Don’t Forget about the Road Behind

Don’t Forget about the Road Behind

If you’re reading this, you’ve survived 2020. Congratulations!—although it probably doesn’t feel like there’s much success to revel in at the moment. Indeed, this has been a year of hardship for everyone in some form and certainly, for many, it still may feel like there’s no end in sight. And it doesn’t seem like much cause for celebration to have dodged a bullet when you’re still staring down the barrel of a loaded gun. However, …

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Necessity (or Not) for Patient Transfer from Urgent Care to the ED Following Traumatic Brain Injury

Necessity (or Not) for Patient Transfer from Urgent Care to the ED Following Traumatic Brain Injury

Urgent message: With patients who have sustained head injuries related to both sports- and non–sports-related activities presenting to urgent care more than ever before, it’s essential for the provider to have a nuanced understanding of which patients truly require transfer or referral to a high-acuity level of care, and which can be managed successfully and safely in the urgent care setting. Anthony P. Doran, PsyD; Robert G. Graw, Jr., MD; Marc Weber, MD; Stanford Coleman, …

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Left Eye Pain in an Overall Healthy 19-Year-old Female

Left Eye Pain in an Overall Healthy 19-Year-old Female

Urgent message: Eye pain is a common presentation to the urgent care clinic. A provider needs to be able to recognize concerning components of history and physical which require further emergent evaluation. Lindsey E. Fish, MD CASE PRESENTATION History A 19-year-old female with past medical history significant only for scoliosis presents to an urgent care clinic complaining of left eye pain for the last 3 days. She reports that the pain feels like it is …

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Abstracts in Urgent Care – December 2020

Projecting Outcomes in mTBI Concussion Recovery in Athletes A New Tool in Assessing Adolescent Concussion Head Injury in Patients Taking Warfarin Infants with Scalp Haematoma To CT or Not to CT Low-Risk Peds Head Injury? Posttraumatic Headache in Children Out-of-Hospital Cardiac Arrest Ivan Koay, MBChB, FRNZCUC, MD Identifying mTBI Patients with Long-Term Poorer Outcomes Key point: Patients with a history of psychiatric disorder, racial minorities, and those with lower level of education are most likely …

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A 33-Year-Old Woman with Blanching on Her Lower Legs

A 33-Year-Old Woman with Blanching on Her Lower Legs

A 33-year-old woman presents to urgent care with symmetrical multiple blanching nodules that developed on her lower legs over the course of 2 weeks. The lesions were round and tender. She had also been fighting a fever, fatigue, and joint pain over the same period. Her only current prescription was for oral contraceptives.             View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on …

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A 46-Year-Old Man with ‘Burning’ Epigastric Pain of Several Hours Duration

A 46-Year-Old Man with ‘Burning’ Epigastric Pain of Several Hours Duration

The patient is a 46-year-old male who presents epigastric pain that started several hours ago after a large meal. He describes the pain as a “burning” sensation. His personal medical history is notable for seizures. View the ECG and consider what your diagnosis and next steps would be. (Case presented by Benjamin Cooper, MD, FACEP, The University of Texas Health Science Center at Houston.)

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A 35-Year-Old Man with Shoulder Pain Weeks After a Car Accident

A 35-Year-Old Man with Shoulder Pain Weeks After a Car Accident

The patient is a 35-year-old male who presents with shoulder pain and weakness. He reports that the pain began when he had a “fender bender” 3 weeks ago. At the time, he didn’t think the pain was severe enough to warrant attention but he’s concerned that it’s “taking too long to get over this.” View the images taken and consider what your diagnosis and next steps would be.

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Antibiotic Stewardship and Sinusitis: A Quality Improvement Project

Antibiotic Stewardship and Sinusitis: A Quality Improvement Project

Urgent message: Acute sinusitis poses frequent challenges in urgent care where patient volumes are high and patient satisfaction is valued. An educational session and an algorithmic clinical decision-support tool were implemented in a multisite urgent care quality improvement project which resulted in a statistically significant reduction in antibiotic prescribing for acute sinusitis. ABSTRACT Background Sinusitis is a common upper respiratory condition seen in urgent care centers, as it is in primary care practices and, increasingly …

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Streptococcal Pharyngitis and Its Sidekicks: Common and Uncommon Etiologies

Streptococcal Pharyngitis and Its Sidekicks: Common and Uncommon Etiologies

Urgent message: Pharyngitis is a common chief complaint in urgent care, but not all sore throats are streptococcal (strep) pharyngitis. Delayed diagnosis and treatment of some causes of sore throat can lead to catastrophic outcomes. Epidemiology Acute pharyngitis accounts for 1%-2% of all visits in the ambulatory setting.1 Most pharyngitis seen in urgent care is viral in etiology. The most common bacterial cause of pharyngitis is group A beta hemolytic Streptococcus (GABHS), which is responsible …

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