Practice Management
A 51-year-old man presents to urgent care concerned about an asymptomatic rash that developed over his face within the last month. On examination, pink and violaceous, annular, scaly papules, and plaques were seen on his cheeks and within his beard area and nasolabial folds. The patient appeared well and reported no systemic symptoms. View the image above and consider what your diagnosis and next steps would be. Resolution of the case is described on the …
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Urgent Message: Steroid overprescribing is a universal urgent care issue. While systemic steroids have several indications in which the preponderance of evidence supports their use in the urgent care setting, indication creep has led to their use outside of these scenarios resulting in significant risk for avoidable and unjustifiable adverse reactions. Citation: Hansen P. Systemic Steroid Stewardship in Urgent Care: Recognizing Indication Creep to Limit Avoidable Harms. J Urgent Care Med. 2023;18(3);29-32 Author Affiliation: Paul …
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Urgent Message: Pediatric emergency medicine researchers have an opportunity to enhance collaboration with general emergency medicine and acute care clinicians to bridge the gap between research and dissemination of evidence-based care recommendations. Bashar S. Shihabuddin, MD, MS, FAAP, FACEP; Jessica Fritter, MACPR, ACRP-CP; Charmaine B. Lo, PhD MPH; Rachel Stanley MD, MHSA; Michael Weinstock, MD Citation: Shihabuddin B, Fritter J, Lo C, Stanley R, Weinstock M. Pediatric Knowledge Needs Assessment: A Pilot Study. J Urgent …
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I have a story I want to share with you, but I’m finding it hard to do without it reeking of privilege. This is a story about feeling 100% welcomed in one place when you don’t feel that way in many others. This is a rare for me, and perhaps it will feel like a poor example to you. Yet, it is part of my lived experience and brought something home for me that made …
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One hour of free CME will be offered in the forthcoming Bouncebacks! Book Club virtual discussions. The book series Bouncebacks!—created by The Journal of Urgent Care Medicine’s Senior Clinical Editor Michael Weinstock, MD, and colleagues—takes a fresh approach to the practice of medicine by focusing on “bounce-back” visits with a collection of case reports. The Bouncebacks! series presents the actual documentation of an emergency encounter, analyzes it from a risk-management and patient-safety perspective, then reveals …
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Joshua Russell, MD, MSc, FCUCM, FACEP Who among us has worked a single urgent care (UC) shift without at least one patient making a humble request for a sick note to take back to work? “Can I have a work note?” It’s a simple ask. In fact, apart from medication refills, work note visits rank among the most welcomed presentations for many overworked clinicians, offering a much-needed mental reprieve and a chance to finally catch up …
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A 75-year-old woman presents to urgent care following a fall in her home that day. An adult daughter explains that her mother has pain on her left side around her ribs. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.
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Urgent Message: The diagnosis of bacterial pharyngitis is often difficult. Rapid polymerase chain reaction testing has potential to improve diagnostic certainty. Despite high accuracy rates, many urgent care providers continue to seek confirmation by throat culture. Justin Bowles, MD, Supreet Ghumman, MS4 Citation: Bowles J, Ghumman S. Real world validation of rapid PCR strep testing in urgent care. J Urgent Care Med. 2023;18(2):15-21 Key Words: bacterial pharyngitis; PCR testing Abstract Introduction: Point-of-care polymerase chain reaction …
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A 66-year-old male presents in the urgent care, saying “it’s hard to breathe.” He’s had weakness and dyspnea for one day. The patient has a medical history of diabetes, hypertension, and heart failure. The patient has a pacemaker. An ECG is obtained. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page
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What Should We Do with the Nail? Nailbed Repair in Children Take Home Point: After nail bed repair, discarding the fingernail was associated with similar rates of infection and similar cosmetic outcomes compared to replacement of the fingernail. Citation: Jain A, Grieg A, Jones A, et al. Effectiveness of nail bed repair in children with or without replacing the fingernail: NINJA multicentre randomized clinical trial. BJS, 2023, 110, 432–438 https://doi.org/10.1093/bjs/znad031 Relevance: Procedures for nail bed …
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