Practice Management
Urgent message: As visits to urgent care after possible traumatic brain injury continue to rise, so does the importance of understanding which patients require a CT scan. Assessing the value of the Canadian Computed Tomography Head Rule in making that determination can raise the urgent care provider’s ability to make informed decisions in this regard, reducing the risk of unnecessary radiation exposure in patients who are determined to not need a CT. Jessicah Ray, DHSc, …
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The patient is a 24-year-old man who presents with excessive foot odor that he describes as “worse than anything I could have imagined.” He denies pain or burning, but reports that the soles of his feet itch occasionally. He also says his feet sweat heavily when he plays recreational ice hockey a few nights a week. Upon examination, several shallow rounded pits are found on the pressure-bearing areas of the soles. View the image …
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The patients is a 48-year-old female with a family history of breast cancer who complains of 2 months of fatigue, nausea, and generalized body aches, including chest pain. She reports 40 pounds of unintentional weight loss during this time. Review the ECG taken and consider what other tests you would order, as well as possible diagnoses. (Case presented by Tom Fadial, MD, McGovern Medical School Department of Emergency Medicine.)
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The patient is a 52-year-old male who presents with a chief complaint of 1 month of right shoulder pain. View the image taken and consider what your diagnosis and next steps would be.
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If you’re reading this, you’ve survived 2020. Congratulations!—although it probably doesn’t feel like there’s much success to revel in at the moment. Indeed, this has been a year of hardship for everyone in some form and certainly, for many, it still may feel like there’s no end in sight. And it doesn’t seem like much cause for celebration to have dodged a bullet when you’re still staring down the barrel of a loaded gun. However, …
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Urgent message: With patients who have sustained head injuries related to both sports- and non–sports-related activities presenting to urgent care more than ever before, it’s essential for the provider to have a nuanced understanding of which patients truly require transfer or referral to a high-acuity level of care, and which can be managed successfully and safely in the urgent care setting. Anthony P. Doran, PsyD; Robert G. Graw, Jr., MD; Marc Weber, MD; Stanford Coleman, …
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Urgent message: Eye pain is a common presentation to the urgent care clinic. A provider needs to be able to recognize concerning components of history and physical which require further emergent evaluation. Lindsey E. Fish, MD CASE PRESENTATION History A 19-year-old female with past medical history significant only for scoliosis presents to an urgent care clinic complaining of left eye pain for the last 3 days. She reports that the pain feels like it is …
Read MoreProjecting Outcomes in mTBI Concussion Recovery in Athletes A New Tool in Assessing Adolescent Concussion Head Injury in Patients Taking Warfarin Infants with Scalp Haematoma To CT or Not to CT Low-Risk Peds Head Injury? Posttraumatic Headache in Children Out-of-Hospital Cardiac Arrest Ivan Koay, MBChB, FRNZCUC, MD Identifying mTBI Patients with Long-Term Poorer Outcomes Key point: Patients with a history of psychiatric disorder, racial minorities, and those with lower level of education are most likely …
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A 33-year-old woman presents to urgent care with symmetrical multiple blanching nodules that developed on her lower legs over the course of 2 weeks. The lesions were round and tender. She had also been fighting a fever, fatigue, and joint pain over the same period. Her only current prescription was for oral contraceptives. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on …
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The patient is a 46-year-old male who presents epigastric pain that started several hours ago after a large meal. He describes the pain as a “burning” sensation. His personal medical history is notable for seizures. View the ECG and consider what your diagnosis and next steps would be. (Case presented by Benjamin Cooper, MD, FACEP, The University of Texas Health Science Center at Houston.)
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