Journal of Urgent Care Medicine

Cold Air For Croup Isn’t an Old Wives’ Tale

Results from a randomized controlled trial presented in Pediatrics indicates that exposing children with laryngotracheobronchitis/acute viral laryngotracheitis to cold, outdoor air (<10°C or <50°F) can be beneficial in reducing symptoms when used as an adjunct to oral dexamethasone. Children in the trial were aged 3 months to 10 years and were seen in a tertiary pediatric emergency department, where they received a single dose of 0.6 mg/kg oral dexamethasone. The group of patients who were …

Supine Blood Pressure Reading Has Advantages

Preliminary research presented by the American Heart Association at its hypertension scientific sessions this week in Boston suggests that measuring blood pressure while a person is lying down may be a better predictor of heart health than typical readings when a patient is sitting. Researchers analyzed data from a long-running study and found that supine blood pressure readings were more effective at predicting strokes, serious heart issues, and by comparison. The study’s 11,369 participants were …

As COVID Cases Rise, Home Tests Are Questioned

Urgent care centers across the United States are treating a rising number of COVID-19 cases, even among patients who say they tested negative at home. Nick Karr, MD, CEO and founder of Citra Urgent Care, noted as many as 20% of patients seeking care at the company’s seven locations in the Dallas/Fort Worth, Texas, area, are testing positive, as reported by Fox 4. Texas had a 32% week-over-week increase in cases recently with hospitalizations rising …

Consider Follow-Up Screening for Hypertension Among COVID-19 Patients

A retrospective study of 45,000 patient records presented in Hypertension found an association between the SARS-CoV-2 virus and the development of hypertension among adults who had no past history of high blood pressure. It’s unknown if the virus could be triggering the development of hypertension or worsening preexisting hypertension, according to the study’s lead author. But the association is significant. Among the records, 21% of those hospitalized with COVID-19 developed high blood pressure. By comparison, only 16% …

Skewed Pulse Oximeter Readings Delayed Care For Patients With Darker Skin

Research presented in JAMA Network Open found that pulse oximeters more commonly overestimated arterial oxygen saturation for Black and Hispanic patients hospitalized with COVID-19 when compared with White patients. Blood oxygen levels were measured with fingertip pulse oximeters, followed by a blood draw. Researchers found Black patients were nearly 50% more likely than White patients to experience undetected low blood-oxygen saturation. Hispanic patients were 18% more likely to experience an issue. The overestimation was associated …

Improving Adherence to Clinical Practice Guidelines for the Treatment of Acute Otitis Media in Pediatric Patients

Urgent message: The treatment of acute otitis media is a common problem throughout healthcare. Many national provider organizations have emphasized the significance of proper diagnosis and treatment is essential for a full, uncomplicated recovery. Jessica M. Crandall, DNP, ARNP-FNP-BC and Misty Schwartz, PhD, RN Citation: Crandall JM, Schwartz M. Improving adherence to clinical practice guidelines for the treatment of acute otitis media in pediatric patients. J Urgent Care Med. 2023;17(11):25-34. Download the article PDF: Improving …

Myotendinous Rupture of Pectoralis Major: A Case Report

Urgent message: Nonspecific presentation and time lapsed between injury and presenting to urgent care can delay diagnosis and initiation of proper management in patients ultimately diagnosed with myotendinous rupture of pectoralis major, a relatively rare injury that is becoming more common. E. Casey Anders, Chinedum Nkemakolam, MA, and Lindsay Tjiattas-Saleski, DO Citation: Anders EC, Nkemakolam C, Tjiattas-Saleski L. Myotendinous rupture of pectoralis major: a case report. J Urgent Care Med. 2023;17(11):21-23. Key words: pectoralis major …

A 75-Year-Old Female with Dizziness and a Slow Heartbeat

The patient is a 75-year-old female who presents with dizziness and a slow heartbeat. She has a history of hypertension. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case begins on the next page.

A 49-Year-Old with a 4-Week-Old Lesion on Her Toe

A 49-year-old woman presents with a lesion that developed over her right toe over the past 4 weeks. It is painless, but has begun to bleed. On examination, a smooth, pink, friable, eroded nodule is seen on the nail bed. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 69-Year-Old with Neck Pain After a Car Crash

A 69-year-old man presents with “neck pain” after a car crash. Lateral and oblique views of the lower cervical spine are ordered. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.