Practice Management
The patient is a 71-year-old female with type 2 diabetes who calls attention to a rash on her shins during an annual physical. The rash appears to be pink, atrophic scars surrounded by hyperpigmented patches. They have developed since her last physical. She denies discomfort but is concerned as to what could have caused them. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described …
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The patient is a 31-year-old woman who presents with new-onset cough and decreased breath sounds to the lower lobes. 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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Urgent message: Syncope in pediatric patients may be attributed to a wide variety of sources. As such, it is essential to keep a broad differential and to eliminate potentially life-threatening etiologies. Nehal Bhandari, MD, FAAP and Abbas Zaidi, MD, FAAP CASE PRESENTATION A 12-year-old previously healthy female presents to urgent care with several episodes of “blacking out” over the past 4 days. Each episode has occurred when she stands up from a sitting or supine …
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Cooling Pain from Digital Nerve Blocks Safety of Corticosteroids in Children Predicting the Course of Pediatric CAP Is Tranexamic Acid Helpful for Epistaxis? Drug Therapy for Sciatica Imaging May Not Correlate with Lumbar Pain COVID-19 Vaccination in Lactating Patients Applying Ice Reduces Pain from Digital Nerve Blocks Take-home point: Use of an ice pack applied prior to the administration of a digital nerve block reduces pain from local anesthetic injection Citation: Rasooli F, Sotoodehnia M, …
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The patient is a 57-year-old female with a history of coronary artery disease, congestive heart failure, and left ventricular thrombus on warfarin who presents with shortness of breath. She denies any bleeding, bruising, dark-colored stools, chest pain, fever, cough, or leg pain. On evaluation, the patient’s vital signs are normal. She is breathing comfortably and speaking in complete sentences. View the ECG and consider what your next steps and diagnosis would be. Resolution of the …
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Urgent message: Many pediatric urgent care centers lack 24/7 pediatric radiologist coverage and rely on the urgent care provider for initial interpretation and subsequent clinical management. If misdiagnosed, this could represent a potential patient safety concern. Allison Wood, DO; Anne McEvoy, MD; Paul Mullan, MD, MPH; Lauren Paluch, MPA, PA-C; Brynn Sheehan, PhD; Jiangtao Luo, PhD; Turaj Vazifedan, DHSc; Theresa Guins, MD; Jeffrey Bobrowitz, MD; and Joel Clingenpeel, MD Citation: Wood A, McEvoy A, Mullan …
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Urgent message: Acute or chronic hallux pain is a common complaint in urgent care. Due to the structure, several diagnoses can have similar presentation on history and exam. With this discussion, we examine a sesamoid stress injury. Sergio P. Ramoa, MD, MS INTRODUCTION The tibial (medial) and fibular (lateral) sesamoids are contained within the flexor hallucis brevis tendons along the metatarsal head.1 They have several roles such as absorbing weight, helping glide and reducing friction …
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Urgent message: Realistic—and recurring—simulation of emergency scenarios is essential to helping urgent care providers and support staff function as a team when real-life pediatric emergencies take place in the urgent care center. Ilanalee Cabrera, MSN, RN, CPNP, Wilma Santiago, BSN, RN, CPN, Tiffany Christensen, Rachel Lucas, DO Citation: Cabrera I, Santiago W, Christensen T, Lucas R. Using simulations and skills stations to enhance emergency preparedness in pediatric urgent care. J Urgent Care Med. 2021;15(10):31-33. Introduction …
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Urgent message: Epistaxis is a common chief complaint representing a wide spectrum of severity. Key features such as the vital signs, location of the bleeding, and patient history, as well as practice and facility with certain procedures, can assist significantly with patient outcomes and dispositions. Lindsay Ballard, MD; Stephanie Fernandez, MD; and Joshua Kornegay, MD Citation: Ballard L, Fernandez S, Kornegay J. Epistaxis: a clinical review. J Urgent Care Med. 2021;15(10):13-18. Introduction Epistaxis is a …
Read MoreFaster Diagnosis of STIs Reduce ED Referrals for SVT Kids’ Dental Pain and Quality of Life Ultrasound-Guided Blocks and Renal Pain EI as a Leadership Attribute in Physicians Avijit Barai, MBBS, FACEM, FRNZCUC, MRCS, MSc (Critical Care), PgCertCPU Rapid Testing for Sexually Transmitted Infections Take-home point: A point-of-care (POC) test for chlamydia and gonorrhoea proved useful for rapid diagnosis of STI in both men and women. Citation: Van Der Pol B, Taylor SN, Mena L, et …
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