Journal of Urgent Care Medicine

Challenges in Assessing and Treating Insect Bites and Stings

Urgent message: When presented with a patient who has experienced an insect bite or sting, the most crucial role for the urgent care clinician is to triage for anaphylaxis, venom toxicity, and local tissue damage. Kent A. Knauer, MD Now that summer is here, it is likely that urgent care practitioners—especially those practicing in suburban and rural areas—will see an increasing number of patients who have experienced an insect bite or sting. Though data are …

Management of Patients Presenting with symptoms of Vulvovaginitis

Urgent message: As the cause of approximately 10 million office visits in the United States annually, vulvovaginitis remains a common but important complaint seen in the urgent care setting. Jansen Tiongson, MD, Samuel Keim, MD, and Peter Rosen, MD Although numerous etiologies account for vulvovaginitis, the vast majority of cases are due to bacterial vaginosis (BV), trichomoniasis, and vulvovaginal candidiasis (VVC). BV causes 40% to 50% of all cases, while candidiasis and trichomoniasis account for …

Management of Erythema Multiforme in the Urgent Care Setting

Urgent message: With the increasing use of medications, especially antibiotics, more and more patients are presenting to urgent care with erythema multiforme. Correct diagnosis and identification of the underlying cause can result in rapid clinical resolution of the lesions. Shailendra Kapoor, MD Descriptions of erythema multiforme (EM) first appeared in the work of Albert and Bazin in 1822, but it was not until 1866 that von Hebra categorized these erythematous eruptions and labeled them “erythema …

An Approach to Care of Injured Workers

Urgent message: Appropriate treatment of workplace injuries and illnesses minimizes long-term disability while promoting rapid return to work and safer work environments. David M. Rosenberg, MD, MPH Physicians rendering care to injured workers must be knowledgeable regarding these injuries and the necessary types of treatment. Also, they must provide this care in an empathetic and caring manner, coupled with aggressive intervention to promote prompt healing. However, physicians must also realize that early return to work …

The Dizzy Patient in the Urgent Care Setting

Urgent message: “Dizziness” can prove to be one of the more vexing complaints encountered in urgent care. To provide appropriate care, the clinician must understand whether the patient is experiencing near-syncope, disequilibrium, ill-defined light-headedness, or vertigo. Martin Samuels, MD, DSc (hon), FAAN, MACP The problem of dizziness can be one of the most exasperating in the practice of medicine. Physicians all know that sinking feeling elicited by the patient who sits down and, when one …

Acute Pain Management in Urgent Care Medicine

Urgent message: Urgent care practitioners are called upon daily to alleviate pain. A thorough understanding of the various pain syndromes and the pharmacology and analgesic potencies of various medications will aid in their safe and appropriate use. Marc R. Salzberg, MD, FACEP and Paolo T. Coppola, MD, FACEP Pain, either chronic or acute, is the main reason patients seek medical care. In this article, we will discuss acute pain management in an urgent care setting, …

Management of Acute Orofacial Pain Syndromes

Urgent message: The differential diagnosis of acute orofacial pain is wide ranging; prompt recognition of these syndromes is vital for ensuring the best possible outcome. John A. Vaughn, MD, Immediate Health Associates, Westerville, OH A cute orofacial pain—pain arising from the teeth or soft tissues of the mouth—is extremely common, affecting 22% of people in the United States. Since it is more likely to affect younger adults and those without adequate access to primary care, …

Telephone Consultations From the Urgent Care Center: An Educational Model

Urgent message: Communication between UC providers and consultant physicians can facilitate timely, efficacious patient management OR it can damage trust between the treating physician and the consultant. Kenneth V. Iserson, MD, MBA, FACEP, FAAEM, Professor of Emergency Medicine, The University of Arizona, Tucson, AZ Urgent care providers, as much as or more than any other specialist, must call consultants to admit, refer, appropriately treat, or obtain follow-up for their patients. At many urgent care centers, …

Epididymitis-The Optimal Urologic Evaluation Management Approach in the Urgent Care Setting

Urgent message: Though epididymitis is clinically non-urgent, its symptoms are driving more and more men to urgent care, making it imperative that providers are familiar with its epidemiology, etiology, evaluation, and treatment. Introduction Epididymitis is among the most frequently diagnosed and treated conditions in men. Typically, men present to, and are diagnosed and treated by, their primary care physicians or their urologist. Treatment is with antibiotics on an outpatient basis. Epididymitis is, in general, non-life …

Epididymitis: The Optimal Urologic Evaluation Management Approach in the Urgent Care Setting

Urgent message: Though epididymitis is clinically non-urgent, its symptoms are driving more and more men to urgent care, making it imperative that providers are familiar with its epidemiology, etiology, evaluation, and treatment. Richard A. Schoor, MD, FACS, Private Practitioner, Smithtown, NY Epididymitis is among the most frequently diagnosed and treated conditions in men. Typically, men present to, and are diagnosed and treated by, their primary care physicians or their urologist. Treatment is with antibiotics on …