Poisoning of a Child Because of an Older Sibling’s Habit

Poisoning of a Child Because of an Older Sibling’s Habit

Urgent message: Be aware of new fads and habits that are growing in popularity. Some of them can result in life-threatening symptoms and serious permanent health consequences. Introduction Vomiting is a common presentation in the urgent care setting, especially in the pediatric population. With children, health-care providers must start with a comprehensive differential diagnosis because of the difficulty in obtaining accurate information directly from the patient. The medical history, often presented by the parent, must be carefully sorted through for clues to a …

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Nonhealing Wounds, Part 1: Diagnosis in the Urgent Care Center

Nonhealing Wounds, Part 1: Diagnosis in the Urgent Care Center

Urgent message: Nonhealing wounds not only are prevalent but also are complex in terms of wound management and treating the accompanying comorbid disease. By both recognizing the diagnosis and understanding how to treat these wounds, urgent care providers have the opportunity to differentiate life-threatening illness from lifeinhibiting disease and improve outcomes for patients. An estimated 6 million people in the United States have a nonhealing wound, with a 1% lifetime incidence for the total population.1,2 This number is expected to increase with the …

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Finger Pain After Jamming During a Basketball Game

A 19-year-old college student presents to an urgent care center with pain at the distal interphalangeal (DIP) joint of the middle finger of his right hand. He reports that the pain started suddenly the previous evening when the finger was jammed while he was playing basketball. The pain is worse through the range of motion, but there is no numbness and no pain at the proximal interphalangeal (PIP) joint.

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Abstracts in Urgent Care – May 2016

SEAN M. McNEELEY, MD Results Unavailable for 71% of Trials Key point: Many research findings are not easily available to clinicians. Citation: Chen Ruijun, Desai NR, Ross JS, et al. Publication and reporting of clinical trial results: cross sectional analyis across academic medical centers BMJ. 2016;352:i637. Researchers investigated the amount of clinical trial findings at academic medical centers that are not published and thus not easily available to clinicians. In a cross-sectional analysis of academic …

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Pelvic Pain, Dysuria, and Back Pain in an Adolescent Female

Pelvic Pain, Dysuria, and Back Pain in an Adolescent Female

Urgent message: Adolescent patients present to urgent care facilities with unique needs and diagnoses. It is imperative that those who care for them be familiar with some of these diagnoses and keep in mind the importance of obtaining a full and accurate medical history and performing a thorough physical examination. Introduction Adolescent patients can represent unique challenges for health-care providers. In caring for them, providers must work from a broad differential, including diagnoses common to …

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Diverticulitis in the Urgent Care Setting

Diverticulitis in the Urgent Care Setting

Urgent message: Abdominal pain due to acute diverticulitis is commonlyseen in the urgent care setting. This is a clinical update on the management and treatment of acute diverticulitis. Abdominal pain commonly presents in the ambulatory setting, in anywhere from 1.5% to 8% of patients.1,2 With diverticulitis being a common diagnosis in the presence of abdominal pain, the clinical challenge in a nurgent care setting is determining uncomplicated from complicated diverticulitis. Diverticulosis French pathologist Jean Cruveilhier …

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The Secret of Success: Caring Is Believing

Dr. James Gore, an old friend and an urgent care pioneer, shared those words of wisdom with me during a recent conversation. We were discussing the current state of health care and the challenges we face in urgent care with the rabid market activity we are seeing. We chatted a bit about the new faces and the outside interests entering the industry, and we laughed about all the mistakes being made by people looking for …

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Time for Urgent Care to Grow Up

I never thought I’d quote the rap artist Kamari aka Lyrikal, but I was drawn to his words of wisdom while preparing for this column: “The hardest part about growing up is letting go of what you were used to, and moving on with something you’re not.” As the “children” of urgent care, we have seen an adventurous and revolutionary spirit create an industry and discipline from scratch. We cared about things our “parents” dismissed …

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The Future Without Flu: Will Public Health Gains Cause Business Ills?

It’s well known that the retail industry has a nasty habit of overreliance on the holiday season to buffer slower sales throughout the year. When the economy is strong, retail sales typically follow, and investors are happy. When the economy falters or when brick-and-mortar retail is disrupted by lowercost, more-convenient alternatives, investors feel a bit under the weather. Similarly, the urgent care dilemma has always been a relative dependence on flu season to account for …

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