Journal of Urgent Care Medicine

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.

Abstracts in Urgent Care – September 2023

How Long Should We Prescribe Antibiotics for Pediatric UTI? Take-Home Point: Children receiving 5 days of antibiotics for urinary tract infection (UTI) had a higher rate of treatment failure that children receiving 10-day courses. However, absolute treatment failure rates were low in both groups. Citation: Zaoutis T, Shaikh N, Fisher B, et. al. Short-Course Therapy for Urinary Tract Infections in Children: The SCOUT Randomized Clinical Trial. JAMA Pediatr. 2023 Jun 26; e231979. Relevance: There have …

Analogy: A Powerful and Underutilized Bedside Tool

Joshua Russell, MD, MSc, FCUCM, FACEP Sophie was back with another one of her kids in tow. This was the fifth time in a month. I could almost hear my staff roll their eyes when she walked through the door. Even though she was a denizen of the clinic, I was about to meet her for the first time because I usually covered other sites. Although I was out of the loop, my medical assistant …

HbA1c as Screening/Diagnoses for Early or Asymptomatic Diabetes in the Urgent Care Facility

Urgent message: The use of all-inclusive kits with compact, table-top analyzers provides a rapid quantification of HbA1c levels in patients. The use of these tests for in-house screening has the potential to increase the diagnoses of early or asymptomatic diabetes in young adults and under-served or overlooked populations. Jay H. Shubrook, DO; Jane M. Caldwell, PhD; and Lindsey E. Fish, MD Citation: Shubrook JH, Caldwell JM, Fish LE. HbA1c as screening/diagnosis for early or asymptomatic …

A 55-Year-Old Female with Sudden-Onset Wrist Pain

The patient is a 55-year-old woman who presents with sudden-onset wrist pain in her right wrist. She reports that she is right-handed and played pickleball the day before onset, and that she is an avid bicyclist, but denies falling or experiencing any pain in the course of those activities. She says she “just woke up with it hurting.” View the image taken and consider what your diagnosis and next steps would be. Resolution of the …

17-Year-Old Athlete Twisted His Ankle

A 17-year-old high school lacrosse player presents to an urgent care center with a painful left ankle. He states that the pain started 2 days earlier when he twisted his left ankle (an inversion injury) while competing in a tournament. He says that he tried to continue to play, but the pain increased. He reports that the ankle swelled over the lateral aspect and that he has pain when he walks. He says that he …

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