Case A 29-year-old woman presents to an urgent care center after a fall from the roof of her house, where she was cleaning the gutters. She reports that her right heel began hurting intensely immediately after the fall and that the pain worsened in the time it took for a family member to get her to the center. She cannot bear weight on her right leg. She mentions that she is a runner who often takes part in …
Read MoreAbstracts in Urgent Care – October 2016
Watching for the Female Athlete Triad Key point: Understanding the female athlete triad is the best way to identify it. Citation: Weiss Kelly AK, Hecht S; Council on Sports Medicine and Fitness. The female athlete triad. Pediatrics. 2016;138:e20160922. The female athlete triad continues to be better understood over time. As more females participate at higher levels of competition this disorder must be considered. The report’s authors note that the triad of amenorrhea, osteoporosis, and disordered …
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Original Research: Early Diabetes Screening in the Urgent Care, Part 2
Urgent message: Various methods have been suggested for screening for type 2 diabetes mellitus in the asymptomatic population, although more consensus about the best approach, especially in settings outside primary care, is required. The usefulness of a diabetes-screening pathway for the early detection of undiagnosed diabetes was assessed in a quality-improvement study of a convenience sample from an urgent care center. How this article/column helps you: by analyzing findings on how screening all adults for …
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A 16-Week-Old Infant with Bloody Vomitus
In Bouncebacks, 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 case is from the book Bouncebacks! Pediatrics, by Michael B. Weinstock, Kevin M. Klauer, Madeline Matar Joseph, and Gregory L. Henry, and is available at www.anadem.com and www.amazon.com. Introduction A 16-week-old infant was brought by her parents to the emergency department (ED) of a children’s hospital. Note: The following is the actual documentation by the provider. Visit …
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Abdominopelvic Pain, Part 2: Approach to Women in the Urgent Care Setting
Urgent message: Diagnosis of abdominal pain is more complex in women than in men because of the more complex anatomy involved. Using a stepwise approach and involving patients in their care can make a difference. Introduction Part 1 of this article, “Abdominopelvic Pain, Part 1: Approach to Men in the Urgent Care Setting,” explained that finding the cause of abdominopelvic pain can be a difficult task for any health-care provider because the diagnostic process is riddled with important …
Read MoreIntroducing JUCM CME
With this October issue, the editorial staff is very pleased to introduce JUCM CME, a convenient and cost-effective way to meet your annual continuing medical education (CME) requirements while reading the only peer-reviewed journal about urgent care. For over 10 years JUCM, the Journal of Urgent Care Medicine, has been a reliable source for the latest and most relevant clinical and practice-management guidance in the industry. Our cover-to-cover readership regularly exceeds the benchmarks for other …
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Ankle Injury Sustained During a Step Off a Curb
A 56-year-old woman with a past medical history of hypertension presents to an urgent care center 1 hour after she injured her ankle while stepping off a curb. She believes that the ankle “twisted inward” but is not sure. She reports sharp, severe, constant pain throughout the joint and that worsens when she attempts to move the ankle through the range of motion. There is no numbness of the foot or ankle, no pain at …
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Severe Hip Pain After a Motor Vehicle Accident
A 62-year-old woman presents to an urgent care center with severe left hip pain that began several hours earlier after a motor vehicle accident. She was the driver, and she was wearing a seat belt. Her car’s driver-side air bag deployed when her car, moving at about 35 miles per hour, rear-ended a stopped car. She refused to be transported from the accident scene by emergency medical services for treatment because her only issue was …
Read MoreThere Ain’t No Shame in Pain
After years of lax oversight and insufficient skepticism from physicians, the United States is in an undeniable opioid epidemic, triggering seismic reforms and a regulatory frenzy. The scope of the problem is indeed staggering: Every 18 minutes, someone dies of opioid overdose, and half of those deaths involve prescription pills. Oversupply and ease of access have been identified as the main culprits, and much of the prevention strategy revolves around physician prescribing. New guidelines have …
Read MoreTen-Day Dry Cough in a 36-Year-Old Man
Case A 36-year-old man presents to an urgent care center with a dry cough that he has had for the preceding 10 days. He has mild dyspnea. He has no rhinorrhea, fever, chest pain, blood in the urine or stool, or lower-extremity pain or swelling. He has no history of previous illnesses. He smokes cigarettes, occasionally drinks alcohol, and has a remote history of intravenous drug use. View the image taken (Figure 1) and consider …
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