Practice Management
Joshua Russell, MD, MSc, FCUCM, FACEP Recently, a PA I supervise called me about a young woman who came in for hematemesis and melena at home. The provider, let’s call him Tom, told me that the patient had normal vital signs, but he thought she should still go to the ED. I could sense some reluctance in his voice though. It was probably because the patient was just 32 years old and looked well. Understandably, …
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Urgent message: Neck and back pain are common issues preceding surgical intervention. Given differences in care plans, outcomes, cost, and length of stay associated with spinal surgeries, the option of referring urgent care patients to either neurosurgeons or orthopedic spine surgeons requires careful consideration. Rami Musleh, PA-C; Angela Blagojevski, MPAS, PA-C; Randy Brush, MS, PA-C; and Jessica Bruskoski, MS, PA-C INTRODUCTION Neck and back pain are two of the most common reasons for people to …
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Urgent message: Throughout the COVID-19 pandemic, unvaccinated people have shown higher rates of morbidity and mortality in comparison with those who are fully immunized. While most vaccination adverse reactions are mild and self-resolving, it is important to consider the timeline of vaccinations to correlate possible adverse reactions. Amanda dos Santos, MD and Michael Pallaci, DO, FACEP, FACOEP INTRODUCTION The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic continues to affect all aspects of our society and …
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Ivan Koay MBChB, FRNZCUC, MD Achilles Tendon Rupture Predictive Value of Seamen’s Sign PT and Meniscus Tears Managing ACS in Rural Areas Following Up on Radiology Recommendations Syncope and Motor Vehicle Accidents Surgical vs Nonoperative Management of Achilles Tendon Rupture Take-home point: Surgery at 12 months postinjury was not associated with better outcomes compared with nonoperative treatment of Achilles tendon rupture. Citation: Myhrvold S, Brouwer E, Andersen T, et. al. Nonoperative or surgical treatment of …
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A55-year-old female presents to urgent care with chest pain that started 1 hour prior. On exam, she appears diaphoretic with normal vital signs. View the initial 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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A 41-year-old male presents to urgent care following a slip-and-fall on a wet swimming pool surface. He complains of dorsal/posterior wrist pain. On exam you find soft tissue swelling of the posterior wrist. View the image 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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I don’t know about you, but I’m tired of being talked at about antibiotic stewardship. We all realize it’s a problem. And though it’s common practice to blame urgent care providers for the situation, we aren’t uniquely culpable for antibiotic overuse. To anyone paying attention, it’s clear that antibiotic overprescribing in urgent care remains as rampant as crime in Gotham City. And the topic has become exhausting for UC providers, not because we believe it …
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Urgent message: Mistaking medical symptoms for psychiatric disease can delay care and lead to adverse outcomes. Elizabeth Yeager-Cordial, MD; Janell Ison, DO; Robert Becker, MD; Courtney Boyd, MD; and Michael Weinstock, MD Citation: Yeager-Cordial E, Ison J, Becker R, Boyd C, Weinstock M. Psychiatric manifestations of organic disease: don’t get fooled! J Urgent Care Med. 2022;16(11):11-15. CASE PRESENTATION A 23-year-old man presented with a strange complaint: visual hallucinations. He had no psychiatric history and was …
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Urgent message: The angle of the mandible is one of the most common locations among bilateral mandibular fractures. Bilateral mandibular angle fractures are a rare traumatic event and often occur in the setting of panfacial fractures due to an impacting force. Chad E. Richmond, DO, DAOBFP; Leonard Powell, DO, MS, FACOFP, CMD; Keith S. Richmond, DMD, MDS. INTRODUCTION The mandibular angle is a weak zone that is more exposed to fractures than other areas of …
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Vapocoolant and Digital Nerve Blocks Dosing Dexamethasone in Pediatric Asthma Infant Clean-Catch Urine Contamination Antibiotic-Associated Diarrhea in Children Treating Acute Diverticulitis Torus Wrist Fractures in Children Efficacy of Antiviral Treatment in COVID-19 Vapocoolant for Pain Reduction in Digital Nerve Blocks Take-home point: Application of vapocoolant prior to digital nerve blocking can reduce pain associated with skin puncture and local anesthetic infiltration. Citation: Selvi F, Bedel C, Akçimen M. Evaluation of vapocoolant spray effect on pain …
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