The patient is a 9-year-old boy who received a blow to the shoulder from a height of approximately 6 ½ feet. He has limited elevation of the arm due to pain. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. <
Read MoreClinical Challenge 2: July 2007
The patient is an 18-year-old male who jumped or fell from a “short height” but landed hard on his heel. He is able to ambulate, but cannot put any pressure on his heel. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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Management of Distal Radial Fractures in Young Patients by Non-Orthopedists in an Urgent Care Center
Wrist fracture is a common injury in children. 1 Many of these fractures are buckle or torus fractures. Traditionally, treatment for buckle fractures has been short-arm casting for two to four weeks.2 However, questions have been raised as to the need for such treatment. A number of recent studies have indicated that many such fractures may be managed without casting by the use of either elastic bandaging alone3 or splints.4-6 Plaster splints can easily be …
Read MoreChoose Words Carefully in an Occupational Health Sales Call
The art of using the “right” words and avoiding words that tend to harm one’s sales effort is undervalued. Consider these recommendations
Read MoreTest the Waters Before Signing an Employment Contract
JOHN SHUFELDT, MD, JD, MBA, FACEP It sounded like a great job. You saw the ad in the back of JUCM and contacted the person listed at the bottom. He seemed pleasant enough on the phone and the pay was what you thought was the market rate for the area. The next day, you drove over for the interview, which consisted of only four questions (the first being “If you were a tree…” and the …
Read MoreAbstracts in Urgent Care: July/August, 2007
Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department with Syncope Key point: Syncope is a common presentation to the emergency department. These recommendations help stratify low- versus high-risk patients. Citation: Huff JS, Decker WW, Quinn JV, et al. Ann Emerg Med. 2007;49:431-444. American College of Emergency Physicians Issues Guidelines for Treatment of Syncope Citation: Barclay L. Medscape News. April 30, 2007. URL: http://www.medscape.com/viewarticle/ 555843?src=mp Syncope accounts …
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Challenges in Assessing and Treating Insect Bites and Stings
Urgent message: When presented with a patient who has experienced an insect bite or sting, the most crucial role for the urgent care clinician is to triage for anaphylaxis, venom toxicity, and local tissue damage. Kent A. Knauer, MD Now that summer is here, it is likely that urgent care practitioners—especially those practicing in suburban and rural areas—will see an increasing number of patients who have experienced an insect bite or sting. Though data are …
Read MoreIt’s the Journey, Not Just ‘The Win’
Lee A. Resnick, MD, FAAFP Brian Sipe’s “Red Right 88.” John Elway’s “The Drive.” Earnest Byner’s “The Fumble.” Michael Jordan’s “The Shot.” Jose Mesa’s “The Choke.” And now, the Cavs’ and “The Sweep.” You’ve just read an abridged version of the History of Cleveland Sports. For those of you who have no interest in sports, fear not; there’s an analogy in here somewhere. Growing up a Cleveland sports fan has been a roller coaster ride …
Read MoreJuly/August 2007
Clinical Challenge 2: June 2007
The patient is a young child with three days of constipation with a non-specific history of abdominal pain. On exam, the child was asleep. The abdomen was easily palpable and soft. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described below.
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