Journal of Urgent Care Medicine

Systematic Rapid Review: Efficacy of Hematoma Blocks for Pediatric Forearm Fractures

Shomel Gauznabi, MBChB, FRNZCGP, FRACGP, FRNZCUC, MD; Ivan Koay, MBChB, MRCS, FRNZCUC, MD Urgent Message: There is literature supporting that regional anesthesia, specifically hematoma blocks, is a safe, effective, and well tolerated alternative to procedural sedation for the management of pediatric forearm fractures. Citation: Gauznabi S, Koay I. Systematic Rapid Review: Efficacy of Hematoma Blocks for Pediatric Forearm Fractures. J Urgent Care Med. 2024; 19(x):42-50 Key Words: pediatric forearm fractures, anesthesia, hematoma blocks, urgent care …

Abstracts in Urgent Care – December 2024

ECG Interpretation: Humans Vs Machines Take Home Point: In this study, cardiologists and emergency physicians (EP) had greater accuracy for electrocardiogram (ECG) interpretation than current versions of ChatGPT and Gemini. Citation: Günay S, Öztürk A, Yiğit Y. The accuracy of Gemini, GPT-4, and GPT-4o in ECG analysis: A comparison with cardiologists and emergency medicine specialists. Am J Emerg Med. 2024 Oct:84:68-73. doi: 10.1016/j.ajem.2024.07.043. Relevance: Artificial Intelligence (AI) is rapidly evolving and becoming an integral part …

‘Health Data Obsessive Disorder’—A Modern Epidemic

“Low blood sugar” was his chief complaint, but Thomas was in my urgent care (UC) mostly because he was feeling anxious. It wasn’t hypoglycemia that was making him nervous either. Thomas didn’t have diabetes or take any medication for high blood sugar. Regardless, he was wearing a continuous glucose monitor (CGM), which he lifted his shirt to show me when I entered the room. Thomas explained his primary care physician (PCP) had prescribed the device …

Urgent Care Diagnosis and Management of Midshaft Ulnar (Nightstick) Fractures

Urgent Message: Fractures of the midshaft ulna, commonly referred to as “nightstick fractures,” typically occur after direct injury to a forearm outstretched above the head as a protective mechanism. Evaluation includes inquiry into the circumstances of the assault, assessment for any other areas of trauma, examination of the skin, wrist and elbow joints, and radiography of the forearm. Management of closed, nondisplaced midshaft ulnar fractures centers around splint immobilization and arrangement of appropriate follow-up. Chandrika …

55-Year-Old With Wrist Pain

A 55-year-old woman presents to urgent care complaining of pain when she moves her right wrist. She reports the pain began suddenly when she woke up that morning without any known trauma. An x-ray is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

35-Year-Old With ESRD

A 35-year-old male with a history of end-stage-renal-disease (ESRD) presents to urgent care complaining of back pain. The patient missed his dialysis session today because of the pain. An ECG is obtained. View the ECG captured below and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

15-Year-Old With Fever

A 15-year-old girl presents to urgent care with complaints of fever, arthralgia, abdominal pain, and a widespread rash that developed over the last 2 days. The patient says that the pain in her knees is severe and debilitating. On examination, the patient has a temperature of 100.3°F (37.9°C) as well as maroon and violaceous, purpuric papules and plaques on the legs, buttocks, and face. Laboratory examination shows elevated erythrocyte sedimentation rate and C-reactive protein, proteinuria, …

Abdominal Pseudohernia and Urinary Retention Due to Spinal Nerve Root Compression From Disc Herniation: A Case Report

Urgent Message: Abdominal pseudohernia is a rare diagnosis with variable presentation. Urgent care clinicians who are familiar with the condition and its variable presentations can reduce the risk of diagnostic errors and unnecessary or inappropriate diagnostic testing. Berkeley E Prewett, BSA; Stephen V Green, MD; Andrew L Juergens II, MD; Taylor K Ratcliff, MD Citation: Prewett BE, Green SV, Juergens AL, Ratcliff TK. Abdominal Pseudohernia and Urinary Retention Due to Spinal Nerve Root Compression From …

30-Year-Old With Back Pain

A 30-year-old woman presents to urgent care with pain in her lower back and pelvis. She denies any injury or accident that might be causing her pain. She has just returned to full-time work after having a baby. An x-ray is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

59-Year-Old With History Of Hypertension

A 59-year-old male with a past medical history of hypertension presents with dyspnea and pleuritic chest pain in urgent care, and an ECG is obtained. View the ECG captured below and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.