Practice Management
A 42-year-old man presents to urgent care on a Sunday afternoon. He explains that he was playing a game of pick-up football in his neighborhood and suffered a rough kick to the face from another player. His nose is swollen, and he’s clearly in pain. An x-ray is ordered to capture a lateral view of the nasal bones. Review the image and consider what your diagnosis and next steps would be. Resolution of the case …
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A 56-year-old female with no past medical history presents to urgent care with 2 episodes of chest pain that woke her up this morning. She had 2 additional episodes while walking and while bathing earlier in the day. The episodes lasted about 10 minutes each, and she is currently free from chest pain. The pain is pressure-like and left-sided, radiating to her back. An ECG is obtained. View the ECG and consider what your diagnosis …
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A 3-week-old girl presents to urgent care with widespread scaly skin. On physical examination, her vital signs are normal. She is noted to have ectropion and large, thick, plate-like scales covering most of her body. The patient had a personal history of prematurity and collodion membrane at birth. There is no family history of dermatological or genetic disorders. View the image below and consider what your diagnosis and next steps would be. Resolution of …
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Urgent Message: Although greater occipital nerve block has demonstrated positive effectiveness and few risks as a treatment for acute headache, it is not commonly used. With more familiarity, urgent care clinicians may consider it a useful treatment modality. Elizabeth Reynolds, PA-C, MS Key Words: Migraine, Headaches, Nerve Block Abstract Headaches are a common presentation in urgent care clinics. Various medication options are available but can sometimes be limited for use due to allergies, side effects, …
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Urgent Message: Rupture of a Baker cyst is a rare complication and may manifest with the classic crescent sign of ecchymosis and swelling over the medial malleolus. Given the similarities in presentation to acute deep vein thrombosis, it is essential for urgent care clinicians to be able to differentiate between these diagnoses. Caroline S. Mifsud, DO, MS; Jennifer Ganzhorn, MD; Michael B. Weinstock, MD; Gregory M. Garrison, MD, MS, FAAFP; Elizabeth Westby, MD Keywords: Baker …
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AI Performs Well in Virtual Urgent Care Visits Take Home Point: This study indicates that an artificial intelligence (AI) algorithm was better at adhering to clinical guidelines and identifying critical red flags during virtual urgent care (UC) consultations, while physicians were better at adapting recommendations to changing information obtained during a patient consultation. Citation: Zeltzer D, Kugler Z, Hayat L, et al. Comparison of Initial Artificial Intelligence (AI) and Final Physician Recommendations in AI-Assisted Virtual …
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Urgent Message: Polymerase chain reaction testing is recommended for patients with lesions that could represent herpes simplex virus infection. It is imperative that urgent care clinicians understand the utility and characteristics of such testing as well as the implications of findings. Brittney Tice, FNP, DNP; Joseph Something, PA; Benjamin Zimmerman, PhD Editor’s Note: The patient case scenario is hypothetical. Abstract In the urgent care (UC) setting, patients commonly present with nominal requests for herpes simplex …
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A 13-year-old boy presents to urgent care after “rolling” his left foot. He explains that he tripped on a cement curb while riding his skateboard. He has foot and ankle pain that is worse with weight. An x-ray is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.
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Urgent Message: While patients with asthma will frequently experience exacerbations following viral respiratory infections, the urgent care clinician must be cautious when assuming dyspnea is due to asthma. As dyspnea can be caused by a wide variety of conditions, it is important to maintain a broad differential diagnoses, even in patients with underlying asthma. Tracey Quail Davidoff, MD, FCUCM Key words: Influenza, Dyspnea, Asthma, Congestive Heart Failure, Myocarditis, Diagnosis Momentum Abstract Introduction: Patients commonly present …
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Can Doctors Predict Patient Outcome from a First Impression? Take Home Point: In this systematic review, the first impressions of “sick versus not sick” and appropriate patient disposition had reasonable predictive value for patient outcomes but was not sufficiently accurate to supplant thorough clinical assessment. Citation: Treloar E, Abraham A, Smith E, et. al. Can first impressions predict patient outcomes? Acad Emerg Med. 2025 Mar;32(3):351-354. doi: 10.1111/acem.15053. Relevance: In busy environments such as urgent care …
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