The patient is a 26-year-old who presents to urgent care after “twisting” the right foot, complaining of local pain but able to bear weight. 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 MoreClinical Challenge: May, 2010
In 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]. The patient is a 50-year-old female who presents with pain in her right thumb after taking a fall. On examination, you not local swelling at the base …
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Here Comes the Sunburn: An Update
Urgent message: The advent of warmer weather is a reminder that many otherwise sensible Americans fail to heed warnings to use adequate protection from the sun. The urgent care clinician can expect to see more patients presenting with varying degrees of sunburn. Deepthi Samindla, MBBS, Beth Braig, BA, Mikayla L. Spangler, PharmD, Shailendra K. Saxena, MD, PhD Introduction Sunburn is an acute cutaneous inflammation to excessive exposure to solar ultraviolet (UV) radiation. About 30% to …
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Ear, Nose, and Throat Urgencies in Children
Urgent message: Many infections and injuries of the ear, nose, or throat are unique to the pediatric population. parents view many of these processes as urgent, leading them to seek immediate medical attention. Ann Mary Bacevice, MD Introduction Children tend to be especially susceptible to a wide range of infectious illnesses, as well as vulnerable to a host of minor traumas to or affecting the ear, nose, or throat. This, added to the fact that …
Read MoreHospital-owned Urgent Care Networks: Coming Soon to a Community Near You
“The whitecoats are coming, the whitecoats are coming!” if Paul Revere were running an independent urgent care network, this would be his call to arms. After years of denial and arrogance, health systems are finally waking up to the system integration benefits of urgent care. Hospitals stumbled in their response, hampered by bureaucracies, turf wars, and stifling status quo. Well, the fog was finally lifted and urgent care is on the radar. Due, in large …
Read MoreAbstracts in Urgent Care: May, 2010
Emergency treatment of Anaphylactic Reactions Key point: Early treatment with intramuscular adrenaline is the treatment of choice for patients having an anaphylactic reaction. Citation: Pumphrey R, Cant A, Clarke S, et al. Emergency treatment of anaphylactic reactions – Guidelines for healthcare providers. Resuscitation. 2008; 77(2): 157-169. Patients experiencing an anaphylactic reaction have life-threatening airway and/or breathing and/or circulation problems usually associated with skin or mucosal changes. Such patients should be treated using the ABCDE …
Read MoreClinical Challenge: April, 2010
In 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] The Case The patient is a 22-year-old male who fell and landed directly on his shoulder. On examination, you note marked local swelling and decreased range of …
Read MoreAbstracts in Urgent Care: April, 2010
Diagnostic Medical Errors: What Goes Wrong and Why Key point: Errors often occur because clinicians don’t consider the diagnosis, test for it, or follow up on abnormal test results. Citation: Schiff GD, Hasan O, Kim S, et al. Diagnostic error in medicine: Analysis of 583 physician-reported errors. Arch Intern Med. 2009; 169: 1881-1887. Autopsy data from the past few decades reveal diagnostic error rates of 10% to 15%, but do not inform us about the …
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Assessing Abnormal Uterine Bleeding in the Urgent Care Center
Urgent message: Vaginal bleeding is a common presentation in the urgent care setting. An assessment of hemodynamic status, as well as an understanding of potential causes, is necessary to initiate treatment and triage the patient correctly. Thomas Sunshine, MD Introduction Patients presenting with what they perceive to be vaginal bleeding will not know whether that bleeding is specifically uterine, cervical, or (rarely) vaginal in origin. It is incumbent upon the urgent care provider to have …
Read MoreA Disconnected World
Texting, chatting, networking, blogging, and posting. The evolution of communication into characters on a screen…digitized snippets, factoids, and acronyms used to express display, inform, and explain. Even emotions have been whittled down into emoticons…a semicolon “wink” and a parenthetic “frown.” E-mail? That is soooo last decade! Electronic communication technology has practically replaced more traditional forms. So what does this mean? What is the impact on socialization, relation, and emotional connection? Are there any negative effects? …
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