Urinalysis: A Simple Test with Complicated Interpretation

Urgent message: The urinalysis is a ubiquitous test in urgent care settings, though there is nuance and complexity in its interpretation. An evidence-based approach is essential to assuring correct interpretation and decision-making. Douglas W. Wallace, MD, Blakeley Hudson, MD, and Matthew Delaney, MD Introduction The urinalysis (UA) is one of the most commonly ordered tests across a variety of practice settings. Despite its ubiquity, interpreting a UA can be complicated and nuanced. Given the variable treatment and disposition decisions that we make based on its results, it is crucial to …
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Caring for the Homeless During the COVID-19 Pandemic

Shelter at home. Wash your hands. Use a tissue and properly dispose it. See your primary care if you are not feeling well. The advice goes on and on. But what if you are homeless? What if you do not have ready access to soap and water, or hand sanitizer, or tissues, or medical care? Universally, efforts to contain and mitigate pandemic diseases such as COVID-19 leave out a vulnerable population: people experiencing homelessness (PEH). An estimated 575,000 Americans are homeless.1 The current COVID-19 outbreak will likely wreak havoc in …
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Utility of POCUS in Skin and Soft Tissue Infection

Urgent message: Point-of-care ultrasound (POCUS), just starting to become more prevalent in the urgent care setting, facilitates improved diagnostic and interventional clinical decision-making by aiding the clinician in discerning between cellulitis, abscess, or both.  Chelsea M. Burgin, MD FAAFP and Dustin S. Morrow, MD FACEP  INTRODUCTION Each year in the United States around 14 million patient encounters present with skin and soft tissue infections (SSTIs). A detailed history and focused exam differentiate between cellulitis and/or abscess the majority of the time. However, there are scenarios when it is challenging to …
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Evaluating a Child with Chest Trauma for Pneumothorax in the Urgent Care Setting

Urgent message: The differential diagnosis is broad for patients presenting with chest trauma. Bedside ultrasound can expedite critical diagnoses and intervention(s) when pneumothorax is in the differential. CASE PRESENTATION History A 12-year-old male rolled an all-terrain vehicle (ATV) in the woods, sustaining head, torso, and extremity injuries. He was helmeted, but lost consciousness for an uncertain amount of time. His father found him and provided initial care at home. Because of persistent headache and vomiting, his father brought him to a local urgent care facility several hours later. In addition …
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The Effect—or Non-Effect—of Rapid Medical Evaluation Programs on Resident Education

Urgent message: With significant overlaps in clinical staff, patient population, and provider training between emergency medicine and urgent care, valuable insights relevant to urgent care can be gleaned from understanding the effect of incorporating provider-in-triage training into emergency medicine resident education. INTRODUCTION Crowding is a major barrier to timely and effective patient care in emergency departments. Crowding occurs when the demand for care exceeds the ability to supply it in an efficient fashion. This is often due to inpatient bed availability (patient boarding), increased patient complexity requiring longer stays in …
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