Journal of Urgent Care Medicine

A New-Onset, Suspicious Skin Lesion

Urgent message: Patients and providers alike may be inclined to eliminate possible diagnoses based on first impressions. It is essential that the urgent care clinician maintain a wide differential when evaluating patients for new-onset complaints that do not have an obvious cause. Failure to do so may cause delayed diagnoses (and, consequently, delayed treatment). Haley Harrington, Ross L. Pearlman, MD and Robert T. Brodell, MD INTRODUCTION Ticks are small—so small that patients often do not …

Preparedness for Emergencies in Pediatric Urgent Care Settings

Urgent message: While standards for pediatric emergency care have been defined for outpatient offices and emergency departments, guidelines have not been published for urgent care centers. This study assesses the presence of equipment, supplies, and medications necessary to manage emergencies in pediatric urgent care centers. Amanda Montalbano, MD, MPH, FAAP and Brian Lee, PhD, MPH Results from this project were presented in poster format the Pediatric Urgent Care Conference in Orlando, FL in 2018. No …

Opportunity is Knocking. Do you hear it?

It is not the strongest species that survive, nor the most intelligent, but the most responsive to change. – Charles Darwin Imagine, if you will for a moment, that you’re a dinosaur. Specifically, a late cretaceous era one —any species you like. I tend to envision myself a triceratops. It’s about 66 million years ago (give or take an epoch or two) and animals like you have dominated the world for over 100 million years—not …

Multisystem Inflammatory Syndrome in Children (MIS-C): Who Should Not Be MISC’ed?

Katie Jerzewski MD, Roshni Patel MD, and Joshua Rocker MD OVERVIEW The novel coronavirus, or SARS-CoV-2, first appeared in the Wuhan province of China in the winter of 2019. Due to the virus’s ability to spread from an asymptomatic carrier to the next new host and Wuhan being a pivotal commercial center, it spread quickly across the globe. Asymptomatic carrier rates have ranged from 1.6% to 56.5%, depending on clinical setting and testing availability.1 In …

Abstracts in Urgent Care – October 2020 (PUCC)

Spotlight on Original Research in Pediatric Urgent Care: Excerpts from the 2020 Pediatric Urgent Care Conference (PUCC). Los Angeles, CA David J. Mathison, MD, MBA Decreasing Length of Stay in the Pediatric Urgent Care with Electronic Discharge Instructions* Wooster J, Patel A, Nedved A, Lee B The aim of this research was to determine if an electronic discharge process could decrease length of stay by an average of 10 minutes per patient. An electronic discharge …

An 8-Year-Old Girl with Lesions on Her Arms

The patient is an 8-year-old girl with a smattering of brown to black lesions on her arms. They’re not painful or causing discomfort, but her mother is concerned because they look darker than the average freckle. Exam reveals small (less than 0.5 mm), round, hyperpigmented macules. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. <

A 60-Year-Old Woman with a 4-Day History of Intermittent Exertional Chest Pain

The patient is a 60-year-old female with no past medical history presents with intermittent exertional chest pain for 4 days. She reports the pain is substernal with radiation to her left arm, is associated with nausea and diaphoresis, and is worsened by exertion. The patient says she experiences pain every 4-5 hours, but currently is pain-free. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case …

A 46-Year-Old Woman with Wrist Pain After Hearing a ‘Snap’

The patient is a 46-year-old female with pain in her wrist. She reports that she heard a “snap” when she put all her body weight on her left hand during an exercise class. View the images taken and consider what your diagnosis and next steps would be.

A 45-Year-Old Man with Thumb Pain After a Fall

The patient is a 45-year-old man who presents as your first patient of the day, with thumb pain after taking a fall in the middle of the night. He tripped walking to the bathroom and tried to catch himself on the doorknob as he went down. His pain worsens with movement or when he tries to grip anything. View the image taken and consider what your diagnosis and next steps would be.

A 28-Year-Old Woman with Foot Pain After a 10-Foot-Fall

The patient is a 28-year-old female who presents with foot pain after experiencing a fall of 10 feet while rock climbing. On exam, you find midfoot dorsal and plantar tenderness, as well as bruising across the top of the foot. Review the image taken and consider what your diagnosis and next steps would be.

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