Journal of Urgent Care Medicine

Repair of Lacerations of the Face and Scalp: Part 1

Urgent message: Management of face and scalp lacerations requires an appreciation of the unique anatomy, sound repair technique, and consideration of patient expectations for cosmesis. TOYIN FAPOHUNDA-ADEKOLA MD, MBA Lacerations of the scalp and face are commonly seen in the urgent care setting. While these injuries can cause anxiety for both patient and practitioner, the basic tenets and techniques for repair are already well known. Following a systematic approach and appreciating the unique anatomic considerations …

Antibiotic Management of Acute Uncomplicated Cystitis and Pyelonephritis in Women

Urgent message: Proper empiric antibiotic treatment in women with acute uncomplicated cystitis and pyelonephritis can prevent unnecessary morbidity and provide urgent relief from these common genitourinary infections. MOZELLA WILLIAMS, MD Genitourinary infections in women are encountered frequently in the urgent care setting. Timely diagnosis and proper empiric antibiotic treatment will usually forestall serious complications and provide speedy relief. Over a lifetime, 50% of women will experience an acute uncomplicated cystitis, also known as a lower …

An Urgent Care Approach to Joint and Soft-Tissue Injection/ Aspiration: Part 2

Urgent message: Injection/aspiration therapy for selected musculoskeletal complaints is becoming more common in urgent care practice. Part 2 of this series offers step-by-step guidance on treatment of conditions from “tennis elbow” to bursitis and cysts. THOMAS V. GOCKE, III, MS, ATC, PA-C, DFAAPA The focus of Part 1 of this series, in the September issue of JUCM, was on understanding the inflammatory response, use of corticosteroids and anesthetic agents (Table 1), pre- and post-aspiration/injection considerations, …

An Urgent Care Approach to Joint and Soft-Tissue Injection/ Aspiration: Part 1

Urgent message: Injection/aspiration therapy for selected musculoskeletal complaints is becoming more common in urgent care practice. Providers need a thorough understanding of injection/aspiration procedures and associated risks to be equipped to deliver rescue therapy to patients. THOMAS V. GOCKE, III, MS, ATC, PA-C, DFAAPA Joint pain, joint effusion, and recurrent soft-tissue trigger point irritation are common presentations in urgent care. As more and more patients present seeking immediate relief of such symptoms, it’s important that …

Evaluation of Headaches in Urgent Care Part 2: Non-Emergent Headaches

Urgent message: Headaches are challenging chief complaints and being able to identify and differentiate among the non-emergent types of headaches will help with medical decision making and patient care. JACQUALINE DANCY, PA-C, MPAS In the conclusion of a two-part series, this article focuses on non-emergent headaches. For the purpose of this article, non-emergent headaches are classified as those that are not life-threatening and pose little to no risk of permanent functional disability. Most non-emergent headaches …

Outpatient Management of Deep Venous Thrombosis

Urgent message: Urgent care providers are on the frontline in diagnosis of DVT. Outpatient management is a consideration for carefully selected patients. SABRINA SOOD, MD Deep venous thrombosis (DVT) is formation of a clot in the deep venous system, usually in a lower extremity. Half of untreated patients with DVT will go on to develop the fatal complication pulmonary embolism (PE). Approximately 300,000 to 600,000 Americans die each year due to venous thromboembolism (VTE).1 Urgent …

Evaluation of Headaches in Urgent Care Part 1: Emergent Headaches

Urgent message: Identifying potentially life-threatening or emergent causes of headaches can be challenging in urgent care. Emergent headaches are the focus of the first of a two-part series, aimed at aiding practitioners in appropriate evaluation and management. JACQUALINE DANCY, PA-C, MPAS Introduction The presentation of headaches in the urgent care setting often elicits some healthy angst. Differentiating between potentially life-threatening headaches and more benign varieties can be challenging, especially when the signs and symptoms are …

Assessment and Management of Asthma Exacerbation in Urgent Care: Part 2

Urgent message: The second part in a two-part series offers expert guidance on short and long-term management of the disease in the urgent care setting through the use of pharmacotherapy, protocols for treatment, and a written asthma action plan at discharge. BRADLEY M. TURNER MD, MPH, MHA, FCAP, FASCP and JANET M. WILLIAMS, MD, FACEP Introduction Once the suspicion of an asthma exacerbation exists, short term management is focused on reducing the severity of the …

Assessment and Management of Asthma Exacerbation in Urgent Care: Part 1

Urgent message: Asthma is increasing in prevalence and so, too, presentations of asthma in ambulatory settings. Urgent care providers have an important role to play in identifying and treating acute asthma exacerbations, including providing a written asthma action plan at discharge to improve long-term outcome. BRADLEY M. TURNER MD, MPH, MHA, FCAP, FASCP and JANET M. WILLIAMS, MD, FACEP Patients often seek assistance in urgent care centers for acute presentations of asthma. This provides unique …

Management of Ocular Complaints in Urgent Care: Part 2

Urgent message: Whether benign or vision-threatening, acute eye conditions seen in the urgent care setting require careful evaluation and triage, based on access to the right tools and knowledge of key clues to diagnosis. SARVOTHAM KINI, MD In Part 1 of this article in January, we discussed urgent care management of foreign bodies in the eye, corneal abrasion, red eye, scleritis, and conjunctivitis. In Part 2, we will review subconjunctival hemorrhage, uveitis, iritis, keratitis, acute …