Journal of Urgent Care Medicine

An Approach to Wound Care in the Urgent Care Setting

Urgent message: Understanding the body’s natural ability to heal itself – and factors that diminish that ability – is of great clinical value and can help you determine whether a wound is acute or chronic, and inform the decision to clean and dress or refer to a wound specialist. Michael S. Miller, DO, FACOS, FAPWCA, CWS and Eric Newgent, DO, MS Introduction The skin is the largest organ in the human body. In simplest terms, …

The Traveling Patient

Urgent message: The accessibility of urgent care makes it a prime venue for patients preparing for international travel and patients who may have become ill due to exposure to infectious agents while traveling overseas. Francine Olmstead, MD, FACP Whether a patient visits an urgent care center for an infection or a primary care physician for follow-up, every healthcare provider should inquire about anticipated overseas travel. In addition, if a patient is being evaluated for a …

Assessment, Intervention, and Disposition of Patients with Psychiatric Symptoms

Urgent message: Assessment of patients presenting with psychiatric conditions requires amodified set of skills compared with traditional medical assessment. Urgent care clinicians must be prepared to determine appropriate interventions—treatment, referral, or both. Gregory P. Brown, MD Introduction Typically, the interaction between clinicians and patients presenting with psychiatric conditions is guided by information obtained from the interview, history, and physical examination rather than emphasizing laboratory or radiological testing. Therapeutic options may be challenged by a lack …

Identifying and Treating Superficial Fungal Infections in the Urgent Care Setting

Urgent message: Rashes often lead patients to seek relief in the urgent care center. The ability to differentiate among common, superficial fungal infections and to select the most appropriate treatment or refer is an important skill to master. Kosta G. Skandamis, MD and George Skandamis, MD Introduction Superficial fungal infections are among the most common skin conditions seen in the urgent care setting. Dermatophytes are the most common type of fungi that infect and survive …

Treating Common Upper Respiratory Tract Infections in an Era of Increasing Antibiotic Resistance

Urgent message: Thorough evaluation and thoughtful prescribing can help ensure responsible, effective care and patient satisfaction. Joseph Toscano, MD Introduction Upper respiratory tract infections (URTIs) are among the most common reasons patients seek assistance in urgent care practice. The common cold, otitis media, acute sinusitis, and acute pharyngitis are well known to patient and provider alike. Acute bronchitis is a lower respiratory tract infection, with features similar to URTIs. These infections are most often self-limited …

Preparing for Pandemic Influenza in the Urgent Care Setting

Urgent message: Between the current – and still growing – volume of H1N1 flu cases and fast-approaching influenza season, the urgent care physician will be challenged to distinguish among a variety of common cold and influenza-like conditions. Gary Klein, MD, MPH, MBA, CHS-V, FAADM Introduction The mainstream media have certainly accomplished the mission of alerting the public to the dangers of H1N1 flu – perhaps to the point that many are tempted to dismiss their …

Assessing Patients in the Wake of Motor Vehicle Accidents

Urgent message: Patients presenting to urgent care in the wake of a motor vehicle accident have self-selected their treatment setting. However, it is imperative to maintain vigilance for potentially serious and even life-threatening injuries that may not be apparent. Gloria I. Kim, MD and Jill C. Miller, MD According to the National Center for Health Statistics, motor vehicle accidents (MVAs) accounted for nearly 5 million ED visits in 2006. The diverse injuries may be temporary, …

Common Lacerations of the Head

Urgent message: Effective management of head lacerations starts with hemorrhage control but also requires an understanding of appropriate use of anesthesia, the possibility of closed head or nerve injury, and vigilance for non-accidental trauma. Clayton Josephy, MD, Samuel M. Keim, MD, MS, and Paper Rosen, MD Introduction Laceration repair is a common and important responsibility of physicians in the emergency and urgent care settings. A recent review of national trends in ED visits revealed that …

Toward Ensuring Patient Safety in Urgent Care

Urgent message: Creating a safety culture in the urgent care clinic starts with proper hand washing before even seeing a patient and ends with transitioning care out of the practice – and includes close attention to every detail in between. The second of two parts. Phillip Disraeli MD, FAAFP The Institute of Medicine’s 1998 Report to Err is Human grabbed media attention by estimating that 98,000 deaths each year can be attributed to adverse events …

Toward Ensuring Patient Safety in Urgent Care

Urgent message: As urgent care’s role in the continuum of care continues to evolve, the practitioner must take steps to create a culture that supports proper patient identification, drug safety, and adherence to lab standards. Phillip Disraeli MD, FAAFP In the 1988 report To Err is Human, the Institute of Medicine defined patient safety as “freedom from accidental injury.” The ensuing media coverage focused on the 98,000 deaths that IOM estimated occur each year due …