Journal of Urgent Care Medicine

HbA1c as Screening/Diagnoses for Early or Asymptomatic Diabetes in the Urgent Care Facility

Urgent message: The use of all-inclusive kits with compact, table-top analyzers provides a rapid quantification of HbA1c levels in patients. The use of these tests for in-house screening has the potential to increase the diagnoses of early or asymptomatic diabetes in young adults and under-served or overlooked populations. Jay H. Shubrook, DO; Jane M. Caldwell, PhD; and Lindsey E. Fish, MD Citation: Shubrook JH, Caldwell JM, Fish LE. HbA1c as screening/diagnosis for early or asymptomatic …

Management of Patients on Low-Dose Naltrexone: A Clinical Review for Urgent Care Providers

Urgent message: Low-dose naltrexone (LDN) is becoming more common as a treatment option for pain and thus will be increasingly prevalent in patients presenting to the urgent care setting. A thorough medication history, prioritization of non-opioid treatment options, and timely referral or transfer for severe uncontrolled pain are important considerations in the management of patients using low-dose naltrexone. Ting-Hsuan Chiang, MD; Kenneth Schmitt, BS; Ariana Nelson, MD INTRODUCTION Naltrexone is an opioid receptor antagonist approved …

Six Tips to Bulletproof Your Chart: Lessons from the Exam Room and the Court Room

Click Here to download the article PDF Urgent message: In the event that you are taken to court over care that is alleged to have been insufficient, negligent, or otherwise poor, your own documentation at the time care is provided can be your saving grace or your undoing. William Sullivan, DO, JD INTRODUCTION Providing proper medical care in urgent care centers is only half of the battle. As the medical record grows in prominence in …

Back Pain, an Urgent Care Visit—and a Devastating Outcome

Click Here to download the PDF Urgent message: By the time an adverse outcome occurs in the urgent care center, it’s too late to go back and ensure the documentation reflects the care the patient received. Lyndsie Pfeifer, DO; Marta Fratczak, Kinkela Harkins, and Michael Weinstock, MD Citation: Pfeifer L, Fratczak M, Harkins K, Weinstock M. Back pain, an urgent care visit—and a devastating outcome. J Urgent Care Med. 2023;17(8):13-17. Key words: back pain, documentation …

How Useful Is Ultrasound in Abnormal Uterine Bleeding?

Urgent message: Ultrasound can provide essential data in the evaluation and urgent care of abnormal uterine bleeding, by facilitating a rapid diagnosis and immediate and appropriate decisions regarding management. Andrew Alaya, MD, MSc Citation: Alaya A. How useful is ultrasound in abnormal uterine bleeding? J Urgent Care Med. 2023;17(7):13-18. Key words: abnormal uterine bleeding, AUB polyp, adenomyosis, leiomyoma, uterine malignancy ABSTRACT Abnormal uterine bleeding (AUB) is one of the most common gynecological conditions presenting at …

Human Trafficking in the Urgent Care Setting: Recognizing and Referring Vulnerable Patients

Urgent message: As it is common for human trafficking victims to present to urgent care, providers should be able to understand and identify common red flags in the patient presentation, history, and physical exam; treat immediate medical concerns; and know how to refer and safely provide resources for suspected cases. Preeti Panda, MD Citation: Panda P. Human trafficking in the urgent care setting: recognizing and referring vulnerable patients. J Urgent Care Med. 2023;17(6):13-22. Key words: …

Key Signs and Symptoms of Severe Illness in Urgent Care: Cervical Necrotizing Fasciitis and Necrotizing Mediastinitis

Urgent message: Cervical necrotizing fasciitis and necrotizing mediastinitis may ultimately occur in patients presenting with symptoms of odontogenic infection. While severe illnesses rarely present in urgent care, it is important to establish a prompt diagnosis and implement rapid medical management for these patients, in order to improve survival. Vitoria Regina Nunes Maia, MS and Lindsey E. Fish, MD ABSTRACT Cervical necrotizing fasciitis (CNF) is a rapidly progressive infection that can be fatal. This condition can …

A Cause of Dizziness Not to Be Missed

Urgent message: Most cases of vertigo are benign. This includes etiologies such as benign paroxysmal position vertigo, labyrinthitis, and psychogenic causes. However, there are serious, “can’t miss” etiologies which should be considered during the urgent care evaluation of a dizzy patient. Cody McCoy, DO and Michael Weinstock, MD Citation: McCoy C, Weinstock M. A cause of dizziness not to be missed. J Urgent Care Med. 2023;17(5):13-16. Key words: dizziness, vertigo, disequilibrium, BPPV INTRODUCTION Dizziness presents …

A Common Complaint, an Unlikely Diagnosis: Psoas Abscess in the Urgent Care Center

Urgent message: Psoas (or iliopsoas) abscess, although rare, is a cause of back pain associated with high morbidity and mortality. Proper diagnosis requires the physician to recognize signs in the history and physical examination that are suggestive of a potentially serious spinal condition prompting further workup. Fabrizia Faustinella, MD, PhD and L. Alexandre Frigini, MD Citation: Faustinella F, Frigini LA. A common compliant with an unlikely diagnosis: psoas abscess in the urgent care center. J …

Facial Nerve Blocks in the Urgent Care Center

Urgent message: Often, patients that could safely be treated for lacerations in the urgent care center are referred to the emergency room due to the quest for expediency, or even providers being out of practice with treating such wounds on site during the COVID-19 pandemic. However, doing so contributes to the degradation of acuity in urgent care while delaying care and raising costs. Anesthesia for wound repair can be achieved in many ways, typically with …