Practice Management
A 64-year-old female presents to urgent care complaining of right thumb pain. The patient states she removed a wooden splinter from her thumb herself about 2 weeks prior, she denies any other trauma or systemic symptoms. The patient has a history of Type II diabetes and her last A1C 2 months prior was 9.3. Physical examination reveals the patient is afebrile with normal vital signs. There is a small, scabbed wound on the palmar surface …
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A 42-year-old male presents to urgent care with complaints of cough, throat pain, and vomiting that developed earlier that morning. He returned from a family vacation to the US Virgin Islands 7 days ago and two days later, he began feeling ill with initial symptoms of high fever, myalgia, and severe headache. Over the past 3 days, he has noticed the development of a widespread rash on his trunk. The rash initially appears faint and …
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Urgent Message: While Bell palsy is the most common diagnosis for patients with unilateral facial weakness/paralysis, it is important for urgent care clinicians to be able to quickly differentiate it from other more serious diagnoses. Keywords: facial palsy; stroke mimic; Bell palsy; central facial weakness; peripheral facial palsy; urgent care evaluation Luke Wisniewski, OMS3; Finley Kocher, OMS3; Muhammad Akhtar, MD Abstract Introduction: Bell palsy is the most common diagnosis for patients with unilateral facial weakness/paralysis …
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Urgent Message: While most pediatric musculoskeletal complaints are usually benign and self-limited, the urgent care clinician must consider more serious underlying causes of pain in the differential diagnosis. Keywords: pediatric osteomyelitis; atraumatic ankle pain; limping child; bone infection; ESR; CRP; MRI diagnosis Erin Loo, PA-C, MHA, FCUCM Abstract Introduction: Pediatric patients commonly present to urgent care (UC) with musculoskeletal complaints. However, a wide differential should be considered, including musculoskeletal injury, synovitis, autoimmune conditions, cellulitis, avascular …
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Urgent Message: Pediatric urgent care providers commonly experience pressure to satisfy parental expectations, which may alter clinical decision making, increase stress levels, and/or impart barriers to administering quality care. Keywords: parental pressure; antibiotic prescribing; shared decision-making; pediatric urgent care; patient satisfaction; clinical decision-making Daniel Moscato, MS, PA-C; Sara Winter, MS, PA-C Abstract Background: Patient-centered care focuses on strengthening patient participation in their own healthcare. Although advantages to such care exist, intended shared decision making between …
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Urgent Message: The prediction model developed for this study suggests that point-of-care ultrasound implementation could have both clinical utility and fiscal viability in an average urgent care center. Future work should validate the prediction model in a real-world urgent care setting. Key Words: point-of-care ultrasound; POCUS utilization; urgent care ultrasound; return on investment; financial modeling; implementation planning John Weissert; Joshua Russell, MD, MSc, ELS, FCUCM, FACEP; Tatiana Havryliuk, MD Abstract Introduction: Point-of-care ultrasound (POCUS) use …
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Do We Need to Manage Presyncope Similar to Syncope? Take Home Point: Patients with unexplained presyncope and syncope in this study had similar rates of serious cardiac outcomes at 30 days following their initial emergency department (ED) visit. Citation: Suh EH, Sacco DL, Winskill C, et al. Serious Cardiac Outcomes and Physician Estimation of Risk in Emergency Department Patients With Presyncope Versus Syncope. Ann Emerg Med. 2025 23:S0196-0644(25)01155-2. doi:10.1016/j.annemergmed.2025.08.014 Relevance: Patients with presyncope and syncope …
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A 61-year-old male with a history of hypertension, diabetes, and chronic kidney disease presents to urgent care on a Tuesday afternoon with 1 week of increased weakness. He says he’s “feeling off balance.” He denies chest pain, shortness of breath, or recent illness. An ECG is ordered. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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Urgent Message: Quality improvement projects can increase the percentage of charts closed within 1 hour of patient discharge at pediatric urgent and express care locations to ensure timely documentation. Key Words: Electronic Health Records, Documentation, Pediatrics, Ambulatory Care, Patient Safety, Quality Improvement Kileen Fernandez, MS, APRN-CPNP-PC; Lisa Ziemnik, MD, FAAP; Beth Williams, MBA, BSIE; Abiodun Omoloja, MD, MBA, CPE, FASN, FAMIA; Jennifer Morris, MS, APRN-CNP-PC, RNC-NIC; Maddie Mock, BSME; Thomas Geglein, BSN, RN, MBA; Kimberly …
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A 4-year-old male presents to urgent care with a swollen, painful right elbow. The mother reports that the child had a witnessed fall from the monkey bars 1 hour prior to arrival. He fell onto his outstretched right hand, was in immediate pain that has not subsided, and has refused to let anyone touch his arm. On initial examination, vital signs are stable, and patient is afebrile. Swelling is noted over the right elbow, and …
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