Practice Management
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. …
Read More
Urgent message: Recent expert opinion has reshaped initial management for suspected acute renal colic. Clinicians often utilize computerized tomography imaging to diagnose acute renal colic; however, there is an increasing role for clinicians to instead use point-of-care ultrasound (POCUS) as the initial imaging modality when acute renal colic is suspected. Renal ultrasound is time and cost effective, radiation-free and completed by the clinician at the bedside. Chelsea M. Burgin, MD, FAAFP; James Frederick W. Pike, …
Read More
Ethnic Background Matters in ECG Evaluation Lean on Risk Stratification Tools in Chest Pain Lasting Effects of Headache in Children Trauma and Childhood Migraine Comparing ‘Fixes’ for Distal Radial Fractures in Adolescents Casting Options in Distal Radius Fractures in the Elderly Avijit Barai, MBBS, MRCS, MSc (Critical Care), PgCertCPU, FRNZCUC Ethnicity and STEMI Criteria of ECG Key point: The ethnic background of patients should be considered during ECG evaluation of ST segment elevation myocardial infarction …
Read More
Urgent message: Patients and providers alike may be inclined to eliminate possible diagnoses based on first impressions. It is essential that the urgent care clinician maintain a wide differential when evaluating patients for new-onset complaints that do not have an obvious cause. Failure to do so may cause delayed diagnoses (and, consequently, delayed treatment). Haley Harrington, Ross L. Pearlman, MD and Robert T. Brodell, MD INTRODUCTION Ticks are small—so small that patients often do not …
Read More
Urgent message: While standards for pediatric emergency care have been defined for outpatient offices and emergency departments, guidelines have not been published for urgent care centers. This study assesses the presence of equipment, supplies, and medications necessary to manage emergencies in pediatric urgent care centers. Amanda Montalbano, MD, MPH, FAAP and Brian Lee, PhD, MPH Results from this project were presented in poster format the Pediatric Urgent Care Conference in Orlando, FL in 2018. No …
Read More
It is not the strongest species that survive, nor the most intelligent, but the most responsive to change. – Charles Darwin Imagine, if you will for a moment, that you’re a dinosaur. Specifically, a late cretaceous era one —any species you like. I tend to envision myself a triceratops. It’s about 66 million years ago (give or take an epoch or two) and animals like you have dominated the world for over 100 million years—not …
Read More
Katie Jerzewski MD, Roshni Patel MD, and Joshua Rocker MD OVERVIEW The novel coronavirus, or SARS-CoV-2, first appeared in the Wuhan province of China in the winter of 2019. Due to the virus’s ability to spread from an asymptomatic carrier to the next new host and Wuhan being a pivotal commercial center, it spread quickly across the globe. Asymptomatic carrier rates have ranged from 1.6% to 56.5%, depending on clinical setting and testing availability.1 In …
Read MoreSpotlight on Original Research in Pediatric Urgent Care: Excerpts from the 2020 Pediatric Urgent Care Conference (PUCC). Los Angeles, CA David J. Mathison, MD, MBA Decreasing Length of Stay in the Pediatric Urgent Care with Electronic Discharge Instructions* Wooster J, Patel A, Nedved A, Lee B The aim of this research was to determine if an electronic discharge process could decrease length of stay by an average of 10 minutes per patient. An electronic discharge …
Read More
The patient is an 8-year-old girl with a smattering of brown to black lesions on her arms. They’re not painful or causing discomfort, but her mother is concerned because they look darker than the average freckle. Exam reveals small (less than 0.5 mm), round, hyperpigmented macules. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. <
Read More
The patient is a 60-year-old female with no past medical history presents with intermittent exertional chest pain for 4 days. She reports the pain is substernal with radiation to her left arm, is associated with nausea and diaphoresis, and is worsened by exertion. The patient says she experiences pain every 4-5 hours, but currently is pain-free. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case …
Read More