thermometer that they use to take rectal temperatures if a baby feels warm or is fussy. In my experience, forehead or ear thermometers often produce misleading temperatures that often lead to unnecessary emergency department visits.
We often see patients with minor lacerations in the office for suturing or closure with a cyanoacrylate adhesive. In previous articles I have recommended that pediatricians consider using Clozex3 wound closures for painlessly closing minor lacerations.Clozex also markets a home use product called “Clozex Emergency Laceration Closures,” which are available for $25 on Amazon, that can be used by parents and have clear instructions for use. There’s even an instructional video on YouTube that’s available at https://youtu.be/eSqU4xmsK-E.
I recently discovered that Amazon also sells a wound closure cyanoacrylate adhesive called SkinStitch.4 It is inexpensive, selling for $23 dollars, and the website features an excellent instructional video. In all cases physicians should advise care in cleansing the wound prior to closure, making sure that the tetanus immunization status is current, and that the closed laceration is protected with an adequate sterile dressing. Parents should be instructed to watch for signs of infection and to call with any concerns.
When the tick bites…
As I practice in New Hampshire I often see children in the spring, summer, and fall with embedded ticks requiring removal. If parents equip their pandemic first aid kit with either the Ticked Off or TickCheck, Tick Remover Spoon, purchased from Amazon, they can use either device to remove most ticks quickly and easily without leaving embedded mouth parts. Multiple how-to videos are available on YouTube, such as https://www.youtube.com/watch?v=XZ14TP7FSQk.
Parents frequently bring their children to the office for treatment of warts, which we often treat with liquid nitrogen spray or by applying cantharidin. Most of the dermatologists I refer to are now recommending that parents first use the WartStick5 which contains 40% salicylic acid in a waxy base. With regular use and following directions on the website - most warts will resolve in 6 to 12 weeks.
Is it an ear infection, strep throat, or COVID-19?
It is even possible to equip a “Pandemic First Aid Kit” with low-cost items that will enable you diagnose otitis media, strep throat, or COVID-19 during virtual visits. For $35 on Amazon parents can purchase a ScopeAround Ear Camera,6 that captures high resolution images of the ear canal and tympanic membrane and displays these via smartphone application. These images can be easily sent to providers for review.In addition, one can purchase rapid strep kits from Amazon for about $40 per box of 25 tests, so with little supervision via a virtual visit you can diagnosis a strep test as easily as one can at an office visit.If you suspect COVID-19 parents can purchase The BinaxNOW COVID-19 antigen test,7 sells for $20 for a 2-test kit. It uses anterior nares specimens, and results are available in 15 minutes. Don’t believe the negative antigen test? Parents can be prepared by purchasing the exquisitely accurate $55 Lucira Check It Home COVID-19 test,8 that uses polymerase chain reaction technology to produce results in 30 minutes!
Most parents keep a supply of band aids, disinfectants, a thermometer, as well as ibuprofen, and diphenhydramine handy in a first aid kit, in anticipation of need.With a little more effort and an Amazon membership, parents can prepare a versatile “pandemic first aid kit” that will facilitate virtual visits with their pediatrician and avoid unnecessary trips to urgent care clinics and emergency department.