Journal of Urgent Care Medicine

Abstracts in Urgent Care – September 2021

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, …

A 57-Year-Old Female with Cardiological History and Shortness of Breath

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 …

Discrepancy Rates in Radiograph Interpretations between Pediatric Urgent Care Providers and Radiologists

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 …

Case Report: Reoccurring Metatarsophalangeal Joint Pain

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 …

Using Simulations and Skills Stations to Enhance Emergency Preparedness in Pediatric Urgent Care

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 …

Epistaxis: A Clinical Review

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 …

Abstracts in Urgent Care – July/August 2021

Faster 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 …

Active COVID-19 Infection Is Indicated by WBC ≤7.0 and PLT ≤200 at Presentation

Yijung Russell, MD; Casey Collier, MD; Steve Christos, DO; and Shu B. Chan MD, MS Citation: Russell Y, Collier C, Christos S, Chan SB. Active COVID-19 infection is indicated by WBC 7.0 and PLT 200 at presentation. J Urgent Care Med. 2021;15(10):35-38. Introduction The impact coronavirus disease of 2019 (COVID-19) has had on individuals, businesses, and governments is unprecedented in many ways. Though widespread and frequent screening is recommended for better containment,1 limited availability of …

Actinomyces neuii as a Cause of Vulvar Abscess

Urgent message: While abscesses are seen commonly in the urgent care setting, location and presenting complaints can offer essential clues as to the causative organism—and inform timely diagnosis and treatment decisions. Tracey Q. Davidoff, MD, FCUCM Introduction Abscesses are common in urgent care and emergency medicine and are easily treated with drainage, and in some cases antibiotics. The majority of cases are caused by Staphylococcus aureus and Streptococcal sp. Rarely, gram-negative bacilli can be found …

Heavy Menstrual Bleeding: Important Considerations for Adolescent Patients in the Urgent Care Setting

Urgent message: Anovulatory cycles are the most common cause of heavy menstrual bleeding (HMB) in adolescent patients. Just as with adult patients in the urgent care setting, it is most important to identify unstable patients and those with life-threatening causes for HMB. Shikha Nigam, MD, MPH and Amy Pattishall, MD Case Presentation A 14-year-old female presents with 6 weeks of menstrual bleeding. Her cycles are irregular but she generally has 4 to 6 weeks of …

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