Practice Management
Efforts to reduce access to opioid medications for acute pain have varied greatly from state to state, in spite of President Trump’s declaration that related addiction and deaths constitute a public health emergency. Now, a bipartisan bill just introduced in Congress would impose a national policy if it passes, restricting prescriptions for opioids for acute pain to 3 days (ample for the urgent care setting). Significantly, the bill would also authorize adding $1 billion to …
Read More
Ohio is placing new limits on the prescribing of opioid medications for acute pain, forbidding clinicians from writing more than a 7-day supply for adults, or a 5-day supply for minors (down from up to 90 days, currently). Prescribers will be allowed to override the acute pain limit if they identify a specific reason in their patients’ medical records, though this is not likely to apply in the urgent care setting. Further, the limits do …
Read More
Urgent message: Urgent care providers have a clinical, legal, and moral obligation to provide appropriate treatment for patients with pain. The first article in a two-part series addresses strategies for managing acute pain. TRACEY Q. DAVIDOFF, MD The interpretation of pain by patients is very subjective and not easily measured. That makes management of pain in the urgent care setting difficult. Current pain scales are often inaccurate or not truly reflective of a patient’s real …
Read MoreThe patient is an otherwise healthy child, age 11, who presents with acute pain to the wrist following a blow. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreThe patient is an otherwise healthy child, 3.5 years of age, who presents with acute pain in his right lower arm to the elbow. Examination reveals multiple fractures. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreA 57-Year-Old Woman with Acute Pain After a Fall The aptient is a 57-year-old woman who presented to urgent care complaining of severe pain in her right foot, leg, hip, and elbow. She reported that she fell three to four hours prior to presentation while outside walking her dog; she was “tripped up” in the pet’s leash. She presented ambulatory, but was unable to bear any weight on her right leg. Past medical history …
Read More
Urgent message: Urgent care practitioners are called upon daily to alleviate pain. A thorough understanding of the various pain syndromes and the pharmacology and analgesic potencies of various medications will aid in their safe and appropriate use. Marc R. Salzberg, MD, FACEP and Paolo T. Coppola, MD, FACEP Pain, either chronic or acute, is the main reason patients seek medical care. In this article, we will discuss acute pain management in an urgent care setting, …
Read More