Journal of Urgent Care Medicine

The Rising Importance of Urgent Care in the Fight Against the STI Epidemic

Urgent message: After a brief hiatus during the peak of the COVID-19 pandemic, the rate of new sexually transmitted infections has resumed at epidemic rates in the United States. With many specialty STI clinics having closed, urgent care may be better positioned than ever to help curb their spread. Glenn Harnett, MD Citation: Harnett G. The rising importance of urgent care in the fight against the STI epidemic. J Urgent Care Med. 2022;16(3):15-20. Key words: …

Managing Cough Without Codeine in the Urgent Care Setting

Urgent message: Opioid prescribing and opioid-related deaths have risen during the COVID-19 pandemic. Although supported by the CHEST Diagnosis and Management of Cough and NICE COVID-19 guidelines, it is time to reevaluate the appropriateness of using codeine in suppressing cough. Megan Penner, PharmD and Hojung Jang, PharmD Candidate CLINICAL SCENARIO A 54-year-old female with a past medical history of diabetes, hypertension, and depression presents to the urgent care center with congestion, nasal discharge, fatigue, and …

When a Fever is Not a URI: If It’s Not in the Differential, It Won’t Be in the Diagnosis

Urgent message: Fever in patients presenting to UC is often attributable to viral infections, urinary tract infections, otitis media, cellulitis, or pneumonia. When the source is not apparent after the initial evaluation, however, it is important to expand the differential in order to avoid missing less common, serious diagnoses. Samidha Dutta, DO; Caleb Marsh, OMS-IV, UP-KYCOM; Michael Weinstock, MD CASE PRESENTATION A 74-year-old man with a history of Parkinson’s disease and diabetes presented with 2 …

Is It Appendicitis? The Role of Clinical Scoring Systems, Labs, and Diagnostic Imaging

Urgent message: Ultrasound can provide essential data in the urgent care evaluation of suspicion of acute appendicitis. Facilitating a rapid diagnosis allows for immediate and appropriate decisions regarding management. Andrew Alaya, MD, MSc INTRODUCTION Appendicitis is thought to be the result of luminal obstruction due to various etiologies (such as lymph node hyperplasia, coprolites, or parasites) which lead to increased mucus production and bacterial overgrowth. This results in wall tension and eventually necrosis and potentially …

A Legal Quandary: A Diagnosis of Cellulitis…That Isn’t

Michael Weinstock, MD; Gabby Gostigian, MD; and Matthew Delaney, MD Urgent message: Failure to consider subtleties and the context in which a patient presents can lead to insufficient differential diagnoses and missed diagnoses that leave the patient at risk for poor outcomes and the provider at risk for litigation. INTRODUCTION Cellulitis from a wound infection in the urgent care is common, and so is our management: wound care and antibiotics. But consider a scenario in …

Where Should I Refer My Spinal Patient? Outcomes with Orthopedic and Neurosurgeons for Common Neck and Back Procedures

Urgent message: Neck and back pain are common issues preceding surgical intervention. Given differences in care plans, outcomes, cost, and length of stay associated with spinal surgeries, the option of referring urgent care patients to either neurosurgeons or orthopedic spine surgeons requires careful consideration. Rami Musleh, PA-C; Angela Blagojevski, MPAS, PA-C; Randy Brush, MS, PA-C; and Jessica Bruskoski, MS, PA-C INTRODUCTION Neck and back pain are two of the most common reasons for people to …

Psychiatric Manifestations of Organic Disease: Don’t Get Fooled!

Urgent message: Mistaking medical symptoms for psychiatric disease can delay care and lead to adverse outcomes. Elizabeth Yeager-Cordial, MD; Janell Ison, DO; Robert Becker, MD; Courtney Boyd, MD; and Michael Weinstock, MD Citation: Yeager-Cordial E, Ison J, Becker R, Boyd C, Weinstock M. Psychiatric manifestations of organic disease: don’t get fooled! J Urgent Care Med. 2022;16(11):11-15. CASE PRESENTATION A 23-year-old man presented with a strange complaint: visual hallucinations. He had no psychiatric history and was …

Management of Burn Blisters in Urgent Care

Urgent message: Though data are limited and approaches to burn blister management remain controversial (eg, leaving blisters intact vs deroofing or aspirating), appropriate initial care in the urgent care setting is both feasible and advisable and can reduce risk for infection and scarring. Muhammad Zeeshan Ahmed MBBS, FRNZCUC, Winston McEwan FRACS, and Sana Maqsood MPhil, Cert PH Citation: Ahmed MZ, McEwan W, Maqsood S. Management of burn blisters in urgent care. J Urgent Care Med. …

Essential Tools for Urgent Care—Finger Tourniquet

Urgent message: Use of a finger tourniquet can ensure a bloodless field when performing laceration repair to fingers and toes, thereby reducing risk for damage to underlying vital structures and increasing the prospects for positive outcomes. Patrick O’Malley, MD After repairing scores of finger lacerations over the years, I have learned there are a few essential supplies required for these cases; the most critical among them, however, is the finger tourniquet. This simple device makes …

Physical Therapy as Nonsurgical Management and Presurgical Management of Most Common Knee Pathologies

Urgent message: Appreciation for the cause of knee pain, along with an understanding of potential nonoperative rehabilitation therapies that could be provided in urgent care, can enhance patient care and improve patient satisfaction while minimizing the need for referral. Dr. Eva Delgado Martinez MBChB, GP, MScCN and Dr. Ivan Koay MBChB, FRNZCUC, MD INTRODUCTION Knee injuries in adults and children are common presentations to urgent care and emergency rooms.1 Rehabilitation of those injuries is essential …