Practice Management
A 60-year-old female with a history of hypertension and diabetes presents to urgent care with fatigue and weakness for 1 day. Her son states she has not been able to get out of bed today because she’s “too tired to walk.” She denies any complaints of chest pain, nausea, vomiting, shortness of breath, or fever. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described …
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The patients is a 32-year-old man who presents with pain in his left thumb after skiing. He reports that he took a fall, instinctively extending his left arm out to cushion the blow. View the thumb 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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Every system is perfectly designed to get the results it gets. This quotation, commonly attributed to Dr. W. Edwards Deming,1 has never been more relevant for urgent care (UC) than right now. Considered the original guru of quality improvement, Dr. Deming was explaining why systems must be redesigned if the desired outcomes are not being achieved. The existing “system” for measuring clinical quality in UC needs an overhaul. It is fragmented and underdeveloped, and lacks …
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Michael B. Weinstock, MD; Michael Pallaci, DO; Amal Mattu, MD; Cameron Berg, MD; Paul Jhun, MD; and Jeff Riddell, MD. Urgent message: Patients who present with chest pain but tests indicate there is little risk for a major event can leave providers uncertain as to what next steps are appropriate, and raise concerns for bad outcomes and litigation. Citation: Weinstock MB, Pallaci M, Mattu A, Berg C, Jhun P, Riddell J. Most Clinicians Are Still …
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Urgent message: While an urgent care center is responsible for the collection and safeguarding of clinical specimens, it’s generally not liable for the activities of a third-party lab that it sends a specimen to. Alan A. Ayers, MBA, MAcc is Vice President of Strategic Initiatives, Experity Urgent care facilities regularly provide bloodwork and laboratory testing for their patients. These services may include allergy screening, diabetes testing, anemia screening, immunity testing, thyroid screening and monitoring, and …
Read MoreJUCM has devoted a lot more space to covering aspects of providing urgent care for children. In this very issue there’s a new original research article on how long the SARS-CoV-2 virus lasts in children who may or may not be symptomatic (see page XX). And if you look at our Masthead, you’ll notice we’ve even engaged a pediatric urgent care provider to provide guidance and to help us ensure we’re conveying the right information …
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Urgent message: Complaints of ear pain in children are among the most common presentations in the urgent care setting. While acute otitis media and acute otitis externa are high on the list of possible causes, it is essential that the urgent care provider be prepared to differentiate these from other possible etiologies. Elizabeth Flasch, MSN, APNP, PNP; Sadia Ansari, MD; Timothy Martin, MD Citation: Flasch E, Ansari S, Martin T. If not otitis externa…then what? …
Read MoreSeptic Knee Joints in Adults Recurrent Cellulitis Analgesics and Risk for Fracture Nonunion Assessing for MACE with and without a Troponin IV Fluids in Headache Management COVID-19 and Telemedicine COVID-19: The Second Wave Dr Avijit Barai, MBBS, MRCS, MSc (Critical Care), PgCertCPU, FRNZCUC Diagnostic Dilemma: Septic Arthritis of Knee Joints in Adult Patients Key point: Synovial fluid white cell count and Gram stain are the most useful laboratory markers for septic arthritis. Clinical evaluation, synovial …
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Urgent message: Knowing the mechanism of injury and presence of wound contamination is important in hand lacerations in order to avoid and anticipate skin and soft tissue infections and tissue necrosis, particularly in the setting of contaminated water sources. Cayla Baker, PA-C and Christina Gardner, DHSc, MBA, PA-C Introduction In 2018, the U.S. Bureau of Labor Statistics reported 77,340 work-related accidents resulting in lacerations, with 51,130 of those being to the hand.1 It is important …
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The patient is a 10-year-old boy who presents with pain in his right knee after twisting his leg during a backyard football game. View the image 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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