Long-term survival following pneumococcal pneumonia Key point: Pneumococcal pneumonia foretold considerably higher 10-year mortality than the expected rate. Citation: Sandvall B, Rueda AM, Musher DM. Long-term sur- vival following pneumococcal pneumonia. Clin Infect Dis. 2013;56(8):1145-1146. Before antibiotics, pneumonia was called “the old man’s friend” for carrying the old and infirm to a swift and relatively painless death. Now that short-term survival after pneumonia is the rule, does the disease provide any long-term prognostic information? Veterans …
Read More
Erythema Infectiosum
Urgent message: Rashes are common in urgent care and taking a careful patient history is important for proper diagnosis of the underlying cause. ICHHA SETHI, MB,BS, JASKARAN S. SETHI, MB,BS, MIKAYLA SPANGLER, Pharm D, BCPS, and SHAILENDRA SAXENA, MD, PhD Introduction Physicians in both primary care and urgent care clinics encounter facial rash quite frequently. Given the high prevalence and variable number of etiologies, it is important to diagnose these patients appropriately so that they …
Read More
Urgent Care Management of Needlestick Injuries: Part 2
Urgent message: Response to a needlestick with potential for HIV exposure requires understanding of both state laws on HIV testing and the latest USPSTF guidelines for post-exposure management. MAYA HECK, MS-2 and JOHN SHUFELDT, MD, JD, MBA, FACEPTwo police officers arrive at your urgent care site with a handcuffed, bloodied prisoner. One officer tells you that the person in custody “spit on me” during the altercation. The officer goes on to tell you that the …
Read MoreThe Urgent Care Foundation: Building a Stronger Specialty
Lee A. Resnick, MD, FAAFP The discipline of urgent care medicine remains in its developmental infancy. While the strong consumer-driven market lurching toward efficient and cost-effective health care delivery systems has supported astounding industry growth, our discipline continues to struggle to define itself. Like all new specialties, urgent care medicine has, in fits and starts, made efforts to evolve an identity, but despite early gains, it’s been an up and down effort. Most every urgent …
Read More
Urgent Care Management of Needlestick Injuries: Part 1
Urgent message: Needlestick injuries are common and require a prompt response based on an understanding of the latest USPHS guidelines and informed consent and counseling of the patient. MAYA HECK, MS-2 and JOHN SHUFELDT, MD, JD, MBA, FACEP Your center is fortunate to contract with a variety of different business to provide employee health services. A local homeless shelter is one of the clients to whom your center provides new hire physicals, drug screens and …
Read MoreClinical Challenge: November, 2013
Abstracts in Urgent Care: November, 2013
Long-term Survival Following Pneumococcal Pneumonia Key point: Pneumococcal pneumonia foretold considerably higher 10-year mortality than the expected rate. Citation: Sandvall B, Rueda AM, Musher DM. Long-term survival following pneumococcal pneumonia. Clin Infect Dis. 2013;56(8):1145-1146. Before antibiotics, pneumonia was called “the old man’s friend” for carrying the old and infirm to a swift and relatively painless death. Now that short-term survival after pneumonia is the rule, does the disease provide any long-term prognostic information? Veterans Administration …
Read More
Schamberg’s Disease
Urgent message: No definitive treatment is available for this condition but diagnosis is important to reassure patients and avoid unnecessary care. SHAILENDRA K. SAXENA, MD, PHD, MIKAYLA SPANGLER, PHARMD, BCPS, and ARCHANA MIKKILINENI, MD Rashes are a common reason for patients to present to the urgent care clinic. Many require treatment but some do not. Schamberg’s disease is one such rash. Case Presentation A 42-year-old male presented to our clinic with a chief complaint of …
Read MoreUrgent Care Under Fire: Is This a Trend?
Lee A. Resnick, MD, FAAFP Well-meaning or not, government regulation of health care is always cause for concern among practicing physicians. No other profession is exposed to the layers of oversight that physicians endure—from OSHA to HIPAA, from Stark to Anti-kickback laws, the OIG and Medicare, just to name a few. Individual health care bills pile on to create a practice environment so mired in regulation that it would paralyze health care delivery to adequately …
Read More
Using Tissue Adhesives in Urgent Care
Urgent message: Tissue adhesives are quick, painless, and result in a good cosmetic outcome, making them well-suited for use to treat wounds in urgent care. SIMON TANKSLEY, M.D. Introduction Tissue adhesives are ideal for closing simple lacerations, especially on the face of children.1-3 Such repairs are quick, painless, and do not require removal of sutures. They are also excellent for treating large skin tears in the elderly (Figure 1) and particularly useful for thin, fragile …
Read More