A Hand Wound Caused by a Pressure Washer

Urgent message: Injuries caused by pressure washers often require debridement or, in severe cases, amputation. Immediate assessment and appropriate management, where feasible, can preclude the need for surgical intervention while effecting a positive outcome. Ellen Hancock, MD; Julie Park; MD, FACS; and Kendall Wermine INTRODUCTION Pressure washer injuries tend to involve the lower extremities and abdomen and usually require a form of surgical intervention such as debridement of tissue and, in severe cases, amputation.1-4 The …
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Hand holding Contaminated Water, Hand Lacerations

A Diagnosis Suspected by Mechanism of Injury: Soft tissue Infection Due to Aeromonas hydrophila and Enterobacter asburiae Following Human Wastewater Exposure

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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Worsening, General Weakness and Immobility in an IV Drug User

Urgent message: Spinal epidural abscesses are a rare condition that can be fatal if untreated. Populations most at risk include the elderly, diabetics, and IV drug users. The most common cause of an epidural abscess is the bacteria Staphylococcus aureus. Savannah Chavez, MD; Jordan Miller, DO; J. Chika Morah, MD INTRODUCTION Incidence of spinal epidural abscesses ranges from 0.2 to 2.8 cases per 10,000 per year, with a peak incidence occurring in patients between 60 …
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Left Eye Pain in an Overall Healthy 19-Year-old Female

Urgent message: Eye pain is a common presentation to the urgent care clinic. A provider needs to be able to recognize concerning components of history and physical which require further emergent evaluation. Lindsey E. Fish, MD CASE PRESENTATION History A 19-year-old female with past medical history significant only for scoliosis presents to an urgent care clinic complaining of left eye pain for the last 3 days. She reports that the pain feels like it is …
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A 69-Year-Old Female with Hypertension, Dyslipidemia, and a Constellation of Otolaryngologic Symptoms

Urgent message: Epiglottitis is classically viewed as a pediatric disease, but has become increasingly common in the adult population. While symptoms may present as an isolated sore throat, they can quickly progress to complete airway compromise with need for emergency cricothyroidotomy. Due to the high risk for morbidity and mortality, urgent care providers must maintain a high index of suspicion to avoid misdiagnosing a potentially catastrophic disease. Zachary DePriest, MS, PA-C INTRODUCTION Adult epiglottitis (AE) …
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