The patient, an 18-year-old male, presented after a fall and blow to the right trochanter. He was ambulating well. View the image taken (Figure 1) and consider what your diagnosis would be. Resolution of the case is described on the next page.
Read MoreAbstracts in Urgent Care: June, 2012
Is Oral Antibiotic Therapy Enough for Children with Acute Pyelonephritis? Key point: A randomized trial failed to prove the acceptability of oral antibiotic monotherapy relative to sequential intravenous and oral therapy, but evidence supporting and treatment alone as an option is accumulating. Citation: Bocquet N, Sergent AA, Jais JP, et al. Randomized trial of oral versus sequential IV/oral antibiotic for acute pyelonephritis in children. Pediatrics. 2012; 129(2): e269-275. Children with acute pyelonephritis typically receive intravenous …
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Drug Toxicity Following Trip to the Local Head Shop
Urgent message: Thorough work-up is mandatory for patients with mild symptoms from recent use of “bath salts” because of the potential for multi-systems failure. JOHN K. GRANDY BS, MS, RPA-C Case Presentation A 19-year-old male is brought to an urgent care clinic by his mother, who states that her son and his friends took “Molly Mosquito Caps” 2 days ago that were purchased from a local head shop. The patient and his friends all experienced …
Read MoreClinical Challenge: May, 2012
The patient, a 40-year-woman, presented with a trauma to the left wrist. View the image taken (Figure 1) and consider what your diagnosis would be. Resolution of the case is described on the next page.
Read MoreAbstracts in Urgent Care: May, 2012
ED Physicians Vary Widely in Use of Head CT Key point: ED physicians vary widely, by as much as 300% for patients who presented with atraumatic headache, in their ordering patterns for head CTs. Citation: Prevedello LM, Raja AS, Zane RD, et al. Variation in use of head computed tomography by emergency physicians. Am J Med. 2012; 125(4): 356-364. A research team led by Dr. Luciano Prevedello, a fellow at the Center for Evidence-Based Imaging …
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High-Risk Conditions Presenting as Back Pain (Part 3)
Urgent Message: Fever plus back pain should alert a provider to a potentially serious condition that warrants further workup. ERICA MARSHBURN, BS, BA, and JOHN SHUFELDT, MD, JD, MBA, FACEP Many high-risk conditions can present as back pain and back pain is a very frequent presenting complaint in urgent care medicine. When the back pain is associated with fever of unknown etiology or if it occurs in someone with a history of receiving intravenous (IV) …
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An Urgent Care Provider’s Guide to Managing Dental Emergencies
Urgent Message: Patients with tooth-related complaints increasingly are presenting to urgent care centers. Managing these cases can be a challenge because physicians often receive limited training in this area. KATHERINE HURST MSC, MD, and RICHARD E. WALTON DMD, MS Tooth or tooth-related complaints are common presenting issues in patients seen at urgent care centers because of the limited availability of dental services in the evenings and on weekends. More patients also are seeking emergency dental …
Read MoreNotes From the Convention
Lee A. Resnick, MD, FAAFP As I write this, the annual convention of the Urgent Care Association (UCA) is in full swing in Las Vegas. This year’s assembly is the largest gathering of urgent care professionals in the world … ever. With well over 700 attendees, the energy is palpable. The excitement surrounding the discipline and the industry has never been greater as more and more physicians, entrepreneurs, health systems and others clamor for a …
Read MoreClinical Challenge 2: April, 2012
The patient, a 14-year-old male, presented with a limp following trauma to his left leg. View the image taken (Figure 1) and consider what your diagnosis would be. Resolution of the case is described on the next page.
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High-Risk Conditions Presenting as Back Pain (Part 2)
Urgent message: Significant cervical spine injuries are rare in urgent care but missing one can have serious implications for patient and provider. ERICA MARSHBURN, BS, BA, and JOHN SHUFELDT, MD, JD, MBA, FACEP In this continuing series on back pain diagnostics in urgent care medicine, we urge providers to carefully consider any high-risk spinal conditions that could be presenting as simple back pain. Although many cases of back pain can be attributed to musculoligamentous injury …
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