KEY QUESTIONS What phenomenon explains the ST elevations in this ECG? What are the features of this condition? What is the clinical significance of this phenomenon?
Read More
A Young Man with Acute Ankle Injury
The patient is a 27-year-old man who complains of severe ankle pain and immobility after stumbling while on a hike. He fell approximately 1 foot onto a rock, landing with his foot in a forced flexion position. View the image taken and consider your next steps, along with possible diagnoses.
Read More
A Million Tests Later: Perspectives on COVID-19 Testing in Pediatric Urgent Care
Urgent message: The depth of COVID-19 testing data specific to the pediatric urgent care market provides insights into the capability of the broader urgent care industry to play a significant role in public health in the United States. David J. Mathison, MD, MBA It’s easy to forget how 24 months ago the urgent care industry was amidst one of the worst influenza seasons in recent memory. Then in February 2020, the first cases of COVID-19 …
Read More
Reducing Low-Acuity Preventable Emergency Room Visits by Utilizing Urgent Care Center Services via Mobile Health Unit Diversion Program
Urgent message: Urgent care centers can execute and implement innovative ideas to ameliorate overcrowded Emergency Rooms. The creation of a mobile health diversion program to transport low acuity conditions to urgent care instead of a hospital emergency department can improve population health and reduce healthcare cost; providing the opportunity to leverage value-based care by targeting the triple aim (reducing cost, increasing patient satisfaction, and improving outcomes) while freeing up the emergency medical system services. Cesar …
Read More
A 46-Year-Old Male Who Presents Due to His Defibrillator Firing
The patient is a 46-year-old male with a history of hypertension and congestive heart failure who presents complaining of his defibrillator firing—twice yesterday and once today. He denies chest pain, shortness of breath, fever, nausea or vomiting. He ran out of his carvedilol about 1 month ago. View the initial ECG and consider what your diagnosis and next steps would be.
Read More
A 60-Year-Old Woman with Dark, Painful Plaques on Her Legs
The patient is a 60-year-old woman who presents to urgent care after developing dark areas over both legs over the course of the past few days. They are extremely painful. On examination, there were violaceous and dark brown, retiform plaques, some depressed and some crusted, over the legs. The patient has a history of diabetes, hypertension, and chronic renal insufficiency for which she required hemodialysis. View the image and consider what your diagnosis and next …
Read More
A 31-Year-Old with Pain After Twisting His Ankle
The patient is a 31-year-old male who presents with lateral ankle pain after an inversion injury during a game of basketball. View the images taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read More
Abstracts in Urgent Care – March 2022
When Handlebar Meets Abdomen Corticosteroids and Asthma Antibiotics in Pediatric PAC Surfactant Use in AOM COVID Pneumonia and Disease Progression Neutralizing Antibodies in COVID Pediatric Abdominal Injuries from Handlebars Take-home point: Handlebar impact is a high-risk mechanism for serious intraabdominal injury in children and necessity of operative intervention is common. Citation: Vanderwalle R, Barker S, Raymond J, et. al. Pediatric handlebar injuries: more than meets the abdomen. Pediatr Emerg Care. 2021;37(9):e517-e523. Relevance: It is important …
Read More
Evaluating Decreased Libido: The Lowdown on Low T
Urgent message: Hypogonadism not only impedes biological development, but also negatively impacts a patient’s sense of identity and well-being. Prompt diagnosis is achievable through strategic utilization of hormone level testing in conjunction with a patient’s stated symptoms and medical history. Lisa O. Iyeke, BS and Mark J. Richman, MD, MPH Citation: Iyeke LO, Richman MJ. Evaluating decreased libido: the lowdown on low T. J Urgent Care Med. 2021;16(6):33-34. CASE PRESENTATION A 46-year-old male with benign …
Read More
Testicular Torsion: The Case of the Dancing Testicle
Urgent message: The differential diagnosis for unilateral testicular pain includes testicular torsion; this is a ”must not miss” diagnosis, as delayed diagnosis can cause significant morbidity both physically and psychologically. Jeannette Vaughn-Dotterer, PA-C CASE PRESENTATION ML is a 47-year-old male who developed left-sided testicular pain after getting out of bed 2 hours prior. He states that his left testicle appears to be “dancing” and seems to be riding higher than his right testicle. ML states …
Read More