Journal of Urgent Care Medicine

Giant Cell Arteritis: A Clinical Review for Urgent Care Providers

Urgent message: Giant cell arteritis is an under-recognized and easily missed vasculitis of older adults, a challenging but “can’t miss” diagnosis. The urgent care clinician must be able to recognize this entity sometimes referred to as the “great masquerader” and be comfortable initiating timely emergency treatment. Ryan C. Jacobsen MD, EMT-P Giant cell arteritis (GCA), more commonly known as temporal arteritis, is an under-recognized vasculitis of older adults that can have potentially devastating consequences, most …

Pitfalls in Assessing and Managing Common Pediatric Injuries

Urgent message: Fractures, in general, are relatively common among pediatric patients. Those most likely to be seen in the urgent care setting include injuries to the radius, ulna, humerus, lateral condyle, clavicle, tibia, and fibula. The second of two parts. Justin Kunes, MD, Shane R. Hanzlik, MD, Allison Gilmore, MD As noted in part 1 of this article (published in the February 2011 issue of JUCM and available at www.jucm.com), fractures are common injuries in …

Pitfalls in Assessing and Managing Common Pediatric Injuries

Urgent message: Fractures are common among pediatric patients. Familiarity with the growth process and the unique properties of the immature skeleton—as well as immediate identification of conditions requiring emergent referral—are necessary for appropriate care and avoidance of long-term sequelae. The first of two parts. Justin Kunes, MD, Shane R. Hanzlik, MD, Allison Gilmore, MD Injuries that ultimately prove to be fractures are a common cause of visits to the emergency room and urgent care among …

Assessing for Life-threatening Chest Pain in the Urgent Care Center

Urgent message: Data show that urgent care centers are becoming a more common destination for patients experiencing chest pain. Immediate recognition of emergent vs. urgent causes may be the make-or-break moment for the patient’s outcome. Jasmeet Singh Bhogal, MD Introduction Evaluation of chest pain always presents as a diagnostic challenge, be it in the outpatient family medicine setting or the hospital emergency department. In fact, urgent care centers occupy a unique position in the equation; …

Cold Weather-related Injuries

Urgent message: Inadequate protection from the cold can put a patient’s life and limb at risk. The urgent care clinician must be able to identify symptoms of specific conditions, using the history and awareness of weather conditions to distinguish among the most common. Introduction Winter months provide ample opportunities for recreation such as skiing, sledding, or snowmobiling – and for an array of injuries related to varying degrees of exposure to lower temperatures. Generally, the …

Assessment and Management of Scrotal Disorders

Urgent message: Males with a scrotal disorder often present to urgent care with pain, swelling, or both. Especially in boys and young men, it is important to quickly assess the acute scrotum, which can be a surgical emergency. Jason Chao, MD, MS Introduction Males with a scrotal disorder often present with pain, swelling, — or both. Because of the location of the problem, patients often choose to seek urgent medical attention. Especially in boys and …

Toxicological Emergencies for the Urgent Care Physician

Urgent message: Several specific toxicological emergencies are most likely to be encountered in the urgent care setting. Prompt recognition of their clinical presentation, understanding the pathophysiology/natural disease progression, and initiation of treatment are critical factors in decreasing morbidity (and potential mortality) in these cases. Michael L. Epter, DO, FAAEM and Alicia Pilarski, DO Introduction Beginning in 2004, poisonings rank second to motor vehicle accidents as the leading cause of accidental death in the U.S., with …

Providing DOT Medical Certification Exams for Commercial Drivers

Urgent message: The Department of Transportation’s responsibility to ensure that commercial drivers are physically qualified to operate in interstate commerce can mean new business for urgent care providers who qualify to perform certification exams. Ellison H. Wittels, MD, FACP The Federal Motor Carrier Safety Administration (FMCSA) – one of nine operating administrations within the United States Department of Transportation (DOT; Table 1) – is tasked with regulating commercial trucks and buses in interstate commerce. That …

Tuberculosis Screening in Urgent Care Medicine

Urgent message: Often placed in the role of first-line clinicians with respect to testing for and treating infectious disease, urgent care practitioners are ideally suited to provide screening services for tuberculosis. Introduction In addition to urgent care services, many of us also offer occupational medicine and provide post-offer/pre-employment evaluations. As such, urgent care clinicians play a key role in screening for tuberculosis (TB). In fact, understanding the complexity of the screening process is essential to …

Asthma in the Pediatric Population: An Urgent Care Approach

Urgent message: though sometimes viewed as an easily controlled disease, asthma can become a medical emergency quickly. It is important for the urgent care clinician to be able to recognize the signs of a potentially life-threatening asthma exacerbation – and know how to treat it accordingly. Muhammad Waseem, MD, Nicholas Caputo, MD, Geeta Krishna, MD, Joel Gernsheimer, MD Introduction Asthma is an episodic and reversible airflow obstruction. It is the most common chronic disease in …