In spite of the fact that urgent care was overlooked as an essential partner in the fight against COVID-19 in the early days of the pandemic, the virus had a major impact on the complaints that drove patients to visit an urgent care center. In fact, according to JUCM research, most of 2019’s top 5 chief complaints fell by at least half as a proportion of all urgent care visits. COVID-19, which was essentially a …
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Weight Loss, Abdominal Pain, and Distension in a 74-Year-Old Woman
Urgent message: Not all GI complaints can be attributed to gastrointestinal pathology; symptoms of dyspepsia, vomiting, early satiety, weight loss, and abdominal pain may also be from a pelvic etiology. Fabrizia Faustinella, MD, PhD and L. Alexandre Frigini, MD INTRODUCTION Gastrointestinal complaints are common in ambulatory centers, urgent care, and in emergency departments. The symptoms of abdominal pain, nausea, and vomiting account for 12% to 15% of ED visits.1 Several non-GI intra-abdominal, endocrine, and pelvic …
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A 23-Year-Old with Wrist Pain After a Mountain Bike Mishap
The patient is a 23-year-old male who presents with a primary complaint of pain in his left wrist after falling from his mountain bike on a rocky path. View the x-ray taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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N gonorrhoeae: Dual Therapy Is Out. Monotherapy Is In.
ICD-10 Changes for 2022
Every year on October 1, the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics release an updated ICD-10-CM Official Guidelines, as well as changes to the code set. This year there are 159 new codes, 32 deleted codes, and 20 revised codes, with a total of 72,748 codes to choose from. (Visit ICD-10-CM Official Guidelines for Coding and Reporting FY 2022 at https://www.cms.gov/files/document/fy-2022-icd-10-cm-coding-guidelines.pdf to see the entire document.) Three …
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Assessing the Rate at which Pacemaker and Defibrillator Patients Present to the Emergency Room with their Manufacturer ID Card: A Cross Sectional Study
Urgent message: Care can be delayed if an urgent care or emergency clinician attempts to interrogate the CIED of a patient who does not know their device manufacturer and does not carry their ID card. This scenario illustrates the importance of patient education in care centers, such as the emergency department and urgent care. Tinh M. Le; James F. Neuenschwander, MD, FACEP; Mary Jones, DNP; Ankur Parekh; Hana Le; Kaitlyn Cedoz; and Clark Daugherty ABSTRACT …
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Counterpoint: Readers React to JUCM Original Research
Andrew Grock, MD; Manuel Celedon, MD; and Jonie Hsiao, MD ​​It was with great interest that we read Most Clinicians Are Still Not Comfortable Sending Chest Pain Patients Home with a Very Low Risk of 30-day Major Adverse Cardiac Event (MACE) by Dr. Michael Weinstock, et al in the February 2021 issue of JUCM.1 In this study, the authors surveyed attendants at an emergency medicine conference in 2018 as to their comfort level discharging patients …
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Return to Sports in the COVID-19 Era: A Clinical Review
Urgent message: The COVID-19 worldwide pandemic has changed sports as we know it. Returning athletes back to sport safely continues to be widely debated among physicians in cardiology, primary care, infectious disease, and sports medicine. The return-to-play process after a COVID-19 infection will depend on the severity of their infection, duration of symptoms in the context of any concerning past medical history, and/or family history. Brian Harvey, DO and Natalie Stork, MD CASE PRESENTATION A …
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Addressing Fraternization in the Urgent Care Workplace
Urgent message: Whereas sexual harassment is defined as unwanted and one-sided, many times employees choose to become romantically involved, requiring that urgent care centers have a policy and a plan to address workplace fraternization. Alan A. Ayers, MBA, MAcc is President of Experity Networks and is Practice Management Editor of The Journal of Urgent Care Medicine. In 2019, McDonald’s fired its Chief Executive Steve Easterbrook for engaging in a relationship that violated company policy. The …
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An Unresponsive Pupil in the Urgent Care: Can A Diagnosis Be Made from the Bedside History and Exam?
Urgent message: Ocular complaints for which there is no immediate, obvious explanation do not necessarily have to be referred to the emergency room or ophthalmology. Employing the process of elimination to narrow down a broad differential, using the available evidence, can expedite the correct diagnosis while allowing the patient to remain in the urgent care. Kayla Penny, BS; Joseph LaRochelle, PharmD, BCPPS, FCCP; Deirdre Hooper, MD; Haley Caire, BS; and Kelsey Rooney, BS CASE PRESENTATION …
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