Abstract In Urgent Care-July 2019

Rush for Outpatient Stress Test Recommendation (Finally) Examined Key point: Rapid outpatient stress testing (ie, within 72 hours), which has long been recommended by the American Heart Association, did not decrease the short-term risk of major adverse cardiac events (MACE). Citation: Natsui S, Sun BC, Shen E, et al. Evaluation of outpatient cardiac stress testing after emergency department encounters for suspected acute coronary syndrome. Ann Emerg Med. April 5, 2019. [Epub ahead of print] The …

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Abstract In Urgent Care-June 2019

Practice of Urgent Care: The Illusion of Multitasking and the Cost of Interruptions Key point: True multitasking is not possible. Rather, when we attempt to multitask, our brains are actually rapidly switching focus. Task-switching and interruptions negatively impact our ability to complete tasks accurately and effectively. Minimizing task-switching reduces the likelihood of cognitive errors and, consequently, adverse patient outcomes. Citation: Skaugset LM, Farrell S, Carney M, et al. Can you multitask? Evidence and limitations of …

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Abstract In Urgent Care-May 2019

Mitigating Risk Through Shared Decisionmaking Key point: Shared decision-making appears to mitigate the risk to clinicians of patient complaints and lawsuits in the event of a bad outcome. Citation: Schoenfeld  EM, Mader S, Houghton C, et al. The effect of shared decisionmaking on patients’ likelihood of filing a complaint or lawsuit: a simulation study. Ann Emerg Med. January 3, 2019. [Epub ahead of print]   Missed and delayed diagnoses of dangerous conditions are unavoidable in …

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Abstracts In Urgent Care – April 2019

Rethinking IV Antibiotics for Cellulitis Key point: Oral antibiotics are noninferior to parenteral antibiotics for uncomplicated cellulitis. Erythema of cellulitis commonly expands somewhat, even if treated with appropriate antibiotics, for the first 1-2 days after starting treatment. Citation: Aboltins CA, Hutchinson AF, Sinnappu RN, et al. Oral versus parenteral antimicrobials for the treatment of cellulitis: a randomized non-inferiority trial, J Antimicrob Chemother. 2015;70(2):581-586. Patients with cellulitis are often referred from urgent care to the emergency …

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Abstracts in Urgent Care-March 2019

Practice of Urgent Care: More Patients, More Decisions, More Fatigue Key point: We should be aware, as clinicians, that as we progress through our shifts, decision fatigue mounts. One manifestation of decision fatigue is an incremental decline in antibiotic stewardship. It is also important to understand that taking breaks seems to combat the harmful effects of decision fatigue. Citations: Linder JA, Doctor JN, Friedberg MW, et al. Time of day and the decision to prescribe …

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Abstracts In Urgent Care – February 2019

Check the Temps: A Timely Throwback Key points: Peripheral temperatures (ie, temporal, tympanic, oral, and axillary) are inaccurate and cannot reliably exclude the presence of fever. If absolute certainty regarding febrile status is critical (eg, neonates, immunosuppressed patients), a (gentle) rectal temperature is the preferred method of temperature acquisition in the urgent care setting. For all others, a tympanic temperature reading <37.5°C appears to best exclude true fever with reasonable certainty. Finally, all this comes …

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Abstracts In Urgent Care – January 2019

A Brief Introduction Happy New Year! 2018 is now behind us and it was another great year for urgent care. We are fortunate to work in one of the most dynamic and rapidly growing fields in medicine. I find it thrilling that the future of urgent care is ours to define and design. According to data from the UCA, last year nearly 150 million patients received care in U.S. urgent care centers (UCCs). These patients …

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Abstracts In Urgent Care – December 2018

The Year in Abstracts: Top Papers of 2018 for the Urgent Care Clinician Reviewed by Andy S. Barnett, MD  This has been an eventful year in the urgent care marketplace. Then again, you could say that at the end of most years in our dynamic, ever-growing industry. That begs the question, what did set 2018 apart from other years? Mergers and acquisitions, evolving technologies, and workplace trends certainly impact what you do every day. But …

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Abstracts In Urgent Care – November 2018

From ID Week: Outbreak-Related Hep A Infections Are on the Rise Key point: Hepatitis A infection may be evolving from common-source exposure to outbreak exposure. Urgent care clinicians can influence this phenomenon by recommending that at-risk adults receive immunization. Citation: Foster M, Hofmeister M, Yin S, et al. Changing epidemiology of hepatitis A virus infections—United States, 2009–2017. Oral Abstract Session. ID Week 2018. Available at: https://idsa.confex.com/idsa/2018/webprogram/Paper74176.html. Accessed October 8, 2018. Between 2007 and 2017, the …

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Abstracts In Urgent Care – October 2018

New Data Show ‘Steep and Sustained’ Increase in STD Occurrence—Especially Syphilis Key point: Over the past 5 years, rates of syphilis, gonorrhea, and chlamydia have all increased in the United States, with syphilis cases almost doubling and cases of antibiotic-reistant gonorrhea rising. Citation: Centers for Disease Control and Prevention. 2018 STD Prevention Conference. New CDC Analysis Shows Steep and Sustained Increases in STDs. August 28, 2018. Available at: https://www.cdc.gov/nchhstp/newsroom/2018/2018-std-prevention-conference.html#Graphics. Accessed September 7, 2018. Every other …

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