Journal of Urgent Care Medicine

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 …

Defining Urgent Care

Lee A. Resnick, MD, FAAFP In this issue of JUCM, The Journal of Urgent Care Medicine, we excerpt the landmark report, “No Appointment Needed: The Resurgence of Urgent Care Centers in the United States”. Funded by the California HealthCare Foundation, and authored by Robin M. Weinick, PhD and Renée M. Betancourt, BA, the report represents the first comprehensive look into urgent care practice and the urgent care industry. Everything from business models and staffing to …

Insights In Images: October, 2007 -2

The patient is a 35-year-old Caucasian female who presented with dysphagia and progressively worsening neck pain. No history of injury was reported. Neurovascular exam was normal. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Abstracts in Urgent Care: October, 2007

A Controlled Clinical Trial of Steroids forBronchiolitis Key point: One dose of oral dexamethasone was no different fromplacebo. Citation: A multicenter, randomized, controlled trial of dexamethasone for bronchiolitis. N Engl J Med. 2007;357:331-339. Bronchiolitis is the leading cause of hospitalization of infants in the U.S. Use of steroids for infants with bronchiolitis remains controversial because of the lack of high-quality, sufficiently powered studies. In a multisite, double-blind clinical trial, researchers randomized 600 infants (age range, …

Abstracts In Urgent Care: October, 2007

Insights In Images: October, 2007

The patient pictured presented with two hours of intense pain and redness along the left side of her head and down her left arm. Though this could easily be mistaken for an infectious process, it was actually reflex sympathetic dystrophy (RSD), also referred to as complex regional pain syndrome (CRPS) type I. By any name, however, this is a rare and poorly understood neurological condition. It may manifest by way of sensory, focal autonomic, or …

Clinical Challenge: October, 2007

The patient is a 52-year-old tourist who presents with a four-day day history of abdominal pain, constipation, not passing gas, and nausea. The patient was not comfortable but was hemodynamically stable. Temperature was normal, pulse was 94, BP was 195/99. The abdomen was markedly distended. WBC was 11. View the x-rays taken (Figure 1 and Figure 2) and consider what your diagnosis and next steps would be. Resolution of the case is described on the …

Supraventricular Tachycardia in a Child with Williams Syndrome after Nebulized Albuterol

Urgent message: Clinicians must be prepared for the possibility of supraventricular tachycardia after administration of nebulized albuterol in patients of any age, especially in the presence of heart disease. Muhammad Waseem, MD, Padma Gadde, MD, and Gerard Devas, MD Asthma is the most common lung disease in children. Five percent of children in the United States have asthma, and status asthmaticus—the leading cause of admission due to asthma exacerbation—accounts for approximately 10% of visits to …

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 …

What About Retail Health?

There is plenty of posturing going on within organized medicine with regard to the “retail health” revolution. Concerns have been raised regarding continuity of care, the “corporatization” of medicine, kickbacks to pharmacies, and the quality of care provided by nurse practitioners and physician assistants. American Academy of Family Physicians, the American Medical Association, and the American Academy of Pediatrics have all chimed in. Only the AAP has come out consistently opposed to the idea on …