Journal of Urgent Care Medicine

Diabetic Emergencies in the Urgent Care Setting

Urgent message: Patients with glucose levels either too high or too low often require immediate, potentially life-saving interventions in the urgent care setting. These patients are often found to be diabetic. Allan F. Moore, MD, Nicolas Abourizk, MD, Jeffrey Collins, MD, MA Diabetes is a common chronic disease affecting approximately 7% of the United States population. Of these individuals, 17.5 million carry a diagnosis of diabetes and over 6 million are undiagnosed. An estimated 54 …

Prescription Drug Abuse and the Drug-Seeking Patient

Urgent message: The urgent care clinic is a prime target for prescription drug abusers seeking possibly inappropriate prescriptions. Clinicians must be vigilant to screen, intervene, and refer such patients. Marcelina Behnam, MD and Mark Rogers, MD Over the past several years, prescription drug abuse has become a problem of epidemic proportions for urgent care centers and emergency departments around the country. There has been an increase both in visits related to the acquisition of these …

Minor Traumatic Brain Injury: Applying the Evidence to Urgent Care

Urgent message: While few data specific to the urgent care setting exist, applying the medical evidence gleaned from other acute care settings can enable the clinician to effect positive outcomes in patients presenting with symptoms indicative of minor TBI. Joseph Toscano, MD Head trauma is among the most important problems evaluated in acute-care medicine. Estimates from the Centers for Disease Control and Prevention indicate that each year in the Unites States, approximately 1.4 million individuals …

Understanding Clinical Decision Rules Regarding Minor Traumatic Brain Injury

Urgent message: Patients with minor traumatic brain injury can be difficult to assess. Identifying those at risk for poor outcomes is critically important in the urgent care setting. Joseph Toscano, MD The term traumatic brain injury (TBI) describes various injury patterns that result from force being absorbed by the brain after a rapid acceleration or deceleration or head impact. TBIs can span a spectrum from minor changes to fatal catastrophes and can affect patients in …

Integration of Pharmacologic and Non-pharmacologic Techniques to Enhance Pediatric Minor Procedures

Urgent message: Integration of various techniques when performing minor procedures on children can enhance clinical care for patients and families while bringing within reach administrative and financial goals. Emory Petrack, MD, FAAP, FACEP, Lisa S. Perry, CCLS, and Kristine Vehar, RN As the practice of urgent care medicine continues to grow, urgent care centers grapple with several important issues, among them the needs to provide optimal clinical care, reduce medical legal risk, and deliver excellence …

CA-MRSA Abscess Care and Treatment Guidelines in Urgent Care Practice

Urgent message: In the absence of controlled outpatient trials, the author proposes urgent-care specific guidelines for treatment of community-acquired MRSA, informed by clinical experience and local and regional case reports. Michael Dickey, MD The goal of any treatment is to maximize the chance of a positive outcome for a patient. The purpose of a treatment guideline is to maximize the chance of positive outcomes in groups of patients that present with a similar disease states. …

The Limping Child in the Urgent Care Center

Urgent message: The ability to evaluate children presenting with a limp—and to recognize red flags that help distinguish those to treat from those requiring immediate referral—should be within the purview of the urgent care clinician. Raymond W. Liu, MD, Hadeel Abaza, MD, and Allison Gilmore, MD A limping child without a clear traumatic history or diagnosis is a common presentation to an urgent care center. The broad differential diagnosis can be daunting, with causes that …

Assessment and Management of Common Hand Infections

Urgent message: Common superficial hand infections may be managed easily by the urgent care physician. Left untreated or undertreated, however, simple hand infections may progress to disabling conditions requiring urgent sub-specialty management. Arthur R. Smolensky, MD, Samuel M. Keim, MD, MS, and Peter Rosen, MD The hand is an intricate and crucial feature of the human body. Yet, with the exception of superficial cellulitis, common hand infections require relatively simple surgical procedures—many of which can …

Evaluation, Identification, and Treatment of Urinary Tract Infections

Urgent message: Urinary tract infections are a common cause of abdominal pain and a common presenting complaint in urgent care. Proper diagnosis, treatment, and patient education on preventive measures are key to optimal outcomes. William Gluckman, DO, MBA, FACEP, Karen Keaney Gluckman, MSN, APN, C, CWCN, CCCN The global term urinary tract infection (UTI) incorporates cystitis and infection involving the bladder (a lower tract source), as well as pyelonephritis, an infection involving the kidneys (an …

Managing Heat Illness in Urgent Care

Urgent message: The urgent care provider’s most critical role in heat illness is to identify risk factors and the cause, to cool and hydrate the patient, assess for complications, and educate the patient in the hope of preventing a more serious exposure. Bridget Dyer, MD, Samuel Keim, MD, and Peter Rosen, MD Heat illness occurs when external heat conditions and internal heat production overwhelm the ability of the body to dissipate heat. Evaporation of sweat …