Journal of Urgent Care Medicine

Urgent Care Diagnosis and Management of Deep Vein Thrombosis

John DesMarais, MD and Samidha Dutta, DO Urgent message: Screening patients with suspected DVT using the Well’s criteria is an efficient tool that would be even more impactful with access to point-of-care, high-sensitivity D-dimer testing in the urgent care setting. Citation: DesMarais J, Dutta S. Urgent care diagnosis and management of deep vein thrombosis. J Urgent Care Med. 2021;15(2):13-17. Case Presentation A 37-year-old woman presents to urgent care with 3-day history of right leg swelling …

Investigation and Assessment of Urine Culture Importance in the Evaluation of Uncomplicated Urinary Tract Infections in an Urgent Care Setting

Dianne Treacy Lore DNP, FNP-BC, CPNP-PC and Marlena Seibert Primeau DNP, FNP-BC, NHDP-BC, BSHEC Citation: Lore DT, Primeau MS. Investigation and assessment of urine culture importance in the evaluation of uncomplicated urinary tract infections in an urgent care setting. J Urgent Care Med. 2021;16(2):37-41. ABSTRACT Purpose Urinary tract infections negatively affect over 150 million individuals globally each year. Traditional management encompasses evaluating a urine culture and sensitivity (C&S). Although the guidelines set forth by the …

Learner Presence Does Not Negatively Impact Patient Experience in Pediatric Urgent Care

Urgent message: Shorter urgent care visits are correlated with higher experience scores. The presence of learners does not negatively impact patient experience scores. David Skoglund, MD, MS; Brian Lee, PhD, MPH; and Amanda Montalbano, MD, MPH Citation: Skoglund D, Lee B, Montalbano A. Learner presence does not negatively impact patient experience in pediatric urgent care. J Urgent Care Med. 2021;16(2):30-36. ABSTRACT Objective The number of trainees seeking pediatric educational opportunities in community outpatient settings is …

A 6-Year-Old Boy with a Lesion on His Ear

The patient, a 6-year-old boy, presented to a pediatric urgent care center for a well-child visit. In the exam room, the father pointed out a red lesion on the helical rim of the patient’s ear. The papule was smooth and well-defined and didn’t seem to bother the boy. The father reports that he and the boy’s mother have grown concerned as they’ve noticed it develop over several months. View the image and consider what your …

A 65-Year-Old Man with Shortness of Breath and a History of Heart Failure

A 65-year-old male with a history of heart failure presents to an urgent care center with shortness of breath of 2 days duration. He denies chest pain, nausea, or vomiting. He reports that he ran out of his medications about a week ago. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. (Case presented by Catherine Reynolds, MD, McGovern Medical School, …

A 75-Year-Old with Chest Pressure

The patient is a 75-year-old male who presents with a primary complaint of pressure in his chest. He denies chest pain, dizziness, or “anything like a heart attack.” View the x-ray taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

The Last Hour Problem

It’s 8 pm and I’m 9 hours into a 10-hour shift when four new patients walk in. Even though I’m feeling drained, I smile warmly as each passes my workstation. I “eyeball” them each as they walk by; my grin persists because they all seem stable and my “TUR” for this shift in the emergency department is now only 45 minutes away. TUR (or “time until relief”) is a metric I continuously track with ruthless …

Weight Loss, Abdominal Pain, and Distension in a 74-Year-Old Woman

Urgent message: Not all GI complaints can be attributed to gastrointestinal pathology; symptoms of dyspepsia, vomiting, early satiety, weight loss, and abdominal pain may also be from a pelvic etiology. Fabrizia Faustinella, MD, PhD and L. Alexandre Frigini, MD INTRODUCTION Gastrointestinal complaints are common in ambulatory centers, urgent care, and in emergency departments. The symptoms of abdominal pain, nausea, and vomiting account for 12% to 15% of ED visits.1 Several non-GI intra-abdominal, endocrine, and pelvic …

N gonorrhoeae: Dual Therapy Is Out. Monotherapy Is In.

Assessing the Rate at which Pacemaker and Defibrillator Patients Present to the Emergency Room with their Manufacturer ID Card: A Cross Sectional Study

Urgent message: Care can be delayed if an urgent care or emergency clinician attempts to interrogate the CIED of a patient who does not know their device manufacturer and does not carry their ID card. This scenario illustrates the importance of patient education in care centers, such as the emergency department and urgent care. Tinh M. Le; James F. Neuenschwander, MD, FACEP; Mary Jones, DNP; Ankur Parekh; Hana Le; Kaitlyn Cedoz; and Clark Daugherty ABSTRACT …