Harris Fleming, Author at Journal of Urgent Care Medicine

Be Alert: Thromboembolism Raises Risk for Mortality with COVID-19

The first evidence that rates of venous and arterial thromboembolism are high in patients with COVID-19 has arrived, in the form of an article just published in The Lancet’s online journal EClinicalMedicine. The meta-analysis of 42 studies involving 8,271 patients notes that rates range anywhere from 20% to 70% among patients who have been diagnosed with the virus. Overall mortality rate among patients with COVID-19 and thromboembolism was 23%, vs 13% without thromboembolism. The authors concluded …

Free Webinar: Now Is the Time to Help Your Team Stave Off Burnout

Burnout is always a concern in busy urgent care centers. However, with a 46% increase in visit volume and urgent care centers administering 25% of U.S. COVID-19 tests weekly recently, the risk is greater than ever. While you may not be able to singlehandedly end the COVID-19 crisis, you can take steps to provide care for your team. Some of them will be spelled out in an upcoming webinar, Managing Provider Burnout: Tips for Physicians …

On the Heels of a Solo Home Test, FDA OK’s a Combo COVID-19–Flu Kit

Just last week we told you about an Emergency Use Authorization from the Food and Drug Administration for a home COVID-19 test—along with an admonition that self-testing may make already-insufficient reporting of COVID-19 data even worse. As the pandemic continues and we wade deeper into flu season, the FDA has now authorized the first home dual test for COVID-19 and influenza A and B. Available by prescription only, the Quest Diagnostics product includes a self-collection …

Update: Study Finds No Evidence That DOAC Use Reduces Risk for Severe COVID-19

Anecdotal evidence that ongoing direct oral anticoagulant (DOAC) use might reduce a patient’s risk for severe disease with COVID-19 appears to have been wishful thinking, if the results of a study just published in the Journal of Internal Medicine are any indication. The authors found no association between DOAC use and lower incidence of hospital admission for COVID-19, or a composite of intensive care unit admission of death. As such, they concluded that DOAC use …

Free JUCM Webinar: Don’t Wind Up in Court Over Inappropriate Antibiotic Prescribing

There’s a constant push-and-pull in every urgent care center in the country: prescribe antibiotics only for the indications for which they’re approved, or give in to patient demands that they “need” an antibiotic even if your years of medical training and experience tell you otherwise. Refuse the patient and they just might stalk out of your office and write a damning review on social media. Give them exactly what they ask for (ie, prioritize making …

Where Do Urgent Care Providers Fall in the Recommended Order of COVID-19 Vaccination?

As many as 40 million doses of coronavirus vaccine may be available in the United States by the end of this year. While that’s clearly good news, it’s significantly fewer than will be needed to offer widespread protection and make a dent in the pandemic. That being the case, the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices has issued its official recommendations on who should be able to be immunized first …

As Pandemic Fatigue Grows, Some Patients Are Becoming Combative. Is Your Team Prepared?

As the COVID-19 pandemic continues to resurge in the United States, urgent care providers aren’t the only ones at risk of experiencing burnout. Many in the general public have had it with restrictions, isolation, and worry over sick loved ones (or those at risk), with some acting out with hostility toward healthcare workers. A woman in Berks County, PA was arrested recently after intentionally coughing on a nurse in an urgent care center. When the …

Should PrEP Be Part of the Discussion When Patients Present with Suspected STIs? One Urgent Care Operator Thinks So

Patients who are concerned they may have contracted a sexually transmitted infection may favor urgent care over their “regular” doctor due to both the convenience and relative anonymity of this setting. Recognizing that such patients are likely to have engaged in unsafe sex practices, should any related counseling routinely include discussion of pre-exposure prophylaxis against HIV (PrEP)? Northwell Health-GoHealth Urgent Care apparently thinks so, as the company is pledging to include discussion of PrEP when …

Be Aware: Hoping to Head Off a Twindemic, FDA Has Approved a ‘New’ Drug to Prevent Flu

Baloxavir marboxil (Xofluza) was approved to help patients in the early stages of influenza infection. However, as the reinvigorated COVID-19 pandemic now coincides with flu season, the Food and Drug Administration has approved it as a preventive measure for patients who have simply been exposed to influenza. As with the original indication, it is approved for patients 12 years of age and older. In a statement accompanying the FDA announcement, Debra Birnkrant, MD, director of …

Most Asthma Patients Don’t Receive Guideline-Directed Therapy in the ED; Can You Do Better?

Less than 6% of patients who present to the emergency room with an exacerbation of asthma receive guideline-directed medical therapy, according to research presented at the Virtual 2020 Annual Meeting of the American College of Allergy, Asthma and Immunology. The data reflect patients between the ages of 22 and 75 who were admitted to the ED of an urban tertiary cancer center between May 1, 2013 and May 1, 2015. The research team used the …