Practice Management
Urgent message: Failure to recognize and treat the early development of skin and soft-tissue infection from a stingray envenomation may result in significant tissue necrosis and systemic inflammatory response syndrome. WILLIAM A. WOOLERY, DO, PhD, MS, MBA, FACOFP Stingray injuries to humans are very common but rarely fatal. Approximately 2000 cases are reported annually in the United States.1–3 At my rural hospital on the west coast of Florida, we see an average of 45 such …
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Urgent message: Because bite and stings can be sustained in a variety of settings from many different animals and can transmit a wide variety of infectious agents, urgent care providers should have specific knowledge about treating wounds from mammals, nonmammals, and marine animals. ALEXANDER NATHANSON, MD Practitioners at urgent care centers often see patients who have sustained animal bites or stings. In addition to causing structural damage to tissues, bites and stings expose patients to …
Read MoreThe Case A patient presents after a backward fall off a ladder. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreIn an era of plummeting leverage and influence over health care and the well-being of our practices and patients, physicians desperately need representation. Our collective voice has been muzzled and utterly dismissed when it comes to health-care delivery and economics. We have essentially been relegated to serving as the voice of public health and clinical best practice, nothing more. How did we get here, and what are our representatives in our professional organizations doing to …
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In Bouncebacks, which appears periodically in JUCM, we provide the documentation of an actual patient encounter, discuss patient safety and risk-management principles, and then reveal the patient’s bounceback diagnosis. This month’s case reflects the actual documentation from an urgent care visit, and the patient’s bounceback the next day to the emergency department. Can you spot the red flags without knowing the outcome? MICHAEL B. WEINSTOCK, MD, and MIZUHO SPANGLER, DO Introduction Apicture tells a thousand …
Read MoreThe Case The patient was a rear-seat passenger in a head-on vehicle collision, wearing only a lap seat belt as a safety restraint. View the image taken (Figure 1) and consider what your diagnosis would be.
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Urgent message: Although frequently overlooked, routine urinalysis results can serve as an important diagnostic indicator of underlying and potentially life-threatening systemic disease states. NATALIE SMITH, MS, PA-C Urinalysis is one of the most common diagnostic tests used in and urgent care medicine. Urinalysis results yield routine clinical information necessary for everyday diagnoses localized to the renal and urologic systems; findings such as pyuria indicative of cystitis or hematuria related to renal calculi are some commonplace …
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Urgent message: Summer brings increased participation in outdoor activities and sports in which patients are likely to sustain injury. Patients with thigh injuries, such as injury to the quadriceps and patellar tendon, may present to the urgent care center. Timely diagnosis is essential in preserving strength and function of the quadriceps complex. TRACEY QUAIL DAVIDOFF, MD Patients who run and jump are at risk for injuring their quadriceps complex. These activities are common in the …
Read MoreSEAN M. McNEELEY, MD Sumatriptan Less Effective in Migraine with Aura Key point: Migraine with aura might require additional treatment measures. Citation: Hansen JM, Goadsby PJ, Charles A. Reduced efficacy of sumatriptan in migraine with aura vs without aura. Neurology. 2015;84:1880–1885. This study used pooled data to compare the response of patients with migraines with aura and the response of those with migraines without aura. A total of 3714 patients were compared; 1199 had an …
Read MoreThe Case A child presents after a fall on an outstretched arm from monkey bars. Pain and voluntary guarding of the elbow are noted. View the image taken (Figure 1) and consider what your diagnosis would be.
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