Practice Management
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.
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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 …
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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 …
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The patient is a 23-year-old male who presents with a primary complaint of pain in his left wrist after falling from his mountain bike on a rocky path. 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.
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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 …
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Urgent message: The COVID-19 worldwide pandemic has changed sports as we know it. Returning athletes back to sport safely continues to be widely debated among physicians in cardiology, primary care, infectious disease, and sports medicine. The return-to-play process after a COVID-19 infection will depend on the severity of their infection, duration of symptoms in the context of any concerning past medical history, and/or family history. Brian Harvey, DO and Natalie Stork, MD CASE PRESENTATION A …
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Urgent message: Ocular complaints for which there is no immediate, obvious explanation do not necessarily have to be referred to the emergency room or ophthalmology. Employing the process of elimination to narrow down a broad differential, using the available evidence, can expedite the correct diagnosis while allowing the patient to remain in the urgent care. Kayla Penny, BS; Joseph LaRochelle, PharmD, BCPPS, FCCP; Deirdre Hooper, MD; Haley Caire, BS; and Kelsey Rooney, BS CASE PRESENTATION …
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Duration of UTI Treatment in Men Acute Respiratory Illness in Children Isopropyl Alcohol for Acute Nausea in Adults Neurological Events and Metronidazole Prescribing Do the Modified Sgarbossa Criteria Offer Advantages Over the Original? Safety of a Second COVID-19 Vaccination Dose in Patients Who Had a Reaction to the First How Long Should We Treat UTI in Men? Take-Home Point: In afebrile men with UTI symptoms, a 7-day course of ciprofloxacin or trimethoprim/sulfamethoxazole was noninferior to …
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A 7-year-old boy is brought to your urgent care center by his mother because she’s concerned about a rash of scaly papules on his trunk, some of which had crusted or healed. A few of the lesions are hemorrhagic. She notes that they appeared a few days ago, accompanied by a mild fever. She dismissed the possibility that the source could be chickenpox because her son had been vaccinated. The boy reports that the papules …
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