Journal of Urgent Care Medicine

Brief Report: A Pilot Quality and Feasibility Project Focusing on Clinician Use of an Order Set for Acute Asthma Care in Pediatric Urgent Care Centers

Urgent Message: There are limited data on implementation and use of clinical decision support tools for the evidence-based management of asthma in pediatric urgent care settings. In this pilot project, providing reports and feedback to clinicians on their use of order sets increased utilization of order sets but not adherence to best practice guidelines for asthma care. Richmond Darko, MD, MPH; Andrea Aguilera, MD; Gabriela Lins, DO; Maria Ramon-Coton, MD Citation: Darko R, Aguilera A, …

Midafternoon May Be the Optimal Time For Asthma Inhaler Use

For adults with mild to moderate asthma, a dose of inhaled beclomethasone dipropionate (BDP) taken in the afternoon suppressed the worsening of nighttime lung function better than other dosing regimens, a small crossover trial published in Thorax showed. A single 400 µg dose between 3PM and 4PM improved nighttime forced expiratory volume compared to baseline in a 28-day study of 25 participants, which included a washout period. However, when the same dose was given between 8AM …

Asthma Patients May Need Fluticasone Alternatives

Earlier this year, drugmaker GSK stopped making the asthma inhaler Flovent (fluticasone)—which was available as a metered-dose inhaler (Flovent HFA) and a dry powder inhaler (Flovent Diskus). Instead, the company opted to produce its own authorized generic version of fluticasone. However, with the manufacturing change, patients are experiencing insurance barriers and delays in getting their prescriptions filled, according to NPR. It’s especially concerning for children under age 5 who may not have many asthma inhaler …

Abstracts in Urgent Care – September 2022

Vapocoolant and Digital Nerve Blocks Dosing Dexamethasone in Pediatric Asthma Infant Clean-Catch Urine Contamination Antibiotic-Associated Diarrhea in Children Treating Acute Diverticulitis Torus Wrist Fractures in Children Efficacy of Antiviral Treatment in COVID-19 Vapocoolant for Pain Reduction in Digital Nerve Blocks Take-home point: Application of vapocoolant prior to digital nerve blocking can reduce pain associated with skin puncture and local anesthetic infiltration. Citation: Selvi F, Bedel C, Akçimen M. Evaluation of vapocoolant spray effect on pain …

Abstracts in Urgent Care – March 2022

When Handlebar Meets Abdomen Corticosteroids and Asthma Antibiotics in Pediatric PAC Surfactant Use in AOM COVID Pneumonia and Disease Progression Neutralizing Antibodies in COVID Pediatric Abdominal Injuries from Handlebars Take-home point: Handlebar impact is a high-risk mechanism for serious intraabdominal injury in children and necessity of operative intervention is common. Citation: Vanderwalle R, Barker S, Raymond J, et. al. Pediatric handlebar injuries: more than meets the abdomen. Pediatr Emerg Care. 2021;37(9):e517-e523. Relevance: It is important …

Is Your Patient Allergic to Ragweed, or Weed?

Spring has officially arrived, and with the snow continuing to melt it won’t be long before seasonal allergens are in full bloom. Urgent care physicians are reminded, however, that symptoms of allergic reactions to pollen and ragweed can be identical to those seen in patients who are allergic to cannabis, ranging from mild sinusitis to acute exacerbations of asthma. Since allergy panels don’t typically test for reaction to marijuana, the only way to get a …

Asthma Presentation? Be Wary of Abdominal Aneurysm Rupture

A new study found a significant link between asthma, the use of bronchodilators, and rupture of abdominal aneurysms (AAA). The news underscores the importance of getting a thorough medical and medication history for patients presenting to urgent care with asthma-like symptoms. Researchers noted that asthma patients over age 50, in particular, appear to have an increased risk for AAA and sudden death from its rupture, with the risk going up with recent asthma activity. Further, …

Abstracts in Urgent Care: March, 2014

Reconsidering antibiotics for COPD exacerbation Key point: Prescribing antibiotics to patients with mild-to-moderate COPD exacerbations who have no change in sputum probably is unnecessary. Citation: Miravitlles M, Moragas A, Hernandez S, et al. Is it possible to identify exacerbations of mild to moderate COPD that do not require antibiotic treatment? Chest. 2013;144(5): 1571-1577. The decision to prescribe antibiotics to patients with moderate to mild-to-moderate chronic obstructive pulmonary disease (COPD) exacerbations is usually based on increased …

Assessment and Management of Asthma Exacerbation in Urgent Care: Part 1

Urgent message: Asthma is increasing in prevalence and so, too, presentations of asthma in ambulatory settings. Urgent care providers have an important role to play in identifying and treating acute asthma exacerbations, including providing a written asthma action plan at discharge to improve long-term outcome. BRADLEY M. TURNER MD, MPH, MHA, FCAP, FASCP and JANET M. WILLIAMS, MD, FACEP Patients often seek assistance in urgent care centers for acute presentations of asthma. This provides unique …

June 2010

« Previous