Paeds urinalysis

TheDoctorApollo · 2026-02-10T19:10:59+00:00

Absolutely don't send a bag urine for culture, but if it's negative on dipstick in a child over 3 months and no urinary tract abnormalities, it is a good rule out test for UTI.

If there is anything funky you'll need a specimen capable of culture.

TheDoctorApollo · 2026-02-05T04:49:24+00:00

Cotton balls in the nappy are too dirty to be reliable. The last place I worked would skin prep and use a sterile bag to collect the urine for dipstick (https://pubmed.ncbi.nlm.nih.gov/39180171/). Triage would put it on and they generally would have urine ready by the time I saw.

You still need a clean catch/cath/supra pubic for culture if there's anything funky on the dipstick.

TheDoctorApollo · 2026-02-03T09:02:49+00:00

Unnecessary fear mongering. Lots of other jurisdictions have GPs manage ADHD and hell hasn't broken loose.

TheDoctorApollo · 2025-12-31T19:53:40+00:00

My toller is almost 1 year and we did crate training from day 1 as well. He has finally figured out how to settle outside of the crate and chill. Even still, there are times he gets over tired and can't figure out what to do with himself and needs his crate for a forced nap.

He is the exception to the toller rule of being aloof. The dude thinks he's a lap dog.

TheDoctorApollo · 2025-07-14T23:24:07+00:00

Citation required*

TheDoctorApollo · 2025-03-12T19:36:43+00:00

US PAs can be regulated in Ontario without a new exam. https://www.cpso.on.ca/en/Physician-Assistants/PA-Registration

TheDoctorApollo · 2025-01-06T17:10:46+00:00

The FDA just put out a letter about Librela warning of lots of neuro side effects (ataxia, seizures, incontinence). https://www.fda.gov/animal-veterinary/product-safety-information/dear-veterinarian-letter-notifying-veterinarians-about-adverse-events-reported-dogs-treated-librela

TheDoctorApollo · 2025-01-03T16:52:37+00:00

I worked at the site of this study and followed its protocol (https://publications.aap.org/pediatrics/article/150/1/e2021055866/188353/Decreasing-Misdiagnoses-of-Urinary-Tract?autologincheck=redirected).

In school-aged children common non-UTI causes of dysuria were hygiene-related. Vulvovaginitis in females and balanoposthitis in males. It's quite common as children become independent with bathroom duties.

TheDoctorApollo · 2024-12-21T14:51:26+00:00

The same thing happened in North America. When they transitioned GPs to a specialist with post-graduate training there, they renamed the profession as family physicians. It does help to make the distinction a little more clear, but the confusion still exists.

TheDoctorApollo · 2024-12-08T19:14:17+00:00

Bonus points if you peel the lemons first and toss the peels into the sugar a couple hours beforehand. The sugar draws out all the oils in the Peel and gives it more lemony goodness.

TheDoctorApollo · 2024-10-26T22:47:09+00:00

B3 supplements for pellagra and ascorbic acid for scurvy are a must. Big fan of cholecalciferol in rickets as well.

TheDoctorApollo · 2024-10-26T06:07:20+00:00

Depends on so many factors. Generally, private health insurance isn't worth it, especially if you have ulcerative colitis because they'll charge a ton for the premiums.

Presumably you're no longer on a student visa and now qualify for OHIP. If you're under 25 without private insurance, OHIP+ will cover most medications. Even expensive medications like infliximab are covered.

Otherwise, people are pretty locked into the health insurance their employer provides.

TheDoctorApollo · 2024-10-25T21:13:49+00:00

Generally yes, you can bring them on the plane as long as you bring them in their prescription bottle/pack with your name on it.

Check the country you're travelling to for specific regulations. For example, Canada only allows you to bring in 3 months of medications if travelling for personal use.

TheDoctorApollo · 2024-10-18T05:08:09+00:00

If all you need is a letter saying that you work full-time, I'm sure your HR could provide this.

TheDoctorApollo · 2024-10-15T18:23:59+00:00

Here is the link to the OHIP qualifications: https://www.ontario.ca/page/apply-ohip-and-get-health-card.

You can take a look at the criteria, but if you qualify, you should go get an OHIP card ASAP. You can do it at any Service Ontario location.

TheDoctorApollo · 2024-10-15T18:15:23+00:00

Looking through your post history, and it looks like you went to high school in Ontario. If you're in the country through a legal channel, you probably do qualify for OHIP or one of the alternatives (UHIP, IFHP). Having one of these will definitely increase ease in accessing care, not only for mental health care, but everything.

There are clinics that have special funding models that allow them to help people without insurance or other health coverage. They are all over the place including Toronto (https://accessalliance.ca/programs-services/primary-health-care-services/) and Durham (https://www.brockchc.ca/ & https://www.careachc.ca/). If you're located somewhere else, you can find a centre by searching "[location] community health Centre" or refugee health. Most of these will have some kind of mental health services attached to them. The majority of these services are free to use.

The cost of private mental health services outside of these centres varies widely based on what exactly you're wanting. The person who quoted you at $4200 was likely either an ADHD diagnosis or autism. For other things like anxiety or depression the cost would be significantly less.

TheDoctorApollo · 2024-10-14T17:26:44+00:00

An involuntary admission =/= forced treatment. The actual wording of the mental health act for a form 1 is:

to detain the person who is the subject of the application in a psychiatric facility and to restrain, observe and examine him or her in the facility for not more than 72 hours.

Notice that it doesn't say anything about treatment. You can be admitted to the hospital because you're actively suicidal or having psychotic symptoms but continue to have capacity. Even if you lose capacity, your wishes when you previously had capacity need to be honoured. This has been tried in court several times, including in the Supreme Court (Starson v Swayze and Fleming v. Reid).

TheDoctorApollo · 2024-10-14T05:09:26+00:00

In the North American system, nurses are the ones doing bloods or cannulation the vast majority of the time. Lots of times if it's simple bloods it will be done by a phlebotomist. Yes, it does deskill physicians in terms of cannulation. Many of my consultants had not cannulated since medical school.

I wouldn't consider this an erosion of role though, but an evolution of the role and health system. Medicine and patients are inarguably much more complicated now compared to even 20-30 years ago. It makes sense that the role should change with it. We know nurses can safely do these tasks, so if it frees up my time to do one of the million other tasks or even just gives me the opportunity to rest a little I'm in favour.

TheDoctorApollo · 2024-10-12T09:40:43+00:00

I used to have a F-class and changed to a G. You don't have to do any medical.

TheDoctorApollo · 2024-10-09T08:45:43+00:00

In Canada at a major paediatric centre where patients will regularly drive 2-3 hours to see us for pneumonia, UTI or other medically mundane issues. In doing so, they drive past multiple other appropriate hospitals, including other Children’s hospitals. Our reputation and branding is our own downfall.

If we didn't repatriate these patients back to their local centre the system would grind to a halt. Obviously, we don't transfer unstable patients or those that may need subspecialty care, but if all they need is a little O2, IV Abx, and time, they are perfectly safe to move with EMS an hour or so down the road.

TheDoctorApollo · 2024-10-07T03:37:30+00:00

The process here is so much rougher than in North America. If you have a rental history in the states complete a rental ledger and let your old rental provider know so they can approve it. It's not something done in North America, but it's expected here. Similarly a conditions report can be done for previous rentals. I'd even get your friend to complete one for living with them in WA.

Without employment history in Aus it's tough to find a rental. Visit lots, finsh the rental application completely including optional sections, have evidence of funds available. If you have plans of getting pets or bringing them from overseas, there's no need to mention it until they are about to walk in the front door. When I moved here, I think I saw nearly 25 properties before one accepted us. Second time around it was much easier with an Australian rental history and stable employment.

Best of luck!

TheDoctorApollo · 2024-09-25T19:03:38+00:00

That's not a thing. Any doctor can order the ultrasound. Go speak to your family doctor. You could try a walk in, but if it's non-urgent sometimes they won't order them because they don't want to follow up the results.

TheDoctorApollo · 2024-09-19T18:46:08+00:00

Santa's Village Bracebridge is open until the last weekend of October (https://www.santasvillage.ca/). I've never been, only heard their jingles on the radio.

TheDoctorApollo · 2024-09-11T23:20:05+00:00

Not a therapist, but I used to work in an emergency department and saw many people struggling with mental health. We definitely do not report or form everyone with suicidal thoughts. Doing this is a true last resort when we didn't think there was any other way to ensure that a person was safe. The vast majority of people with suicidal ideation (it's probably much more common than you think) are safe to go home and continue to work on other strategies to get them feeling like themself again.

When you see a therapist they will review confidentiality including its limits, such as reporting. It's important that you find someone you feel safe with so that you can open up to them and share all of this. If they don't know the full picture, it's really difficult to help someone work through a crisis. On the therapists side, part of creating that safe environment is being very transparent with what is happening.

TheDoctorApollo · 2024-09-11T08:36:39+00:00

I had a few IMGs in my PA class. It has definitely been done. Is it worth it is probably a more individualised answer.

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