Practice Management
The patient is a 35-year-old male who presents with shoulder pain and weakness. He reports that the pain began when he had a “fender bender” 3 weeks ago. At the time, he didn’t think the pain was severe enough to warrant attention but he’s concerned that it’s “taking too long to get over this.” View the images taken and consider what your diagnosis and next steps would be.
Read More
Urgent message: Acute sinusitis poses frequent challenges in urgent care where patient volumes are high and patient satisfaction is valued. An educational session and an algorithmic clinical decision-support tool were implemented in a multisite urgent care quality improvement project which resulted in a statistically significant reduction in antibiotic prescribing for acute sinusitis. ABSTRACT Background Sinusitis is a common upper respiratory condition seen in urgent care centers, as it is in primary care practices and, increasingly …
Read More
Urgent message: Pharyngitis is a common chief complaint in urgent care, but not all sore throats are streptococcal (strep) pharyngitis. Delayed diagnosis and treatment of some causes of sore throat can lead to catastrophic outcomes. Epidemiology Acute pharyngitis accounts for 1%-2% of all visits in the ambulatory setting.1 Most pharyngitis seen in urgent care is viral in etiology. The most common bacterial cause of pharyngitis is group A beta hemolytic Streptococcus (GABHS), which is responsible …
Read More
Urgent message: Acute otitis media (AOM) is the leading diagnosis for antibiotic prescribing in pediatric patients. As antibiotic stewardship becomes more essential in preventing antibiotic resistance, safe and effective management of AOM becomes all the more important in urgent care. The treatment path should reflect nuances in management to inform decisions regarding the necessity of antibiotics—and if they are deemed necessary, targeting the type, delivery vehicle, and duration to keep a narrow treatment effect. When …
Read More
Urgent message: Epiglottitis is classically viewed as a pediatric disease, but has become increasingly common in the adult population. While symptoms may present as an isolated sore throat, they can quickly progress to complete airway compromise with need for emergency cricothyroidotomy. Due to the high risk for morbidity and mortality, urgent care providers must maintain a high index of suspicion to avoid misdiagnosing a potentially catastrophic disease. Zachary DePriest, MS, PA-C INTRODUCTION Adult epiglottitis (AE) …
Read MoreAntibiotics (or Not?) for Dog Bites Scaring the Quest for Antibiotics Out of Patients Post-Op Antibiotics in Complex Appendicitis How Long Should Sepsis Patients Receive Antibiotics? Times Are Changing for Patients with Allergic Rhinitis Avijit Barai MBBS, MRCS, MSc (Critical Care), PgCertCPU, FRNZCUC Prophylactic Antibiotics for Dog Bites Key point: The majority of the patients presenting to emergency room with dog bites receive prophylactic antibiotics either in the hospital or on discharge. About one quarter …
Read More
The patient is a 45-year-old female who presents with lower extremity, lateral pain. She reports being a competitive runner who logs roughly 60 miles a week. The pain is worse when she’s running, but minimal when she’s walking and absent when at rest. View the images taken and consider what your diagnosis and next steps would be.
Read More
Urgent message: As understanding of COVID-19 in the pediatric age group evolves, it has come to light that children may contract the virus, yet be asymptomatic, more commonly than we initially believed. We have found a high prevalence of asymptomatic pediatric patients testing positive for COVID-19 in our urgent care clinics in the NY metro region. Katharine Miao MD, Frank Illuzzi MD, and Alexander C. Hwang IMPORTANCE SARS-CoV-2 is the novel virus that causes COVID-19. …
Read More
Urgent message: Recent expert opinion has reshaped initial management for suspected acute renal colic. Clinicians often utilize computerized tomography imaging to diagnose acute renal colic; however, there is an increasing role for clinicians to instead use point-of-care ultrasound (POCUS) as the initial imaging modality when acute renal colic is suspected. Renal ultrasound is time and cost effective, radiation-free and completed by the clinician at the bedside. Chelsea M. Burgin, MD, FAAFP; James Frederick W. Pike, …
Read More
Ethnic Background Matters in ECG Evaluation Lean on Risk Stratification Tools in Chest Pain Lasting Effects of Headache in Children Trauma and Childhood Migraine Comparing ‘Fixes’ for Distal Radial Fractures in Adolescents Casting Options in Distal Radius Fractures in the Elderly Avijit Barai, MBBS, MRCS, MSc (Critical Care), PgCertCPU, FRNZCUC Ethnicity and STEMI Criteria of ECG Key point: The ethnic background of patients should be considered during ECG evaluation of ST segment elevation myocardial infarction …
Read More