Practice Management
Urgent message: Urinary tract infection is a common diagnosis in pediatric urgent care. As such, efforts must be made to ensure antibiotics are prescribed only when necessary and to decrease the rate of unnecessary prescribing. Benjamin Klick, MD; Tammy Speerhas, DNP, FNP-C; Jessica Parrott, DNP, CPNP-PC, CNE; Jeffrey Bobrowitz, MD; Anne McEvoy, MD; Debra Conrad, MD, Jade Eves, PA-C; Theresa Guins, MD Citation: Klick B, Speerhas T, Parrott J, Bobrowitz J, McEvoy A, Conrad D, …
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Download the article PDF: A 30-Year-Old Male with Chest and Leg Pain—and a History of Polysubstance Use A 30-year-old male with history of polysubstance use presents after a motor vehicle collision. He reports chest and leg pain, and denies nausea, vomiting, or shortness of breath. He has no known cardiac history. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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Download the article PDF: A 59-Year-Old with a Painful Finger Skin Lesion A 59-year-old woman presents with a painful skin lesion near her fingernail which has developed over the past week. She reports a history of advanced non-small cell lung cancer, for which she was recently started on erlotinib. On examination you observe a glistening, hemorrhagic papule at the lateral nail fold with surrounding erythema and edema. The patient denies trauma or exposure to skin …
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A 41-year-old male presents with knee pain after playing basketball in his driveway with his teenage son. He reports that he had sudden pain and heard a “pop” as he landed after jumping. He is unable to fully extend his leg. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.
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Download the article PDF: Six Tips to Bulletproof Your Chart: Lessons from the Exam Room and the Court Room Urgent message: In the event that you are taken to court over care that is alleged to have been insufficient, negligent, or otherwise poor, your own documentation at the time care is provided can be your saving grace or your undoing. William Sullivan, DO, JD INTRODUCTION Providing proper medical care in urgent care centers is only …
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Urgent message: Headache is most often a benign complaint among patients presenting to urgent care. Vigilance for risk factors and appropriate use of validated screening criteria are essential to uncovering potentially life-threatening etiologies. Paul Hansen, MD Citation: Hansen P. More than a simple headache: using the SNNO-OP10 criteria to screen for life-threatening headache presentations. J Urgent Care Med. 2023;17(9):18-21 ABSTRACT Introduction: Headache is most commonly a benign complaint among urgent care patients. Chronic subdural hematomas, …
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Download the article PDF: Abstracts in Urgent Care – June 2023 Ivan Koay MBChB, MRCS, FRNZCUC, MD Immersive Virtual Reality Use in Reducing Pediatric Procedural Anxiety Take-home point: Immersive virtual reality (IVR) use in pediatric patients significantly improved pain and anxiety compared with the control group. Citation: Wong C, Choi K. Effects of an immersive virtual reality intervention on pain and anxiety among pediatric patients undergoing venipuncture: a randomized clinical trial. JAMA Netw Open. 2023;6(2):e230001. …
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Urgent message: Lacerations are a common reason for patients to present to urgent care. Data suggest not all providers are comfortable managing lacerations, however. Clinicians who need additional training should be afforded such in order to reduce acuity degradation and unnecessary referrals to the emergency room. David T. Ford, MD; Patrick M. O’Malley, MD; and Brantley Dick, MD Citation: Ford DT, O’Malley PM, Dick B. Assessing Urgent Care Clinics’ Readiness to manage a lip laceration. …
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Figure 1: Initial ECG (Case presented by Benjamin Cooper, MD, MEd, FACEP, Department of Emergency Medicine, McGovern Medical School at UTHealth Houston.)
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A 46-year-old female presents with an evolving eruption that developed on her right hand and spread to her forearm over the past several weeks. She is an immunocompetent commercial landscaper who lives in Brazil, and she does not recall any specific injury. She is regularly exposed to toxic plants and sustains minor scratches and cuts at work. She also suspects that she could have experienced bug bites. She appears well and is without systemic symptoms. …
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