Practice Management
Urgent message: Most burn injuries can be handled in an outpatient setting—if they are classified accurately, treated appropriately, and referred to a regional burn center when indicated. TRACEY QUAIL DAVIDOFF, MD A “burn” is defined as a traumatic, thermal injury to the skin and deeper structures. Some or all of the cells of the skin can be destroyed not only by heat but also by cold, chemicals, electricity, or radiation. Burns are the third-leading cause …
Read MoreThe patient is a 49-year-old woman who presents with a two-day history of chest pain and vomiting. The exam reveals no cause for alarm, and other than the primary complaint the patient is in no remarkable distress. However, you discover that she has had intestinal volvulus twice in the past. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next …
Read MoreRandomized Controlled Trial of Cephalexin Versus Clindamycin for Uncomplicated Pediatric Skin Infections Key point: When it comes to curing skin infected with MRSA (methicillin-resistant Staphylococcus aureus), timely and proper wound cleaning and draining may be more important than the choice of antibiotic. Citation: Chen AE, Carroll KC, Diener-West M, et al. Pediatrics. 2011;127(3):e573-e580. Researchers originally set out to compare the efficacy of two antibiotics commonly used to treat Staph skin infections, ran- domly giving 191 …
Read MoreLee A. Resnick, MD, FAAFP “Single?” “Married”? Or, “It’s complicated?” In an era of revealing your relationship status to millions of strangers, we have grown accustomed to people sharing “TMI” about themselves. How might this affect the doctor-patient relationship of a new generation? Are younger patients more likely to share important information with their physicians, where older generations are less forthcoming? Is there a silver lining to this comfort with exposing one’s personal information for …
Read MoreLee A. Resnick, MD, FAAFP Spring is here. It’s time to shake off the cobwebs of winter and take a fresh look toward the future. With clear eyes, and a little more daylight, our focus is more acute, and our visionary juices start flowing. The Urgent Care Association has always been a forward-thinking organization, trying to be a step ahead in a dynamic healthcare arena. Over the last seven years, UCA membership has grown sharply, …
Read MoreThe patient is a 4-year-old child who presents after experiencing a blow to the forearm while taking a fall. He is otherwise well-appearing, and other than pain in the affected arm the examination is unremarkable. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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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 …
Read MoreThe patient is a 37-year-old woman in her second trimester of pregnancy. She presents a day after experiencing a fall, with impact to her left hip. She is walking, but with a noticeable limp. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreNot All Infectious Diseases Society of America Practice Guidelines Are Created Equal Key point: More than 1/2 of recommendations in guidelines from the Infectious Diseases Society of America rely on low-quality evidence. Citation: Lee DH, Vielemeyer O. Analysis of overall level of evidence behind Infectious Diseases Society of America practice guidelines. Arch Intern Med. 2011;171(1):18-22. Researchers examined 41 guidelines published by the Infectious Diseases Society of America (IDSA) since 1994. Of the 4,200 in- dividual …
Read MoreThe patient is a 64-year-old woman who presents with sudden onset, bilateral hip pain. She otherwise appears healthy, but reveals that she has a history of breast cancer. Examination reveals nothing remarkable. View the image taken (Figure 1) and consider.
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