Clinical Articles

Urgent message: It is common for patients with injuries to the upper extremity due to falls on outstretched hands to present to urgent care. As such, evaluation, appropriate imaging, and initial treatment should all be within a clinic’s capabilities.  Michael Bartuseck, MSN, ARNP, FNP-C, EP-C Introduction Urgent cares centers play an integral role in providing care for patients who have sustained injuries due to falls on outstretched hands (FOOSH). While complex anatomy of the wrist, hand, and elbow often lead to confusion and misdiagnosis of FOOSH injuries, the high prevalenceRead More
Urgent message: Initial evaluation of a patient with an arrhythmia in the urgent care setting can be as difficult as it is critical to the patient’s survival—one key concern being sudden cardiac death, which occurs in roughly 328,000 cases annually.  Riaz Fabian, DO  Introduction Cardiac arrhythmias are a group of conditions in which a patient has an abnormal heart rate or rhythm. They are caused by any disruption of the electrical conduction system of the heart, which impacts the normal activation sequence of the myocardium. Arrhythmias can be broadly classifiedRead More
Urgent message: Opioid abuse, addiction, and resultant deaths have drawn the attention of both the medical community and legislative bodies from the local health department to the White House. Urgent care is a frequent destination for addicts trying to secure drugs illicitly—but it also has the potential to be the first stop on the road to recovery. Jason M. Ramos and Robert S. Crausman, MD, MMS Case Presentation Manny is a middle-aged white male who presented to our urgent care for the third time in 2 weeks complaining of severeRead More
Urgent message: Chest pain is both more common and, typically, less concerning in children than in adults. If anything, however, this underscores the importance of guarding against a false sense of safety in low-risk causes, and maintaining vigilance for life-threatening etiologies. SABAH F. IQBAL, MD, FAAP and HANSEL OTERO, MD The case: A 12-year-old healthy African-American boy presents to urgent care with 2 days of midsternal chest pain, which is worse when he’s taking big breaths. It is not changed by exercise or rest, and no medications have been takenRead More
Urgent message: Snakebite envenomation is relatively rare, but immediate action upon presentation to the urgent care center—including quick and accurate identification, appropriate care, and sound decisions regarding transfer to the ED—maximize the chance for optimal outcomes. Andrew Vang, DO Introduction Snake venom poisoning is a complex medical emergency that is seen infrequently, but when encountered requires rapid recognition and urgent management. The following discussion will focus on appropriately identifying snakebites from indigenous venomous species in North America, Crotalid and Elapid snakes; initiating urgent management; and indications for transfer. Epidemiology InRead More
Urgent message: Follow-up after a patient visit is essential to the continuum of care and to the perception of customer service. Especially in the urgent care setting, where providers may have no ongoing relationship with a patient, the most basic office practices (eg, collecting accurate and accessible contact information) can seem deceptively simple but are of critical importance. Jimmie Toler, MSN, NP-C, Emily E. Johnson, PhD, and Barbara J. Edlund, PhD, ANP, BC Introduction Continuum of care is synonymous with appropriate care. In the urgent care environment, this continuum includesRead More

Posted On July 3, 2017 By In Clinical, Clinical Articles

The Red-Hot Joint

Urgent message: Septic arthritis can lead to significant morbidity if not treated in a timely manner. Bacteria within the synovial space can lead to rapid joint destruction and irreversible loss of function. When patients present to the urgent care center with a red, hot, swollen, painful joint, every attempt must be made to rule out this disease entity to prevent significant morbidity and mortality. Introduction Patients frequently present to urgent care with a red, swollen, and painful joint in the absence of trauma. Causes of acute monoarticular arthritis can rangeRead More
Quality Improvement Report
Urgent message: Urgent care providers are valued for their ability to treat nonemergent acute healthcare needs efficiently, but in so doing they are also well positioned to identify other, underlying healthcare issues such as hypertension. Introduction Heart disease is the leading cause of death in the United States and accounts for approximately 24% of all deaths.1 Many known risk factors are associated with heart disease, including high blood pressure. The Centers for Disease Control and Prevention estimates that 46,000 deaths each year may be prevented through effective treatment of hypertension,Read More