Journal of Urgent Care Medicine

Cost-Effective Ambulatory Care for Emergency Department Avoidance

Urgent message: Industry perception is that urgent care offers the opportunity for potentially substantial cost savings while also providing safe, effective care for complaints of appropriate acuity. Data supporting those claims have been lacking, however. Lo Fu Tan, MD, MS, FCFP, FAAFP and Jillian Kreston, MBA, MEcon Citation: Tan L F, Kreston J. Cost-effective ambulatory care for emergency department avoidance. J Urgent Care Med. 2022;16(10):25-32. BACKGROUND A 2019 brief published by the United Health Group …

Management of Burn Blisters in Urgent Care

Urgent message: Though data are limited and approaches to burn blister management remain controversial (eg, leaving blisters intact vs deroofing or aspirating), appropriate initial care in the urgent care setting is both feasible and advisable and can reduce risk for infection and scarring. Muhammad Zeeshan Ahmed MBBS, FRNZCUC, Winston McEwan FRACS, and Sana Maqsood MPhil, Cert PH Citation: Ahmed MZ, McEwan W, Maqsood S. Management of burn blisters in urgent care. J Urgent Care Med. …

Essential Tools for Urgent Care—Finger Tourniquet

Urgent message: Use of a finger tourniquet can ensure a bloodless field when performing laceration repair to fingers and toes, thereby reducing risk for damage to underlying vital structures and increasing the prospects for positive outcomes. Patrick O’Malley, MD After repairing scores of finger lacerations over the years, I have learned there are a few essential supplies required for these cases; the most critical among them, however, is the finger tourniquet. This simple device makes …

Brain Abscess in an Immunocompetent Patient: Complex Pathology and Communication

Urgent message: Remain diligent in the evaluation of headache; though often a benign condition, the possibility for severe morbidity and mortality warrants careful evaluation of subtle aspects within the history and/or physical exam. INTRODUCTION Headache is one of the most common complaints in the urgent care setting, yet also one that can be daunting for a provider. While there are many benign causes, such as a migraine or tension headache, the potential for an emergent …

An 87-Year-Old Male with Chest Pain, SOB, and a History of Valvular AFib, Stroke, and Heart Failure

An 87-year-old male with past medical history of valvular atrial fibrillation, prior stroke, and heart failure presents to urgent care with chest pain and shortness of breath for 3 days. The pain and difficulty breathing are associated with bilateral lower extremity swelling for 1 week. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Abstracts in Urgent Care – July/August 2022

Colchicine in Acute Gout POCUS and Necrotizing Fasciitis Assessing Patient Satisfaction Misinterpreting Pediatric Radiographs Lung Ultrasound and Pediatric Pneumonia Diagnosing Pneumothorax A Review of the Evidence for Colchicine in Acute Gout Take-home point: Colchicine appears to be no more effective than NSAIDs for acute gout flares and evidence does not indicate greater efficacy at higher doses. Citation: Gottlieb M, Rabah W, Long B. Colchicine for acute gout. Acad Emerg Med. 2022;29(3):387-388. Epub ahead of print …

A 43-Year-Old Woman with a New Ulcer on One Hand

A 43-year-old woman presents with 2 weeks of a smooth nodule on her right hand. The patient denies recent travel but recalls that she “banged up” her hand while cleaning out a fresh-water fish tank prior to noticing the nodule. Past medical history is significant for renal transplantation. Exam reveals a tender, erythematous plaque with an ulcer on dorsal aspect of her hand. View the image and consider what your diagnosis and next steps …

A 12-Year-Old Boy with Knee Pain After a Baseball Game

The patient is a 12-year-old boy who presents with pain in his left knee. His mother reports that during a baseball game earlier in the day he slid hard into a base and came up limping. Review the x-rays taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Playing in the Band

I got my first guitar when I was 14. It was an Alvarez acoustic with an electric pick-up, and I played it every day—at least for a while. I thought it would make me cool and make the girls take notice. But after about a year, when neither of those things had happened, I just about gave up the guitar for good. There simply wasn’t much joy in always playing alone. What revived and has …

Bullous Pemphigoid Reaction After Second Dose of COVID-19 Vaccine

Urgent message: Throughout the COVID-19 pandemic, unvaccinated people have shown higher rates of morbidity and mortality in comparison with those who are fully immunized. While most vaccination adverse reactions are mild and self-resolving, it is important to consider the timeline of vaccinations to correlate possible adverse reactions. Amanda dos Santos, MD and Michael Pallaci, DO, FACEP, FACOEP INTRODUCTION The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic continues to affect all aspects of our society and …

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