Practice Management
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 …
Read MoreThe patient is a 77-year-old who presents with pain in the left wrist. She reports injuring it in a fall. 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 MoreOn ED Visits, Corticosteroids and COPD, Intranasal Steroid in Allergic Rhinitis, Intussusception in Children Under 5, Urinary Antigen Testing, and Emergency Contraception Nahum Kovalski, BSc, MDCM Each month, Dr. Nahum Kovalski reviews a handful of abstracts from, or relevant to, urgent care practices and practitioners. For the full reports, go to the source cited under each title. Emergency Department Visits on the Rise Key point: ED use in the U.S. is up dramatically; these stats …
Read MoreThe patient is a 54-year-old woman who presents with a three-day history of constipation. She denies any vomiting, and you note no abdominal distension. She is passing small amounts of gas. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the page.
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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 …
Read More“We make a living by what we get, we make a life by what we give.” – Winston Churchill Physician mentoring sounds like an easy enough proposition. Who wouldn’t jump at the chance to opine and proselytize, in a position of power, to a new employee who is looking to impress his/her boss? Indeed, you can say most anything you want, with a very low risk of rebuttal or confrontation. Even well-intentioned mentors tend to …
Read MoreOn Imaging Head Injuries, Routine Cellulitis, Alteplase and Ischemic Stroke, Head Lice, Steroids for Pharyngitis, and Brain Injury in Children Nahum Kovalski, BSc, MDCM Each month, Dr. Nahum Kovalski reviews a handful of abstracts from, or relevant to, urgent care practices and practitioners. For the full reports, go to the source cited under each title. Diagnostic Imaging Rates for Head Injury in the ED and States’ Medical Malpractice Tort Reforms Key point: The authors found …
Read MoreIn each issue, JUCM will challenge your diagnostic acumen with a glimpse of x-rays, electrocardiograms, and photographs of dermatologic conditions that real urgent care patients have presented with. If you would like to submit a case for consideration, please e-mail the relevant materials and presenting information to [email protected]. A 17-year-old patient presents with a “twisted” left knee sustained in a fall, able to bear weight despite obvious pain. View the image taken (Figure 1) and …
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Most new third-year medical students can recite the “red flags” of back pain: extremes of age, fever, history of cancer, history of trauma, failure to improve after one month of therapy. Few would fail to consider metastatic disease in a 64-yearold woman with a history of breast cancer and new-onset low back pain, but what about the 51-year-old male without a significant past medical history?
Read MoreThe patient is a 32-year-old man who presents after experiencing a blow to the face while falling from a bicycle. The patient complains of tenderness over the front of his face. Neurological exam is normal. You note that his neck is supple. 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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