Practice Management
A 59-year-old male with a past medical history of hypertension presents with dyspnea and pleuritic chest pain in urgent care, and an ECG is obtained. View the ECG captured below and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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A 25-year-old man undergoing chemotherapy with cyclophosphamide, vincristine, doxorubicin, and dexamethasone for acute lymphoblastic leukemia arrives in urgent care because he’s developed a painful, burning palmar eruption. On examination, tender, shiny, erythematous papules and plaques were seen on the palms and fingers as well as the soles of his feet. View the image above and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.
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The American Hospital Association (AHA) and the FBI’s Behavioral Analysis Unit collaborated on a new bulletin that offers the first in a series of practical resources to help mitigate violence in healthcare settings. The goal is to promote greater adoption of violence prevention strategies and address the escalating threats and acts of violence against healthcare facilities and workers. As the program moves forward, AHA will provide updated resources for providers to implement threat assessments and …
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Scabies, bedbugs, and body lice commonly cause pruritus and rash, and accurate diagnosis of the symptoms should include consideration for social drivers of health, such as housing status and living environment, according to a recent literature review presented in JAMA. It’s concerning because pruritus may persist after scabies treatment—largely due to misdiagnosis and inadequate treatment—and persistent scratching can present a risk for skin infection. While bedbug bites usually resolve after 1 week without treatment, professional …
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The Food and Drug Administration (FDA) has approved the combination sulopenem etzadroxil and probenecid, an oral antibiotic, to treat bacterial urinary tract infections (UTI) in adult women caused by Escherichia coli, Klebsiella pneumoniae, or Proteus mirabilis. Manufacturer Iterum Therapeutics anticipates a commercial launch for the drug, branded as Orlynvah, in 2025, according to Reuters. The oral drug is taken twice daily for 5 days and can be used to treat uncomplicated UTIs in women who …
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What many industry observers suggested is now confirmed: The Change Healthcare cyberattack earlier this year affected personal information of 100 million people, making it the nation’s largest-ever breach of healthcare data. Parent company UnitedHealthcare recently updated the Department of Health and Human Services’ Office for Civil Rights confirming the scope of the impact. However, it could be months or years before the department completes its investigation of Change and determines a financial penalty if it …
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Urgent Message: Proximal humerus fractures most commonly occur in older patients after a fall and can be sentinel events that offer an opportunity to identify undiagnosed medical conditions or unsafe home environments. Lauren Schuermann, MS4; Shivani Kothari, MS4; W. Bradley Strauch, MD Citation: Schuermann L, Kothari S, Strauch B. Urgent Care Recognition and Management of Proximal Humerus Fractures. J Urgent Care Med. 2024; 19(2): 13-19 Questions for the Clinician at the Bedside Clinical Scenario A …
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Urgent Message: Urethral obstruction can occur due to impacted urinary calculi. This etiology should be considered in patients with known or suspected history of kidney stones who present with urinary retention. Point-of-care ultrasound can be used to evaluate for and confirm this diagnosis in male patients, in whom the phenomenon is most likely. Nicholas Maenza, DO; Jeffrey Darko, MD Citation: Maenza N, Darko J. Urinary Retention Caused by a Urethral Stone Diagnosed with Point-of-Care Ultrasound: …
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Urgent Message: There are no consensus definitions for what defines a “positive” urinalysis in the pediatric population. This secondary analysis of data from a quality improvement project in a network of pediatric urgent care centers used a machine learning approach to determine which variables on urinalysis most strongly predict a subsequently positive urine culture. Kari Flicker, BS; Jessica Parrott, DNP, CPNP-PC, CNE; Tammy Speerhas, DNP, FNP-C; Turaj Vazifedan, DHSc; Theresa Guins, MD; Jeffrey Bobrowitz, MD; …
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Urgent Message: Incorporating questions regarding the use of intravenous drugs may help ensure the diagnosis of puffy hand syndrome is included in the differential for patients presenting with bilateral hand swelling. Citation: Majeed I, VanDyke K. Puffy Hand Syndrome: A Case Report. J Urgent Care Med. 2024; 19 (2): 25-27 Abstract Introduction: Bilateral hand swelling is a common presentation in a variety of conditions, particularly rheumatological disorders. Urgent care (UC) providers can avoid unnecessary testing …
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