Treating Patients Infected with Influenza Virus in the Urgent Care Setting

Treating Patients Infected with Influenza Virus in the Urgent Care Setting

Urgent message: As patients start to feel the effects of the 2018–2019 influenza season, urgent care centers can expect to see visits by patients with related symptoms increase. Providers must be prepared to identify and treat patients most at risk for complications and poor outcomes—armed with old standbys and a newly approved antiviral agent. Samantha Arnold, DO Introduction Last month, JUCM explored prevention, diagnosis, and testing for influenza. In this issue, we focus on management …

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An Urgent Care Approach to Influenza—Before Onset

An Urgent Care Approach to Influenza—Before Onset

Urgent message: The urgent care clinician must have a thorough understanding of different influenza types and strains, disease course, and preventive measures—including, but not limited to, vaccination—at the outset of flu season.   Introduction Influenza is most deadly in the very young, very old, and those with comorbid conditions. Typically, onset is rapid and seasonal, though patients may initially present with few or nonspecific symptoms. Complicating things further, there are many different strains of the …

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Syphilis in the Urgent Care Center

Syphilis in the Urgent Care Center

Urgent message: Seeking information beyond the stated history  can prompt  important information that informs the true diagnosis. This is especially true in patients  with a complicated or potentially embarrassing history.  Case Presentation A 59-year-old female with a past medical history of type 2 diabetes and hypertension presents to an urgent care facility with complaints of abdominal pain. She is well known to the urgent care staff. She is consistently noncompliant with medical care. Her hypertension …

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Employing the Parental Papoose Technique in Treating Young Children

Employing the Parental Papoose Technique in Treating Young Children

Urgent message: Children presenting to the urgent care center are often in a state of distress and agitation—to the extent that they may be difficult to treat when it comes to certain procedures. The parental papoose technique may help soothe the patient—and the parent—making effective treatment more accessible. Oscar D. Almeida, Jr., MD, FACOG, FACS It is common for a young child to enter our urgent care center calmly—while being held by a parent, only …

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The Approach to the Hypertensive Patient in the Urgent Care Setting

The Approach to the Hypertensive Patient in the Urgent Care Setting

Urgent message: Previously undiagnosed hypertension is common among ambulatory patients, and urgent care providers are often the first to recognize and diagnose this condition. Initiating treatment, testing, and providing patient education and follow-up are well within the scope of urgent care practice and help ensure positive outcomes. Being attentive to the presentation and care of hypertensive emergencies is also paramount.   Taylor Fischer MMS, PA-C and Rebecca L. McClough, MPAS PA-C   Hypertension (HTN) affects …

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Approach to Fever and Drooling in Infants and Toddlers

Approach to Fever and Drooling in Infants and Toddlers

Urgent message: Typical drooling is no cause for alarm in infants and toddlers. However, excessive drooling accompanied by fever or other various red flags could be signs of more serious concerns such as retropharyngeal abscess, Ludwig angina, or upper airway obstruction. Recognition should trigger a thorough evaluation by the urgent care provider. Katherine P. Dureau, MD CASE A 24-month-old previously full-term and vaccinated male presents to an urgent care center with 24 hours of fever …

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Head Injuries and Cirrhosis: Does everyone need a CT Scan?

Head Injuries and Cirrhosis: Does everyone need a CT Scan?

Urgent message: The decision of whether or not to image a patient with a head injury has significant implications—for the patient and the urgent care provider. Understanding which patients are at greatest risk for serious head injury, indications for testing, and options for management/disposition is essential. Brandon Godfrey, MD; Haylie Wiesner, BS; and John Shufeldt, MD, JD, MBA, FACEP Case A 47-year-old male with a history of alcohol abuse and cirrhosis presents to an urgent …

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Concussion Management in Urgent Care: A Primer for Implementation

Concussion Management in Urgent Care: A Primer for Implementation

Urgent message: Sports-related concussions are particularly dangerous injuries due to their complex nature and difficulties associated with diagnostic and return-to-play decisions. Some of the most commonly employed assessment tools have been shown to be unreliable, leading to misdiagnoses. Guidelines for selecting more effective concussion assessment instruments and the use of such tests in urgent care settings are here suggested as an optimal framework for improved care. Len Lecci, PhD, MA Introduction Millions of adults, adolescents, …

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Management of Acute Exacerbation of Chronic Low Back Pain in the Urgent Care Setting

Management of Acute Exacerbation of Chronic Low Back Pain in the Urgent Care Setting

Urgent message: A systematic approach to evaluating, diagnosing, and treating low back pain in the urgent care setting reduces unnecessary hospital visits, identifies red flag symptoms that warrant further diagnostic or neurosurgical evaluation, promotes returning to work quicker, and helps to reduce the number of opioid prescriptions that are prescribed for episodic exacerbation and/or chronic conditions. Ashley Clay, MS, PA-C Introduction Up to 80% of the United States population experiences back pain at some point; …

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Tattoos and Piercings: What the Urgent Care Provider Needs to Know

Tattoos and Piercings: What the Urgent Care Provider Needs to Know

Urgent message: Tattoos and piercings are becoming commonplace, but patients who experience complications with these forms of body art may present to urgent care centers, as access to dermatology and plastics specialists frequently requires a referral or extended wait periods. The urgent care provider should possess a working knowledge about how tattoos and piercings are performed, how to recognize the complications, and how to treat them appropriately. Tracey Quail Davidoff, MD  TATTOOS Introduction The term …

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