Journal of Urgent Care Medicine

Preparing for Pandemic Influenza in the Urgent Care Setting

Urgent message: Between the current – and still growing – volume of H1N1 flu cases and fast-approaching influenza season, the urgent care physician will be challenged to distinguish among a variety of common cold and influenza-like conditions. Gary Klein, MD, MPH, MBA, CHS-V, FAADM Introduction The mainstream media have certainly accomplished the mission of alerting the public to the dangers of H1N1 flu – perhaps to the point that many are tempted to dismiss their …

Keeping an Eye on the H5N1 Virus

The H5N1 avian flu virus is spreading in dairy cows across the country, however, the risk of human-to-human transmission is rare. Because the virus is spreading so rapidly, scientists are considering wastewater sampling for surveillance, according to CIDRAP. Baylor College of Medicine and the University of Texas Health Sciences Center researchers reported 19 of 23 monitored wastewater sites had at least 1 result of H5N1 detected in wastewater from March 4 to April 25. It’s …

Influence of Clinical Setting on Antibiotic Prescribing Practices for Acute Otitis Media in Children at an Urban Academic Medical Center

Urgent Message: This retrospective chart review study found that the odds of children receiving an antibiotic prescription for acute otitis media in urgent care and the emergency department were significantly higher compared to a primary care setting. Further research is needed to better understand factors contributing to higher antibiotic prescribing rates in acute care settings. Angelica M. Mangahas, BS; Heather M. Weinreich, MD, MPH; Johanna Wickemeyer, MD; Margaret Schmit MD; Rakhi Thambi, MD, MBA Citation: …

Flu Season Winds Down With Lower Than Average Visits in Early April

Outpatient visits for flu like illness are on a steady decline in the United States, indicating reduced activity of respiratory viruses including flu, COVID, and respiratory syncytial virus. The Centers for Disease Control and Prevention (CDC) reports the first week of April showed that visits for respiratory illness with fever plus a cough or sore throat fell to 2.8%, just below the national baseline of 2.9%. Positive labs for flu were down 7.7% since the …

Rapid Viral Tests Best When They Inform Treatment Decisions

A recent review suggests that the routine application of rapid respiratory viral tests in emergency departments (EDs) offers limited benefits for antimicrobial stewardship. Presented in JAMA Internal Medicine, the review examined 11 randomized clinical trials involving patients with acute respiratory infections (ARIs) seeking care in EDs. It revealed that while rapid viral testing led to increased usage of influenza antivirals among positive cases (absolute risk difference 1%), it did not significantly impact overall antibiotic use, …

Abstracts in Urgent Care – March 2024

Omicron versus Flu & RSV – Which is Most Dangerous for Children? Take Home Point: In this study, hospitalization rates were highest for patients with RSV than Omicron (COVID-19) in all age groups of children. Citation: Hedberg P, Abdel-Halem L, Valik J, et. al. Outcomes of Pediatric SARS-CoV-2 Omicron Infection vs Influenza and Respiratory Syncytial Virus Infections. JAMA Pediatr. 2023 Dec 26: e235734. doi: 10.1001/jamapediatrics.2023.5734 Relevance: With increasing availability for respiratory pathogen testing, it is …

Nine Recurring Coding Pitfalls for Urgent Care Clinicians to Avoid

Brad Laymon, PA, CPC, CEMC Over my career as a physician assistant, I have delved extensively into the intricacies of medical coding guidelines. Through collaborative initiatives with healthcare systems and fellow clinicians, I have been able to identify 9 common, recurring coding pitfalls. This process came with significant time and experience, and I want to share what I’ve learned as my ultimate objective has always been advancing charting accuracy to instill confidence among providers in …

Flu Can Increase Risk of Heart Attack and Stroke in Older Patients

The risk of atherothrombotic events in patients aged 50 and older care more than double in the 14 days following an influenza diagnosis, according to research presented in The Journal of Infectious Diseases. For those with severe cases, the risk of acute myocardial infarction and ischemic stroke increased more than 4-fold and remained high for 2 months following the flu event. Authors examined the link between influenza illness diagnosed in the primary care and hospital settings …

Incomplete Kawasaki Disease Clinically Diagnosed From Urgent Care: A Case-Report-Based Review

Urgent Message: The accurate and prompt diagnosis of Kawasaki disease depends on clinicians’ familiarity with the diagnostic criteria and ability to recognize the waxing and waning manifestations of this pediatric condition. Dominic K. Hardatt, DMSc, PA-C Citation: Hardatt DK. Incomplete Kawasaki Disease Clinically Diagnosed from Urgent Care: A Case Report Based Review. J Urgent Care Med. 2024;18(5);34-39. Keywords: Kawasaki disease, mucocutaneous lymph node syndrome, incomplete Kawasaki disease, febrile illness, fever, polymorphous rash, pediatric, coronary artery …

Antiviral Use Higher Than Years Past

Flu season continues, and providers in several US markets are seeing surges in respiratory-virus-related visits. Meanwhile, new data also shows a year-over-year increase in antiviral prescriptions to treat influenza, according to a news report in Fierce Healthcare, leveraging data from Evernorth Research Institute (a Cigna subsidiary). Analyzing pharmacy claims for 32 million people, researchers noted an uptick in antiviral prescriptions in the weeks following Thanksgiving 2023 when compared to a similar time period during past …