Repetitive Motion Injuries: Urgent Diagnosis, Patient-Centered Management

Urgent message: Musculoskeletal disorders result in costly, disabling outcomes for Americans—causing significant economic impact (work-related injuries, early retirement, days away from work) and representing a leading cause of chronic diseases nationwide. Frequently, the initial treating facility, which determines if the injured/ill patient is capable of returning to work or needs time away from work or modified duty, is an urgent care center. Ashley Clay, MSPAS, PA-C INTRODUCTION An estimated one in two adults older than 18 years of age, or 126.6 million Americans, are affected by musculoskeletal disorders (MSDs),1 exceeding the percentage …
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Top 5 Wilderness Medicine Topics for the Urgent Care Provider

Urgent message: “Wilderness” medicine is less exotic than one would think. Patients with complaints that began during or after an outdoor outing in any season are likely to present to urgent care, making wilderness medical knowledge of paramount importance. Stewart Harsant, MMS, PA-C Introduction Every season holds its own unique appeal to those who love the great outdoors. Similarly, every season has its own distinct set of risks, ranging from gastrointestinal symptoms, dermatological conditions, and infection from insect bites to external and internal damage from exposure to frigid temperatures. Here, …
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Top 5 Common Causes—and Controversial Conducts—of Heel Pain in Urgent Care

Urgent message: Nontraumatic heel pain is a common presenting complaint in urgent care. Knowing how to accurately diagnose and develop a treatment plan is important, as the course is typically prolonged. Katty Grand-Pierre, MD, CMSS, Frank Ida, BS, EMT-B, and Vincent D’Amore, MD, FACEP INTRODUCTION The heel can absorb 110% of body weight while a person is walking and 200% of body weight during running.1 While the most common cause is plantar fasciitis (PF), accounting for approximately 2 million office-based visits a year,2 the causes and treatments are often confusing …
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Suspected Pertussis in Infants and Adolescents—What to do?

Urgent message: Familiarity with the schedule for immunization against pertussis, as well as expertise in diagnosing and prescribing treatment, should be within the urgent care provider’s capabilities—as should the ability to distinguish which patients require transfer to a higher-acuity setting.   Ellen Laves, MD Microbiology and Immunity Pertussis is a toxin-mediated disease caused by the gram-negative coccobacillus Bordetella pertussis. Toxins produced by B pertussis impair ciliary clearance of pulmonary secretions through the paralysis of normally beating cilia.1 Childhood immunity to pertussis is conferred through the administration of the acellular pertussis …
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Initiating PrEP Services in Urgent Care

Urgent message: Urgent care centers may offer opportunities to provide preexposure prophylaxis (PrEP) services for HIV due to large numbers of patients seeking testing and treatment for sexually transmitted infection. In the same sense, the urgent care center may also serve as an important ally in providing referrals for patients not currently linked to primary care services. Yeow Chye Ng, PhD, FNP-BC, NP-C, CPC, AAHIVE, Jack J. Mayeux, MSN, APRN, NP-C, and Thuy Lynch, PhD, RN. Introduction Preexposure prophylaxis (PrEP) services for HIV are not currently offered in a majority …
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