Improving Chart Closure Time in a Pediatric Urgent Care Setting

Improving Chart Closure Time in a Pediatric Urgent Care Setting

Urgent Message: Quality improvement projects can increase the percentage of charts closed within 1 hour of patient discharge at pediatric urgent and express care locations to ensure timely documentation. Key Words: Electronic Health Records, Documentation, Pediatrics, Ambulatory Care, Patient Safety, Quality Improvement Kileen Fernandez, MS, APRN-CPNP-PC; Lisa Ziemnik, MD, FAAP; Beth Williams, MBA, BSIE; Abiodun Omoloja, MD, MBA, CPE, FASN, FAMIA; Jennifer Morris, MS, APRN-CNP-PC, RNC-NIC; Maddie Mock, BSME; Thomas Geglein, BSN, RN, MBA; Kimberly …

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4-Year-Old Male With Elbow Pain Following a Fall from Monkey Bars

4-Year-Old Male With Elbow Pain Following a Fall from Monkey Bars

A 4-year-old male presents to urgent care with a swollen, painful right elbow. The mother reports that the child had a witnessed fall from the monkey bars 1 hour prior to arrival. He fell onto his outstretched right hand, was in immediate pain that has not subsided, and has refused to let anyone touch his arm. On initial examination, vital signs are stable, and patient is afebrile. Swelling is noted over the right elbow, and …

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53-Year-Old Woman With Dark Patchy Spots on Face and Neck

53-Year-Old Woman With Dark Patchy Spots on Face and Neck

A 53-year-old woman visits urgent care for dark patchy spots on her neck and face that have been spreading over the past 3 months. The lesions are not painful or itchy, she denies exposure to allergens or irritants, and has no systemic symptoms. The patient states that sun exposure darkens the spots further and she has not tried any treatments to date. On examination she appears well with normal signs; hyperpigmented gray macular patches are …

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60-Year-Old With Prior Myocardial Infarction

60-Year-Old With Prior Myocardial Infarction

A 60-year-old male with a past medical history of prior myocardial infarction (MI) is presenting with left-sided chest pain for 1 day. He reports nonadherence to his clopidogrel for 2 weeks after running out of his medications. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

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Abstracts in Urgent Care – January 2026

Abstracts in Urgent Care – January 2026

Prevention of RSV Disease in Healthy Infants Take Home Point: In this early phase, drug-manufacturer-funded clinical trial, a single dose of clesrovimab reduced the incidence of respiratory syncytial virus (RSV)-associated medically attended lower respiratory infection and RSV-associated hospitalization, with a safety profile similar to that of a placebo. Citation: Zar HJ, Simões E, Madhi S, et. al.  Clesrovimab in Infants and Children at Increased Risk for Severe RSV Disease.  New Eng J Med. 2025:393, 13;1292-1303. …

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Management of Acute Opioid Withdrawal in a Patient With an Unknown Prescribing History: A Case Report

Management of Acute Opioid Withdrawal in a Patient With an Unknown Prescribing History: A Case Report

Urgent Message: Opioid prescribing in urgent care can present difficulties, particularly in patients with an unclear prescription history where added caution is needed. There are a number of ways to reduce the risks associated with opioid prescribing and to initiate the treatment of opioid withdrawal in the urgent care setting. Jacob Mather, BSc MBChB Key Words: Addiction, Opioid Withdrawal, Prescribing, Urgent Care Abstract Introduction: We report a complex case of a 37-year-old woman presenting to …

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Leveraging Physician-Patient Relationships to Increase Patient Portal Access During an Urgent Care Visit

Leveraging Physician-Patient Relationships to Increase Patient Portal Access During an Urgent Care Visit

Urgent Message: Urgent care physicians can leverage the physician-patient relationship established during a visit to improve patient portal enrollment and use in a healthcare system. Sandy Wang, MD, MPH; Carolyn Stern, MD; Kevin Fiscella, MD, MPH; Amaya Sanders, BS; Erik Herbert, BS; Rosie Booker, BS; Tyra Barton, LPN; Mechelle Sanders, PhD Key Words: Electronic Health Records, Patient Portals, Urgent Care, Quality Improvement Abstract Background: Patient portals for accessing electronic health records are useful for easy …

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7-Year-Old With Knee Pain After Activity

7-Year-Old With Knee Pain After Activity

A 7‑year‑old male presents to the urgent‑care clinic with left‑knee pain that began after gym class and has gradually worsened over the past several weeks. The mother reports no significant trauma and notes that the pain improves with rest. Physical examination reveals a slightly overweight child with a visible bowing deformity just distal to the knee. The patient demonstrates a full range of motion and normal knee strength, and no bony tenderness, effusion, or laxity …

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Chronic Calf Pain and Limp: A Case Report of Pediatric Slipped Capital Femoral Epiphysis

Chronic Calf Pain and Limp: A Case Report of Pediatric Slipped Capital Femoral Epiphysis

Urgent Message: Pediatric patients frequently present to urgent care with musculoskeletal complaints, but clinicians must remain aware of the less common surgical and medical emergencies that can present with these symptoms. Key Words: Slipped Capital Femoral Epiphysis; Pediatric Limp; Antalgic Gait; Obesity; Urgent Care Diagnosis Abstract Clinical Presentation: A 13-year-old male presented to a pediatric urgent care with the chief complaint of left calf pain for a month that had acutely worsened over the past …

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STEMI With Musculoskeletal Chest Pain: A Case Report

STEMI With Musculoskeletal Chest Pain: A Case Report

Urgent Message: Reproducible chest wall pain is often considered a symptom that indicates a musculoskeletal diagnosis. However, it should not be used as the sole criterion for ruling out acute coronary syndrome, especially in high-risk populations. Key Words: STEMI; Reproducible Chest Pain; Atypical ACS; Urgent Care Evaluation Abstract Introduction: Chest pain remains a leading cause of emergency department (ED) visits, and its differential encompasses both life-threatening and benign conditions.  In the United States, the lifetime …

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