Syphilis in the Urgent Care Center

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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Employing the Parental Papoose Technique in Treating Young Children

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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The Approach to the Hypertensive Patient in the Urgent Care Setting

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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Approach to Fever and Drooling in Infants and Toddlers

Urgent message: Typical drooling is no cause for alarm in infants and toddlers. However, excessive drooling accompanied by fever or other various red flags could be signs of more serious concerns such as retropharyngeal abscess, Ludwig angina, or upper airway obstruction. Recognition should trigger a thorough evaluation by the urgent care provider. Katherine P. Dureau, MD CASE A 24-month-old previously full-term and vaccinated male presents to an urgent care center with 24 hours of fever with a maximum temperature of 102.5⁰F. The father also reports drooling, decreased oral intake, fussiness, …
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Head Injuries and Cirrhosis: Does everyone need a CT Scan?

Head Injuries and Cirrhosis: Does everyone need a CT Scan?

Urgent message: The decision of whether or not to image a patient with a head injury has significant implications—for the patient and the urgent care provider. Understanding which patients are at greatest risk for serious head injury, indications for testing, and options for management/disposition is essential. Brandon Godfrey, MD; Haylie Wiesner, BS; and John Shufeldt, MD, JD, MBA, FACEP Case A 47-year-old male with a history of alcohol abuse and cirrhosis presents to an urgent care center after hitting his head on a cement column during “a minor altercation” with …
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