Practice Management
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 …
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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 …
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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 …
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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 …
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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 …
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Urgent message: Triage of eye conditions in urgent care to ensure the best patient outcome requires knowing what equipment to use and understanding when to refer to an ophthalmologist. Always remember to document acuity of vision in all patients presenting with an eye complaint. SARVOTHAM KINI, MD Introduction Ocular complaints are extremely common in the urgent care setting. Yet the capacity of individual urgent care centers to provide high quality eye care is variable. The …
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Urgent message: Response to a needlestick with potential for HIV exposure requires understanding of both state laws on HIV testing and the latest USPSTF guidelines for post-exposure management. MAYA HECK, MS-2 and JOHN SHUFELDT, MD, JD, MBA, FACEPTwo police officers arrive at your urgent care site with a handcuffed, bloodied prisoner. One officer tells you that the person in custody “spit on me” during the altercation. The officer goes on to tell you that the …
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Urgent message: Needlestick injuries are common and require a prompt response based on an understanding of the latest USPHS guidelines and informed consent and counseling of the patient. MAYA HECK, MS-2 and JOHN SHUFELDT, MD, JD, MBA, FACEP Your center is fortunate to contract with a variety of different business to provide employee health services. A local homeless shelter is one of the clients to whom your center provides new hire physicals, drug screens and …
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Urgent message: Tissue adhesives are quick, painless, and result in a good cosmetic outcome, making them well-suited for use to treat wounds in urgent care. SIMON TANKSLEY, M.D. Introduction Tissue adhesives are ideal for closing simple lacerations, especially on the face of children.1-3 Such repairs are quick, painless, and do not require removal of sutures. They are also excellent for treating large skin tears in the elderly (Figure 1) and particularly useful for thin, fragile …
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Urgent message: From pregnancy confirmation to the evaluation of bleeding, urgent care centers are often the initial location for management of obstetric-related issues. Careful use of evidence-based guidelines is the key to successful outcomes. DAVID N. JACKSON, MD, FACOG and PETAR PLANINIC, MD, FACOG Case Presentation Urgent care providers are called upon to manage a variety of complaints in pregnancy. Some conditions can be managed at the urgent care center whereas others require stabilization and …
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