Chest X-Ray Findings in 636 Ambulatory Patients with COVID-19 Presenting to an Urgent Care Center: A Normal Chest X-Ray Is no Guarantee

Chest X-Ray Findings in 636 Ambulatory Patients with COVID-19 Presenting to an Urgent Care Center: A Normal Chest X-Ray Is no Guarantee

Michael B. Weinstock, MD, Ana Echenique, MD, DABR, Joshua W. Russell, MD, MSc, FACEP, Ari Leib, MD, Jordan A. Miller, DO, David J. Cohen, MD, Stephen Waite, MD, Allen Frye, NP, and Frank A. Illuzzi, MD, FACEP Abstract Background/Objective Patients with COVID-19 commonly present to Urgent Care (UC) centers. Our primary objective was to determine what percentage of UC patients with confirmed COVID-19 had normal vs abnormal chest x-rays (CXR). Secondarily, we aim to describe …

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Conducting Preparticipation Sports Physicals in the Urgent Care Center

Conducting Preparticipation Sports Physicals in the Urgent Care Center

Urgent message: Youth athletic programs are ubiquitous in the United States, with leagues requiring players to have a physical exam before they’re allowed to take part. Ensuring your urgent care center is ready to be a “go to” resource for a thorough work-up increases young athletes’ chances for a safe experience and bolsters your position as a valued community health resource. INTRODUCTION Millions of juveniles participate in organized athletics the world over every year. In …

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Management of Lisfranc Dislocation in the Urgent Care Center

Management of Lisfranc Dislocation in the Urgent Care Center

Urgent message: Lisfranc dislocations are relatively rare, but should be on the urgent care provider’s radar in patients who refuse to bear weight and who have significant midfoot pain and swelling after an acute trauma causing hyperplantarflexion of the foot. Introduction The tarsometatarsal (TMT), or Lisfranc, joint complex is the attachment between the forefoot and midfoot. This joint is the keystone to normal foot function and is thus critical for normal gait.1 Jacques L. Lisfranc …

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A 22-Year-Old Female with Frequent Nosebleeds and Abnormalities on Her Lips and Tongue

A 22-Year-Old Female with Frequent Nosebleeds and Abnormalities on Her Lips and Tongue

The patient is a 22-year-old woman who presents complaining of frequent nosebleeds. On exam, you note bright red macules and spider veins on her lips and tongue. They disappear briefly when you press on them. Review the image below and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

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Abstracts in Urgent Care May 2020

General Statistics of COVID-19 Clinical Characteristics of COVID-19 Characteristics of Healthcare Workers Infected with COVID-19 A Simple Algorithm for Treatment of Nonpurulent Infections Topical Lidocaine for Oral Ulcers in Children Walking Boot vs Rigid Cast in Achilles Tendon Rupture General Statistics of COVID-19 Key Point: The majority of patients with COVID-19 have mild symptoms; however, those with critical disease have a mortality rate of 49%. Citation: Wu Z, McGoogan JM. Characteristics of and important lessons …

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A 55-Year-Old Female with Hip Pain

A 55-Year-Old Female with Hip Pain

The patient is a 55-year-old woman who presents with what she calls minor pain in her left hip. She denies any trauma, and insists the pain “isn’t that bad.” She’s only seeking care as a precautionary measure in advance of a family camping trip. View the image taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.

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Guttate Psoriasis: An Uncommon Cause of a Rash

Guttate Psoriasis: An Uncommon Cause of a Rash

Urgent message: While skin-related complaints are not uncommon in the urgent care setting, with psoriasis being a relatively common source, evaluation and diagnosis of a rash can be challenging. This is especially true in the case of a rare variant like guttate psoriasis.  Chasity L. Falls, MS, PA-C INTRODUCTION Psoriasis is a common condition. However, the guttate variant is rarer, commonly affecting children and young adults less than 40 years of age and accounting for …

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Abstracts in Urgent Care April 2020

JUCM 0420 Abstracts  COVID-19: The Long View Quarantine Duration in Suspected COVID-19 Bedside Ultrasound Use with COVID-19 Fluoroquinolones and Arrhythmia Isopropyl Alcohol and Nausea Relief Patient Preferences Re: the ED vs Urgent Care  The Nuts and Bolts of COVID-19 Key Points: Most patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19 experience mild URI symptoms; however, the virus tends to cause disproportionately severe illness in older and chronically ill adults. …

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A 72-Year-Old Female with Lesions on Her Lower Legs

A 72-Year-Old Female with Lesions on Her Lower Legs

The patient is a 72-year-old woman who complains of multiple skin lesions on her lower legs. She says she first noticed them several months ago, appearing in a net-like pattern, then becoming painful ulcerations, and finally leaving atrophic scars. She is concerned because she had already had several bouts of deep vein thrombosis. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the …

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