THE CASE The patient, a 6-year-old girl, presented with a fever and cough. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreAbstracts in Urgent Care: March, 2014
Reconsidering antibiotics for COPD exacerbation Key point: Prescribing antibiotics to patients with mild-to-moderate COPD exacerbations who have no change in sputum probably is unnecessary. Citation: Miravitlles M, Moragas A, Hernandez S, et al. Is it possible to identify exacerbations of mild to moderate COPD that do not require antibiotic treatment? Chest. 2013;144(5): 1571-1577. The decision to prescribe antibiotics to patients with moderate to mild-to-moderate chronic obstructive pulmonary disease (COPD) exacerbations is usually based on increased …
Read MoreClinical Challenge – March 2014
THE CASE The patient, a 67-year-old man, presented after a blow to his left shoulder. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreMOC…Part Duhhh!
Lee A. Resnick, MD, FAAFP I first wrote about the disaster that is Maintenance of Certification (MOC) in June 2012. As a refresher, MOC was adopted by all 24 American Board of Medical Specialties (ABMS) member boards in 2006. The move was promoted under the guise of a commitment to quality care and best practices. Despite no clear evidence that MOC works to achieve these goals, the requirements were adopted without debate. That’s right, the …
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Side Effects of New Weight Loss Medications
Urgent message: With the epidemic of obesity and recent FDA-approval of weight loss drugs, urgent care providers should be on alert for patient presentations related to side effects of these agents. Introduction An estimated 154.7 million Americans over the age of 20 are currently overweight or obese. These Americans are at increased risk of disease, including diabetes mellitus, cardiovascular disease, end-stage renal disease and cancer. If current trends remain unchanged, an estimated $861 to $957 …
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Assessment and Management of Asthma Exacerbation in Urgent Care: Part 1
Urgent message: Asthma is increasing in prevalence and so, too, presentations of asthma in ambulatory settings. Urgent care providers have an important role to play in identifying and treating acute asthma exacerbations, including providing a written asthma action plan at discharge to improve long-term outcome. BRADLEY M. TURNER MD, MPH, MHA, FCAP, FASCP and JANET M. WILLIAMS, MD, FACEP Patients often seek assistance in urgent care centers for acute presentations of asthma. This provides unique …
Read MoreClinical Challenge 2: January, 2014
THE CASE This x-ray was taken on a 29-year-old man with a blow to his left elbow. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreAbstracts in Urgent Care: February, 2014
Pyuria Poor Predictor of UTI in Nephrolithiasis Key point: Classic symptoms and urine culture are the best indicators of infection in patients with acute nephrolithiasis. Pyuria proved a poor predictor. Citation: Abrahamian FM, Krishnadasan A, Mower WR, Moran GJ, Talan DA. Association of pyuria and clinical characteristics with the presence of urinary tract infection among patients with acute nephrolithiasis. Ann Emerg Med 2013;62(5):526-533. Infection can complicate the diagnosis of acute nephrolithiasis. Patients with both a …
Read MoreClinical Challenge: February, 2014
THE CASE The patient, a 47-year-old woman, twisted her left ankle while playing badminton 24 hours ago and was unable to bear weight on the left foot since then. Examination revealed moderate swelling of the lateral malleolus, no bruise, marked tenderness, slight ankle supination, inversion and adduction. View the image taken (Figure 1) and consider what your diagnosis would be.
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Sacral Tumor
Urgent message: Each case—and patient presentation—in urgent care must be evaluated on its own merits. Rare diagnoses are possible and “benign” back pain complaints sometimes are not. HEATHER VARLEY, PA-C, and WILLIAM GLUCKMAN, DO, MBA, FACEP Introduction Each day in the urgent care setting, we are presented with a range of various pain complaints, from headaches, to back pain, to extremity pain. These complaints may be the result of injury, overuse, infection, arthropathy, or have …
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