Published onChildren's View
Kids don’t always get sick or injured during their pediatrician’s office hours. That’s why Children’s Hospital of Philadelphia offers pediatric-specific Urgent Care at several locations. Grishma Rali, MBBS, MPH, has been one of CHOP’s Urgent Care doctors for three years. This is a day in her life.
6:30 a.m. Gets up and out for a 3-mile run, despite a late night after a 13-hour shift the day before. Then it’s breakfast with her 5-year-old son, 2-year-old daughter, and husband, Parth Rali, MD, a critical care physician and respiratory system specialist at Temple Health.
8:30 a.m. A morning of baths and play time with the kids, followed by a lunch of homemade Indian food.
1:30 p.m. Leaves home in Haverford for CHOP’s King of Prussia Specialty Care & Surgery Center, which transforms into Urgent Care in the evenings and on weekend days like this one.
2 p.m. Arrives and greets today’s staff. It’s been a busy morning with 35 patients. The most critical was a teenager who had overdosed on 95 Benadryl tablets. He was stabilized and transported by ambulance to a nearby emergency room. Starting in 2021, patients like this teen will be able to move seamlessly to CHOP’s new co-located Emergency Department and, if needed, inpatient hospital, which are under construction at the King of Prussia site.
2:10 p.m. Her day’s first patient: a 4-year-old girl with belly pain, fever and sore throat. A rapid strep test comes back negative, but samples from the girl’s throat are sent to the lab. “Sometimes the rapid test is negative, but the culture is positive.”
2:30 p.m. A foster mother has brought in a grinning 11-month-old boy. He has spots on his feet and torso and a sore throat. The boy’s twin, in another foster home, was just diagnosed with hand-foot-and-mouth disease, a viral skin infection. The twins had visited each other last week. “The throat lesions are the classic presentation of hand-foot-and-mouth,” Rali explains. “We treat it with Tylenol and Motrin, since it’s a virus.”
3 p.m. A 14-year-old boy has dark-red urine. A test shows blood but is negative for infection. Concerned for potential kidney or urinary tract problems, Rali makes an expedited referral to CHOP Nephrology. “Not having to wait weeks for an appointment — that’s huge,” his guardian says.
4:45 p.m. An 8-year-old girl with fever and ear pain won’t allow an ear exam. “I’ll be gentle, I promise.” Even a trip to the snack cart won’t change her mind. Sends a prescription for antibiotics to a pharmacy open late on Sundays.
5:15 p.m. A 10-year-old boy splashed hot oil on his chest while making pancakes. “I’m proud you are cooking by yourself, but you need to be careful and always wear a shirt.” Prescribes burn cream and advises no swimming for a week, to the boy’s chagrin.
5:35 – 7:50 p.m. Sees five more patients, including a 13-year-old with an abscess, before taking a 10-minute break for dinner. Sneaks in a quick call home to tell her children good night.
8 p.m. Talks to the foster mother who was in earlier. Her child’s twin was diagnosed with MRSA, a staph bacteria that resists most antibiotics. Prescribes the specific antibiotic that will be effective.
8:10 p.m. Two more abscesses. “That’s three in a row. That’s a first.”
9:20 p.m. A 3-year-old boy arrives with a sore arm. X-rays — taken on-site and read quickly by a pediatric radiologist at CHOP’s University City hospital — show a possible break in his elbow. Makes a referral for an expedited appointment with CHOP Orthopaedics and splints his arm.
10:10 p.m. Treats the day’s final patient.
10:45 p.m. Arrives home, showers, tiptoes into the kids’ room for a goodnight kiss and watches a Netflix show with her husband.
11:30 p.m. Bedtime!
About CHOP's Urgent Care services
CHOP’s after-hours Urgent Care centers, staffed by our board-certified pediatricians and pediatric nurses, provide fast, convenient care for children with nonlife-threatening illnesses or injuries that don’t need the resources of an emergency room.
Number of Urgent Care visits in fiscal year 2019: 39,875
The top 5 reasons families bring their children to Urgent Care: respiratory distress, minor trauma (sports injuries, sprains, broken bones, lacerations/ abrasions), fever, ear pain and sore throat.
Categories: Children's View Fall 2019