A Legal Quandary: Poor Care…or Malpractice?

A Legal Quandary: Poor Care…or Malpractice?

Urgent message: Failure to consider subtleties and the context in which a patient presents can lead to insufficient differential diagnoses and, therefore, mis- or missed diagnoses that leave the patient at risk for poor outcomes and the provider at risk for litigation. Michael Weinstock, MD and Charles Pilcher, MD Back pain is usually back pain, whether it’s from a muscular strain or another self-limiting, non-serious cause. But there is potential danger lurking below the surface, …

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Abstracts in Urgent Care – December 2021

Abstracts in Urgent Care – December 2021

The Importance (or Not) of High BP Readings Learning While Driving—Does It Work? Considering Sucralfate in Pediatric Oral Ulcers Osteopathic Manipulation for Low Back Pain Safety of Oral Corticosteroid Bursts in Children Nathan M Finnerty, MD FACEP and Brett C Ebeling, MD Do High Blood Pressure Readings Matter? Take-home Point: Elevated blood pressure readings in the emergency room were not associated with an increased risk of poor cardiovascular outcomes in 2 years.  Citation: McAlister F, …

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Abstracts in Urgent Care – September 2021

Abstracts in Urgent Care – September 2021

Cooling Pain from Digital Nerve Blocks Safety of Corticosteroids in Children Predicting the Course of Pediatric CAP Is Tranexamic Acid Helpful for Epistaxis? Drug Therapy for Sciatica Imaging May Not Correlate with Lumbar Pain COVID-19 Vaccination in Lactating Patients Applying Ice Reduces Pain from Digital Nerve Blocks Take-home point: Use of an ice pack applied prior to the administration of a digital nerve block reduces pain from local anesthetic injection Citation: Rasooli F, Sotoodehnia M, …

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Lumbar Hernia: An Unusual Cause of Back Pain

Lumbar Hernia: An Unusual Cause of Back Pain

Urgent message: Back pain is a common complaint in the urgent care setting. Common causes of musculoskeletal back pain include overuse and work-related injury. Other causes can include disc herniation, metastasis, osteoporosis, arthritis, spinal stenosis, and nephrolithiasis. Crystal N. Bharat MD, Ronald Dvorkin, MD, and Glenn G. Gray MD Case Presentation A 65-year-old female complained of 1 day of low back pain radiating to her left flank, which was aggravated with movement. Symptoms began while …

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‘Take Two Aspirin and Call Me in the Morning’ Doesn’t Cut It for Back Pain

‘Take Two Aspirin and Call Me in the Morning’ Doesn’t Cut It for Back Pain

There’s no shortage of patients reporting to urgent care centers with back pain being their chief complaint. A new study published in Annals of the Rheumatic Diseases confirms they’re not likely to get satisfactory relief from nonsteroidal anti-inflammatory drugs (NSAIDs), though. Machado, et al looked at 35 randomized, placebo-controlled trials that compared the efficacy and safety of NSAIDs with placebo for spinal pain. They found that treatment effects met the threshold for clinical importance in …

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Back-to-School Shouldn’t Mean Back Pain

Back-to-School Shouldn’t Mean Back Pain

If parents bring in young children complaining of acute back pain, try taking a history that might be just a little more detailed than usual before ordering expensive images or referring. Actually, focusing on one specific question might reveal the answer: Did the onset of pain coincide with the start of the school year? If the answer is “yes,” ask for a detailed list of what goes into the child’s backpack every morning, and how …

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Pelvic Pain, Dysuria, and Back Pain in an Adolescent Female

Pelvic Pain, Dysuria, and Back Pain in an Adolescent Female

Urgent message: Adolescent patients present to urgent care facilities with unique needs and diagnoses. It is imperative that those who care for them be familiar with some of these diagnoses and keep in mind the importance of obtaining a full and accurate medical history and performing a thorough physical examination. Introduction Adolescent patients can represent unique challenges for health-care providers. In caring for them, providers must work from a broad differential, including diagnoses common to …

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Serious Pathology Masquerading as Chronic Back Pain

Serious Pathology Masquerading as Chronic Back Pain

Urgent message: Do not be fooled by the diagnosis made by clinicians before you. Many seemingly benign symptoms can be harbingers of more serious pathology. JESSICA HOFFMANN, MS-4, and JOHN SHUFELDT, MD, JD, MBA, FACEP Chronic back pain is a common presentation in both the urgent care and emergency department (ED) settings. Care-on-demand providers often find themselves deciding how extensive a workup to do for a patient with acute-on-chronic back pain. After a patient has …

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