By: Naomi Zilkha, MD (Telemedicine, Allied Physicians Group)
This week in Allied Telemedicine it has been all about stomach viruses and high fevers.
Today I’m going to talk about stomach viruses. They are normally super contagious, and usually within 24-72 hours, so I’ve had consults where multiple family members have been affected.
The most important part of my Telemedicine visit for a stomach virus is to determine if my patient seems dehydrated, so I ask about urine output/wet diapers or tears when crying.
Also, I can see a lot just by my observations from the video, and I was glad that didn’t need to send anyone to Urgent Care to be seen, and they were able to follow up by phone or in-person at their Allied office the next day, with my note from the visit ready and waiting.
Most of my patients called when they were in the vomiting stage of the virus, but some also called during the diarrhea.
For vomiting, I usually recommend not giving any fluids for an hour, and then very small amounts of clear fluids such as Pedialyte, Gatorade (watered down by half). Avoid milk or milk products and juices (and only white grape if they must have juice)
For the babies, I recommend a teaspoon every 15 minutes for an hour. If they keep that down, every 10 minutes for an hour, and then if they keep that down, every 5 minutes for an hour. After that, I recommend slowly increasing the fluids.
Since my visits are in the evening towards bedtime, I then recommend trying to have the patient sleep at their bedtime (or earlier) and trying again in the morning.
For diarrhea, there’s the usual BRAT diet of bananas, rice, applesauce, dry toast (dry cereal, dry pasta)
I hope that the stomach bug does not make a visit to your house this week, but remember, for after-hours urgent care #ThinkTelemedicine first!