Practice Management
Anticipated updates for asthma treatment guidelines are shifting away from oral or systemic corticosteroids because of increasing evidence of long-term harm. Negative effects can come from even short, intermittent use, according to coverage in MedPage Today of the American College of Allergy, Asthma and Immunology meeting. Studies show that as few as 3 or 4 steroid bursts over a lifetime may lead to side effects such as bone loss, metabolic disorders, and adrenal suppression. The …
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A 5-year study that was presented this month at the annual scientific meeting of the American College of Allergy, Asthma and Immunology finds that thunderstorms can trigger measurable increases in asthma-related emergency department (ED) visits. Researchers analyzed 4,439 asthma-related visits across 3 hospitals in Kansas from January 2020 to December 2024, during which time, they identified 38 thunderstorm days. Data showed the mean number of admissions on storm days (17.91) was significantly higher than on …
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Urgent Message: While patients with asthma will frequently experience exacerbations following viral respiratory infections, the urgent care clinician must be cautious when assuming dyspnea is due to asthma. As dyspnea can be caused by a wide variety of conditions, it is important to maintain a broad differential diagnoses, even in patients with underlying asthma. Tracey Quail Davidoff, MD, FCUCM Key words: Influenza, Dyspnea, Asthma, Congestive Heart Failure, Myocarditis, Diagnosis Momentum Abstract Introduction: Patients commonly present …
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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, …
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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 …
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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 …
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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 …
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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 …
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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 …
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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, …
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