StuWilli, Author at Journal of Urgent Care Medicine

Management of Venous Thromboembolism in Urgent Care

Urgent message: Clinical evaluation that includes pretest probability tools and judicious use of diagnostic tests is a requirement for patients who present in the urgent care setting with symptoms suggestive of VTE. MELVIN LEE, MD, CCFP, RMC Early diagnosis of venous thromboembolism (VTE) is important to prevent the morbidity and mortality associated with it.Introduction VTE is subdivided into pulmonary embolism and deep venous thrombosis (DVT). DVT is most common in lower extremities. Those involving …

Understanding the Landscape of Occupational Medicine

Urgent message: Expanding into occupational medicine requires a long-term commitment and willingness to respond to employer and employee needs. ALAN A. AYERS, MBA, MAcc, Experity Urgent care providers have conventionally defined their offering as “treatment of acutely rising episodic medical conditions.” However, widespread acceptance of the urgent care business model-retail-facing locations, extended hours, and walk-in service—has led many urgent care centers to expand into longitudinal primary care as well as occupational medicine. Specifically, when people …

Stevens-Johnson Syndrome

Urgent message: Early diagnosis is crucial in patients with this rare – but potentially fatal – condition, Stevens-Johnson Syndrome. RACHEL CETTA, BSBE, MSBE, and JOHN SHUFELDT, MD, FACEP Overview Stevens-Johnson Syndrome (SJS) is a rare and potentially life-threatening condition. While the exact etiology is unclear, SJS often is associated with an adverse drug reaction to an assortment of drugs ranging from nonsteroidal anti-inflammatory drugs (NSAIDs) to anticonvulsants.1 SJS involves blistering and sloughing off of necrosed …

Clinical Challenge 2: December 2012

The patient, a 76-year-old woman, presented with a blow to her right wrist. View the image taken (Figure 1) and consider what your diagnosis would be. Resolution of the case is described on the next page.

Tricks of the Trade: Making Eustachian Tube Physiotherapy Fun For Kids

Tricks of the Trade Making Eustachian Tube Physiotherapy Fun For Kids Author: Ali Ahmadizadeh, MD Author Information: Ali Ahmadizadeh is a Fellow at New York Head and Neck Institute, New York, NY. Eustachian tube dysfunction/obstruction is common and in most cases, a developmental presentation in the pediatric population. In the urgent care setting, it commonly presents as an earache and patients may think they have an ear infection. Eustachian tube dysfunction/obstruction often is associated with …

30-year-old male with a complaint of feeling something stuck in his throat

The patient, a 30-year-old male, presented with a complaint of feeling something stuck in his throat. View the image taken (Figure 1) and consider what your diagnosis would be.

Developing Data: December, 2012

Developing Data These data from the 2010 Urgent Care Benchmarking Survey are based on responses of 1,691 US urgent care centers; 32% were UCAOA members. The survey was limited to “full-fledged urgent care centers” accepting walk-ins during all hours of operation; having a licensed provider and x-ray and lab equipment onsite; the ability to administer IV fluids and perform minor procedures; and having minimal business hours of seven days per week, four hours per day. …

Billing for Medications, Supplies, and X-rays

DAVID STERN, MD (Practice Velocity) Q. What is the CPT code for Tetracaine Ophthalmic used in an urgent care setting? A. If you are referring to the drops used as part of the treatment in the office, then you should not charge separately for them. They are part of the E/M service. If you are providing a bottle of the solution for a patient to use at home, there are a few practical issues to …

Abstracts in Urgent Care: December, 2012

OTC Topical Pain Relivers Poses Burn Risk Key point: Over-the-counter topical muscle and joint pain relivers containing capsaicin, methyl salicylate, or menthol (e.g., Bengay, Icy Hot) may cause serious chemical burns. Citation: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertforHumanMedicalProducts/ucm319353.htm A review of two adverse drug event databases, as well as the medical literature, found 43 reports of burns linked to these products. Those containing menthol were the most likely to cause second- and third-degree burns. The FDA advises clinicians to warn …

‘Why Can’t We All Get Along?’

JOHN SHUFELDT, MD, JD, MBA, FACEP It’s not often you get to quote the late Rodney King, but there it is. Mr. King’s quote was made famous during the Los Angeles riots, which were arguably incited by the acquittal of the police officers accused of excessive force during Mr. King’s arrest. In 1860, a book review on medico-legal jurisprudence argued that “law and medicine had evolved into mutually incompatible professions.”1 One hundred and sixty-two years …

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