Clinical Feature Articles

Urgent message: As visits to urgent care after possible traumatic brain injury continue to rise, so does the importance of understanding which patients require a CT scan. Assessing the value of the Canadian Computed Tomography Head Rule in making that determination can raise the urgent care provider’s ability to make informed decisions in this regard, reducing the risk of unnecessary radiation exposure in patients who are determined to not need a CT. Jessicah Ray, DHSc, MS, PA-C and Jeffrey L. Alexander, PhD, FAACVPR, ACSM-CEP Abstract Background Despite years of training …
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Urgent message: With patients who have sustained head injuries related to both sports- and non–sports-related activities presenting to urgent care more than ever before, it’s essential for the provider to have a nuanced understanding of which patients truly require transfer or referral to a high-acuity level of care, and which can be managed successfully and safely in the urgent care setting. Anthony P. Doran, PsyD; Robert G. Graw, Jr., MD; Marc Weber, MD; Stanford Coleman, MD; Kevin Crutchfield, MD; and Daniel Pokrifka, ATC ABSTRACT Background Urgent care, family practice, and …
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Urgent message: Pharyngitis is a common chief complaint in urgent care, but not all sore throats are streptococcal (strep) pharyngitis. Delayed diagnosis and treatment of some causes of sore throat can lead to catastrophic outcomes. Epidemiology Acute pharyngitis accounts for 1%-2% of all visits in the ambulatory setting.1 Most pharyngitis seen in urgent care is viral in etiology. The most common bacterial cause of pharyngitis is group A beta hemolytic Streptococcus (GABHS), which is responsible for 5%–15% of visits for sore throat in adults and 20%–30% in children.2 Case An …
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Urgent message: Acute otitis media (AOM) is the leading diagnosis for antibiotic prescribing in pediatric patients. As antibiotic stewardship becomes more essential in preventing antibiotic resistance, safe and effective management of AOM becomes all the more important in urgent care. The treatment path should reflect nuances in management to inform decisions regarding the necessity of antibiotics—and if they are deemed necessary, targeting the type, delivery vehicle, and duration to keep a narrow treatment effect. When should I suggest ‘watchful waiting’? Consider watchful waiting, rather than immediate antibiotic treatment, for patients …
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Urgent message: As understanding of COVID-19 in the pediatric age group evolves, it has come to light that children may contract the virus, yet be asymptomatic, more commonly than we initially believed. We have found a high prevalence of asymptomatic pediatric patients testing positive for COVID-19 in our urgent care clinics in the NY metro region. Katharine Miao MD, Frank Illuzzi MD, and Alexander C. Hwang IMPORTANCE SARS-CoV-2 is the novel virus that causes COVID-19. After first being identified in China in December 2019, this disease has erupted into a …
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