Practice Management
An 8-year-old male is brought to urgent care by his mother reporting a widespread, itchy facial rash. The patient says that the rash is severely painful and pruritic, and that he feels tingling and pain in his lips. The facial rash presented 3 days prior, and the mother states that her son repeatedly scratches the legions. The patient and is family are from Honduras; they deny any recent travel. The patient is otherwise well and denies …
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A 64-year-old woman with a history of chronic obstructive pulmonary disease, diabetes mellitus, osteoarthritis, and obesity presents to urgent care with acute right posterior ankle pain after stumbling on a curb earlier that day. She says she felt a sudden sharp pain in the back of her ankle and experienced immediate difficulty walking and climbing stairs. She reports 10 days of mild posterior ankle discomfort before this event, which she treated with ice, an elastic …
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Urgent Message: Recurrent or unexplained periorbital ecchymosis (“raccoon eyes”) in an infant should prompt consideration of metastatic neuroblastoma and escalation for appropriate imaging. Alejandro Lopez, BS; Julia Gamache, BS; Ella Weiss, BS; Aaron J. Maki, MD, PhD Keywords: neuroblastoma; metastatic neuroblastoma; periorbital ecchymosis; orbital metastasis; suprarenal mass; pediatric malignancy Abstract Introduction: The presenting symptoms of pediatric neuroblastoma are highly variable. Patients may first present to urgent care for what they perceive as a minor complaint. …
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Urgent Message: Nitrous oxide-associated peripheral neuropathy may present similarly to Guillain-Barré syndrome, and clinicians are encouraged to conduct a careful clinical assessment of patients with neurological symptoms. Ivan Koay, MBChB, MRCS, FCUCM, FRNZCUC, MD; Cameron Olphert, BSc (Hons), MSc Keywords: nitrous oxide toxicity; vitamin B12 deficiency; peripheral neuropathy; myeloneuropathy; Guillain-Barré syndrome; paresthesia Abstract Introduction: Although often regarded as “safe,” repeated exposure to nitrous oxide can result in serious neurological sequelae, most notably functional vitamin B12 …
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Web-Based Pediatric Point-of-Care Ultrasound Cases Take Home Point: Implementation of a web-based point-of-care ultrasound (POCUS) educational intervention resulted in improved learning outcomes and favorable participant evaluations among clinicians working in resource-limited settings. Citation: Ricci A, Lindsay D, Schwanfelder C, et al. Web-Based Deliberate Practice of Pediatric Point-of-Care Ultrasound Cases in Resource-Limited Settings: A Multicenter Implementation and Effectiveness Study. J Ultrasound Med. 2025;44(7):1231-1244. doi:10.1002/jum.16679 Relevance: POCUS is an increasingly valuable tool in clinical practice, providing rapid …
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An 83-year-old female with a past medical history of hypertension, diabetes mellitus, and hyperlipidemia presents to urgent care with palpitations and dizziness for the past 2 weeks. She does not have any family members present. An ECG is obtained. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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Urgent Message: Despite national recommendations regarding childhood vaccination, some parents are hesitant or refuse to vaccinate their child. This survey assessment presents parents’ perceptions of vaccination and the scope of undervaccination in a pediatric urgent care population. Stacy B. Buchanan, DNP, APRN, CPNP-PC; Brooke Cherven, PhD, MPH, RN; Betsy Dye, MS, CPNP-PC, NPD-BC, EBP-C; Temima Oratz, BSN, RN, EBP-C; Margaret Gettis, DNP, APRN, CPNP-PC, EBP-C Keywords: vaccine hesitancy; childhood immunization; undervaccination; measles-mumps-rubella vaccine; varicella vaccine; …
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Lindsey E. Fish, MD, FCUCM, Editor-in-Chief, The Journal of Urgent Care Medicine, [email protected] In this issue of JUCM, you will find an original research article exploring parental vaccine hesitancy. Vaccine hesitancy is a challenging issue because it frequently triggers charged emotions in patients and clinicians alike. While there have always been strong opinions regarding vaccines, from the clinician perspective, the degree amplified significantly during the COVID-19 pandemic. I will never forget reading about front-line physicians …
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A 28-year-old female presents to urgent care complaining of right ankle pain after awkwardly stepping off a high curb, subsequently rolling her ankle while running outside earlier today. She is unable to bear weight on her ankle. She has no past medical history, takes no medications regularly, and has not tried any treatments since the injury. Physical exam reveals she is afebrile with normal vital signs, and she has marked tender edema to the lateral …
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Urgent Message: The placebo effect can produce clinical manifestations of various disease states, particularly for pain. It has practical clinical implications for urgent care clinicians who routinely recommend oral medications for pain. Vinay Sharma, BS; Ariana M. Nelson, MD Keywords: acute pain; chronic pain; placebo effect; expectation; verbal suggestion; endogenous opioid signaling; dopamine signaling; placebo analgesia; medical ethics Abstract The placebo effect—the nonspecific beneficial effect of a medical treatment—involves complex psychological, biological, and physiological interactions. …
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