Bush Bulldog Clinic

All the important info YOU need to know

Albuterol can be overused!


It’s nearly impossible to overdose on albuterol however it can certainly be overused. I often see kiddos using a rescue inhaler in a manner that seems to be more for comfort rather than treatment of an asthma exacerbation. This is why there are times I will assess a child and then recommend NOT using the inhaler. Daily use before exercise without specific instruction from the physician is most often the example I see. Occasionally it is too frequent use (extra unnecessary doses within the 4-6 hour time frame). Please call and chat with me if you have specific concerns over your student’s albuterol use.


Let’s Talk about Albuterol

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Oral Temperatures


Middle school students should know how to take an oral temperature. If you are still taking tympanic or temporal temps please consider changing your ways.

How Do I Take an Oral Temperature?


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The Flu is Back!


Now that Covid is endemic and no longer a novel pandemic, our usual seasonal influenza is back. Please do not send children to school with symptoms of illness including but not limited to temperatures greater than 100.4, cough, sore throat, nausea, vomiting or diarrhea. Children who are medicated with fever reducing medications are still sick and can still spread illness to others. Testing is not required but we do recommend that students are fever free for at least 24 hours without the use of fever reducing medications and show a significant improvement in their symptoms before returning to school. As always, rest and recovery is the primary goal. But if your student feels up to it they can check for class assignments in google classroom.

You can monitor national flu activity:

Weekly US Map: Influenza Summary Update

Information about this year’s flu season and vaccination:

CDC Reports Early Increases in Seasonal Flu Activity

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Home care for common viruses


From “My Friend the Pediatrician” on Facebook:

Did you know that mild cases of COVID, RSV, and flu can all be treated the same way from home? 😷
Here are my TOP TEN at-home tips for the combination of cough, congestion, runny nose, poor appetite, and/or fever:
1. Remember that COVID-19, RSV, and flu are all caused by viruses, just like the common cold. Antibiotics are not the answer because antibiotics only treat bacteria. 💊 In fact, using antibiotics for a virus can harm the recovery process and lead to antibiotic resistance. Most viral illness can be safely handled from home (with several exceptions listed in #10).
2. FEVERS are natural and safe in babies 3 months and up. 🔥 Babies less than 3 months need to be evaluated by a doctor for fever (defined as 100.4°F and above). Beyond this age, a fever is the body’s way of ramping up the immune system to fight off infection. You only need to treat a fever if it’s making your child uncomfortable. Do not use aspirin. Get checked at your doctor’s office for a true fever lasting longer than 4 days.
3. Otherwise, fever is not the enemy – dehydration and respiratory distress are the enemies! You know your child is staying hydrated if they are urinating at least every 8 hours. 🕞 Signs of respiratory distress include sucking in with each breath, panting, head-bobbing, grunting, turning blue, or flaring of the nostrils to breathe – all of these things would warrant medical attention ASAP.
4. Loss of appetite is common. It’s actually OK if your child refuses to eat SOLID food for several days, but they need to stay hydrated. 🍼 Give them whatever they are willing to drink as long as it is age-appropriate. Using sports drinks or Pedialyte for electrolyte replacement is a great idea. You could try popsicles, jello, and frozen juice cubes as well. Again, the goal is to urinate at LEAST every 8 hours.
5. For nasal congestion in babies and toddlers, use nasal saline drops and suction: Place a few drops into each nostril followed by gentle suction with a bulb syringe or device such as NoseFrida – this is especially helpful before sleep and feeds. 😴 For nasal congestion in older children, have them gently blow their nose and stay hydrated. A bit of Vaseline along the outer nostrils may prevent the skin from getting chapped/sore.
6. At any age, a cool-mist humidifier or vaporizer can be used to moisten the air. This may help to decrease cough and congestion. ☁ Do not worry about the color or consistency of your child’s mucus – the idea that green mucus is bad is a myth.
7. A sore throat paired with the cough and runny nose is likely viral and does NOT warrant testing for strep throat! Offer plenty of fluids, rest, and Tylenol/Motrin as needed for discomfort. For older kids, try gargling salt water.
8. Coughing protects the lungs from mucus build-up. 😁 Cough and cold medicines are NOT recommended in children under 6 years of age. Try half a teaspoon of honey for children ages 2-5 years or 1 teaspoon for kids ages 6 and above. Do not give honey to children less than 1 year old. Cough drops/lozenges are okay starting at 4 years and up.
9. Cough and congestion often last for weeks. HANG IN THERE. ⏳ Prevent the spread of germs by washing your hands (or using alcohol-based hand sanitizer) as often as possible. Cover your nose and mouth with a tissue or sleeve whenever you cough or sneeze (not your bare hand). Disinfect hard surfaces. Avoid touching your eyes, nose, and mouth.
10. Seek rapid medical care for any of the following 🚩 RED FLAG signs: Bulging soft spot, inconsolable crying, confusion, disorientation, stiff neck, seizures, difficult or rapid breathing, blue lips or nails, refusal to move an arm or leg, severe abdominal pain/swelling, dehydration, or simply looking very ill. Touch base with your pediatrician if your child has any complex medial condition such as heart disease, diabetes, sickle cell disease, cystic fibrosis, or kidney problems.
If your intuition is overall telling you that your child is really sick, please bring them in! If a child becomes sick enough to be hospitalized, there may be several other treatment modalities to consider.
Lastly, please know that many urgent care/emergency room centers are VERY overwhelmed with patients right now (plus full of germs and long wait times). If your concern is not urgent or emergent, please schedule a visit through your pediatrician. ❤
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It’s healthier? Not really…


NEISD has posted an information page about Vaping

Escape the Vape

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Getting Ready for Summer: Dry Drowning


“You know there is an issue when medical providers are learning medical terms from social media, and not the other way around. That’s exactly what happened to me (and many of my colleagues) with dry drowning.”

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Gaming addiction, is this a real disorder?


“Andrew Newberg, M.D., a neuroscientist at the Marcus Institute of Integrative Medicine at Jefferson Health, has devised a way to illustrate some of the physiological and structural changes happening to gamers. He wants to compare a gamer’s brain to a non-gamer’s brain to see how the response to different stimuli affects them. Amado, a 12-year-old fellow student at Cash’s school who loves music, basketball and watching movies, fits the profile of a non-gamer, occasionally playing car-racing games but who overall isn’t into video games.”

Check out this comparison of MRI scans in these two boys


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Snakes Bites and Children


If you have lived here longer than 5 minutes you know that this is a legitimate concern in our area.

Some recommendations for treating snake bites have changed from the old recommendations and some are counter-intuitive.
Click here to read up on symptoms and treatment for snake bites

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Speaking of breakfast!


I grew up in the DFW area and was never confused about what is a kolache. Apparently this is just a South Texas thing? But soon after we moved here in the early 2000s I had my first “but that isn’t a kolache” disappointment.

let’s let Texas Monthly set you straight!

If it’s not Sweet it’s not a Kolache

P.S. You can bring me a kolache anytime 😉

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They need to eat breakfast


I tell students all day erryday they need to eat a good breakfast in the morning. They often come to the clinic in the late morning before lunch with complaints of stomachaches and headaches. Guess what? They haven’t had anything to eat yet. Turns out, that nagging from the school nurse really is just good advice 😉

from the Journal of the American College of Cardiology: Association of Skipping Breakfast With Cardiovascular and All-Cause Mortality

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