Clinical Feature Articles

Urgent message: As patients start to feel the effects of the 2018–2019 influenza season, urgent care centers can expect to see visits by patients with related symptoms increase. Providers must be prepared to identify and treat patients most at risk for complications and poor outcomes—armed with old standbys and a newly approved antiviral agent. Samantha Arnold, DO Introduction Last month, JUCM explored prevention, diagnosis, and testing for influenza. In this issue, we focus on management of patients who have been diagnosed with influenza, with attention to duration of infectivity, complications …
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Urgent message: The urgent care clinician must have a thorough understanding of different influenza types and strains, disease course, and preventive measures—including, but not limited to, vaccination—at the outset of flu season.   Introduction Influenza is most deadly in the very young, very old, and those with comorbid conditions. Typically, onset is rapid and seasonal, though patients may initially present with few or nonspecific symptoms. Complicating things further, there are many different strains of the flu. Spread can occur from the host even before the onset of symptoms, and current …
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Urgent message: Seeking information beyond the stated history  can prompt  important information that informs the true diagnosis. This is especially true in patients  with a complicated or potentially embarrassing history.  Case Presentation A 59-year-old female with a past medical history of type 2 diabetes and hypertension presents to an urgent care facility with complaints of abdominal pain. She is well known to the urgent care staff. She is consistently noncompliant with medical care. Her hypertension and diabetes are both uncontrolled. She has a right below-knee amputation and is wheelchair-bound. She …
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Urgent message: Children presenting to the urgent care center are often in a state of distress and agitation—to the extent that they may be difficult to treat when it comes to certain procedures. The parental papoose technique may help soothe the patient—and the parent—making effective treatment more accessible. Oscar D. Almeida, Jr., MD, FACOG, FACS It is common for a young child to enter our urgent care center calmly—while being held by a parent, only to start crying uncontrollably when separated from that parent in order to be restrained by …
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Urgent message: Previously undiagnosed hypertension is common among ambulatory patients, and urgent care providers are often the first to recognize and diagnose this condition. Initiating treatment, testing, and providing patient education and follow-up are well within the scope of urgent care practice and help ensure positive outcomes. Being attentive to the presentation and care of hypertensive emergencies is also paramount. Taylor Fischer MMS, PA-C and Rebecca L. McClough, MPAS PA-C Hypertension (HTN) affects approximately 29% of American adults, according to the latest report released from the Centers for Disease Control.1 …
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