Urgent Care Transfers: Why, When, and How

Urgent Care Transfers: Why, When, and How

Urgent message: Urgent care is well established as an appropriate destination for many patients whose symptoms are not being limb- or life-threatening. When a truly emergent case presents, however, we need to provide immediate care and assess whether the patient can receive optimal care on site or needs transfer to higher-acuity setting. Deb Rogers, DO and Douglas A. Rund, MD, FACEP, FAEMS Cowboys of medicine? We are able to diagnose and manage almost all complaints …

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Injuries to the Upper Extremity Due to Falls on Outstretched Hands (FOOSH) 

Injuries to the Upper Extremity Due to Falls on Outstretched Hands (FOOSH) 

Urgent message: It is common for patients with injuries to the upper extremity due to falls on outstretched hands to present to urgent care. As such, evaluation, appropriate imaging, and initial treatment should all be within a clinic’s capabilities.  Michael Bartuseck, MSN, ARNP, FNP-C, EP-C Introduction Urgent cares centers play an integral role in providing care for patients who have sustained injuries due to falls on outstretched hands (FOOSH). While complex anatomy of the wrist, …

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Urgent Care Evaluation of Arrhythmias

Urgent Care Evaluation of Arrhythmias

Urgent message: Initial evaluation of a patient with an arrhythmia in the urgent care setting can be as difficult as it is critical to the patient’s survival—one key concern being sudden cardiac death, which occurs in roughly 328,000 cases annually. Riaz Fabian, DO Introduction Cardiac arrhythmias are a group of conditions in which a patient has an abnormal heart rate or rhythm. They are caused by any disruption of the electrical conduction system of the …

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The Red-Hot Joint

The Red-Hot Joint

Urgent message: Septic arthritis can lead to significant morbidity if not treated in a timely manner. Bacteria within the synovial space can lead to rapid joint destruction and irreversible loss of function. When patients present to the urgent care center with a red, hot, swollen, painful joint, every attempt must be made to rule out this disease entity to prevent significant morbidity and mortality. Introduction Patients frequently present to urgent care with a red, swollen, …

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Acute Compartment Syndrome—An Urgent Care Review

Acute Compartment Syndrome—An Urgent Care Review

Urgent message: Acute compartment syndrome (ACS) is an important high-risk diagnosis to exclude when evaluating peripheral extremity injury. Providers must maintain a high clinical index of suspicion with careful attention to the history and mechanics of injury in an urgent care setting to preclude the devastating, rapidly developing sequela of ACS. Missing a case of ACS may result in significant morbidity—and even mortality. Awareness of both subtle and overt signs will ensure the best care …

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Pain in the Hand After Punching a Wall

Pain in the Hand After Punching a Wall

Case An 18-year-old man presents to an urgent care center with pain at the distal aspect of the metacarpal bone of the little finger. The pain began 2 hours earlier, after he punched a wall. He has pain with range of motion and a minimal amount of numbness in the finger. He reports that he has no other injuries. View the image taken (Figure 1) and consider what your diagnosis would be.

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Abdominopelvic Pain, Part 2: Approach to Women in the Urgent Care Setting

Abdominopelvic Pain, Part 2: Approach to Women in the Urgent Care Setting

Urgent message: Diagnosis of abdominal pain is more complex in women than in men because of the more complex anatomy involved. Using a stepwise approach and involving patients in their care can make a difference. Introduction Part 1 of this article [see “Abdominopelvic Pain, Part 1: Approach to Men in the Urgent Care Setting,” at https://jucm.com/abdominopelvic-pain-part-1- approach-men-urgent-care-setting/] explained that finding the cause of abdominopelvic pain can be a difficult task for any health-care provider because the diagnostic process is riddled with important decisions. …

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Original Research: Early Diabetes Screening in the Urgent Care, Part 1

Original Research: Early Diabetes Screening in the Urgent Care, Part 1

Urgent message: Undiagnosed type 2 diabetes mellitus affects more than 9 million Americans. This first part of a two-part article focuses on evaluation of diabetes screening for the adult urgent care patient in whom diabetes has not been diagnosed, using effective early disease-detection strategies to reduce the long-term burden of diabetes. How this article helps you: by providing data to assist you in deciding about screening in your center. Introduction There are now more than …

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U.S. Tuberculosis Cases Up for the First Time in 23 Years

U.S. Tuberculosis Cases Up for the First Time in 23 Years

After a decades-long slog toward elimination of tuberculosis in the United States, 2015 saw a slight increase in the number of domestic TB cases. While around half of all reported cases occurred in Texas, California, Florida, and New York, 29 states and the District of Columbia reported increases over 2014. While the Centers for Disease Control and Prevention suggests that lower funding of TB prevention programs may be on reason, urgent care clinicians faced with …

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