Journal of Urgent Care Medicine

Development and Implementation of a Headache and Migraine Pathway in Pediatric Urgent Care: A Quality Improvement Initiative

Urgent Message: There are an estimated 250,000 visits annually associated with pediatric headaches in the United States, 84% of which are not treated according to best evidence-based practice (EBP). The development of an EBP headache and migraine pathway in a pediatric urgent care improved access to evidence-based guidelines and increased clinician confidence and knowledge regarding the diagnosis and management of headaches in children. Sarah J. Nembu, DNP, APRN, FNP-C, CPNP-AC; Melissa R. Penkalski, DNP, APRN, …

Recognition and Management of Achenbach Syndrome (Paroxysmal Finger Hematoma)

Urgent Message: By understanding the symptoms of paroxysmal finger hematoma, clinicians can reduce patient anxiety and decrease unnecessary testing, as the condition is generally mild and has a favorable prognosis. Citation: Sanz Martinez E, Kranichfeld WH, Ceballos Y. Achenbach Syndrome: Diagnosis of Paroxysmal Finger Hematoma. J Urgent Care Med. 2024; 19(1): 25-29 Introduction Paroxysmal finger hematoma (PFH), also known as Achenbach syndrome, is a vascular disorder of unknown etiology characterized by subcutaneous bleeding in the …

Emesis Ad Nauseum: A Case Report of Cannabinoid Hyperemesis Syndrome in Urgent Care

Urgent message: Frequent cannabis use can lead to a syndrome characterized by severe and cyclical vomiting without other clear triggers. Termed “cannabinoid hyperemesis syndrome,” this disorder is often refractory to conventional antiemetic pharmacotherapy. Citation: Ramos J, Russell J. Emesis Ad Nauseum: A Case Report of Cannabinoid Hyperemesis Syndrome in Urgent Care. J Urgent Care Med. 2024; 18 (11): 13-18 John Ramos, MMS, PA-C, CAQ-EM, Joshua Russell, MD, MSc, ELS, FACEP, FCUCM Abstract Introduction: Cannabinoid hyperemesis …

Abstracts in Urgent Care – September 2024

Can Large Language Models Help in Assessing Acuity of Patients Presenting to ED? Take Home Point: Integration of large language models (LLMs) in the emergency department (ED) could enhance triage processes. This warrants further investigation particularly in the urgent care (UC) space. Citation: Williams C, Zack T, Miao B, et. al. Use of a Large Language Model to Assess Clinical Acuity of Adults in the Emergency Department. JAMA Netw Open. 2024 May 1;7(5): e248895. doi: …

Major Adverse Cardiovascular Events in Patients with Chest Pain And Moderate Heart Risk Scores Who Were Referred For An Expedited Outpatient Cardiology Evaluation: A Multi-Center Descriptive Study

Urgent Message: Patients with a moderate-risk HEART score referred from an urgent care center for an expedited outpatient cardiology evaluation were found to have a very low rate of MACE and no occurrence of ischemic cardiac deaths. Citation: Thomson N, Barbarash S, Lebron-Gallagher D, Julson H, Weinstock M. Major Adverse Cardiovascular Events in Patients with Chest Pain And Moderate Heart Risk Scores Who Were Referred For An Expedited Outpatient Cardiology Evaluation: A Multi-Center Descriptive Study. …

Urgent Care Recognition and Management of Maisonneuve Fractures

Urgent Message: Clinicians should inquire about the mechanism of injury when a patient presents with ankle pain and consider x-ray that includes the ankle, tibia, and fibula to evaluate for the possibility of Maisonneuve fracture, especially when pain in the inferiolateral knee is also present. Willie O’Neal, MD; Bradley Strauch, MD Citation: O’Neal W, Strauch B. Urgent Care Recognition and Management of Maisonneuve Fractures. J Urgent Care Med. 2024; 18 (11): 21-28 Editor’s Note: While …

47-Year-Old With Right Hand Pain

A 47-year-old man presents to urgent care after trying out a new cardio boxing class at the local recreation center. He indicates that his right hand has been hurting ever since he hit a punching bag this morning, and the pain has been getting worse. X-rays are ordered, both anterior posterior (AP) and oblique views. Review the images and consider what your diagnosis and next steps would be. Resolution of the case is described on …

52-Year-Old With Palpitations

A 52-year-old male presents to urgent care complaining of palpitations. An ECG is obtained. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Progressive Diaphyseal Dysplasia: A Case Report

Urgent Message: Progressive diaphyseal dysplasia, also known as Camurati-Engelmann disease, is a rare genetic disease that predominantly affects the bones. Clinicians who understand the manifestations of this disorder are better equipped to ensure appropriate management of disease flares and coordinate specialist follow-up. Swetha Gogu, DO, MPH; Sudhir Gogu, DO, PhD, MBA Citation: Gogu S, Gogu S. Progressive Diaphyseal Dysplasia: A Case Report. J Urgent Care Med. 2024; 18 (11): 34-37 Abstract Introduction: Camurati-Engelmann disease (CED), …

64-Year-Old With Facial Lesion

A 64-year-old man presents to urgent care with a lesion on his face for the last 2 months. On examination, a shiny, eroded, blue-black nodule was seen on his right cheek. He is a postal worker. Histopathology examination showed aggregates of melanin and melanocytes within sheets of basaloid keratinocytes with peripheral palisading and surrounding clefts within a fibromyxoid stroma containing melanophages. View the image above and consider what your diagnosis and next steps would be. …

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