The Limping Child in the Urgent Care Center

The Limping Child in the Urgent Care Center

Urgent message: The ability to evaluate children presenting with a limp—and to recognize red flags that help distinguish those to treat from those requiring immediate referral—should be within the purview of the urgent care clinician. Raymond W. Liu, MD, Hadeel Abaza, MD, and Allison Gilmore, MD A limping child without a clear traumatic history or diagnosis is a common presentation to an urgent care center. The broad differential diagnosis can be daunting, with causes that …

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Assessment and Management of Common Hand Infections

Assessment and Management of Common Hand Infections

Urgent message: Common superficial hand infections may be managed easily by the urgent care physician. Left untreated or undertreated, however, simple hand infections may progress to disabling conditions requiring urgent sub-specialty management. Arthur R. Smolensky, MD, Samuel M. Keim, MD, MS, and Peter Rosen, MD The hand is an intricate and crucial feature of the human body. Yet, with the exception of superficial cellulitis, common hand infections require relatively simple surgical procedures—many of which can …

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Evaluation, Identification, and Treatment of Urinary Tract Infections

Evaluation, Identification, and Treatment of Urinary Tract Infections

Urgent message: Urinary tract infections are a common cause of abdominal pain and a common presenting complaint in urgent care. Proper diagnosis, treatment, and patient education on preventive measures are key to optimal outcomes. William Gluckman, DO, MBA, FACEP, Karen Keaney Gluckman, MSN, APN, C, CWCN, CCCN The global term urinary tract infection (UTI) incorporates cystitis and infection involving the bladder (a lower tract source), as well as pyelonephritis, an infection involving the kidneys (an …

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Managing Heat Illness in Urgent Care

Managing Heat Illness in Urgent Care

Urgent message: The urgent care provider’s most critical role in heat illness is to identify risk factors and the cause, to cool and hydrate the patient, assess for complications, and educate the patient in the hope of preventing a more serious exposure. Bridget Dyer, MD, Samuel Keim, MD, and Peter Rosen, MD Heat illness occurs when external heat conditions and internal heat production overwhelm the ability of the body to dissipate heat. Evaporation of sweat …

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Challenges in Assessing and Treating Insect Bites and Stings

Challenges in Assessing and Treating Insect Bites and Stings

Urgent message: When presented with a patient who has experienced an insect bite or sting, the most crucial role for the urgent care clinician is to triage for anaphylaxis, venom toxicity, and local tissue damage. Kent A. Knauer, MD Now that summer is here, it is likely that urgent care practitioners—especially those practicing in suburban and rural areas—will see an increasing number of patients who have experienced an insect bite or sting. Though data are …

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Management of Patients Presenting with symptoms of Vulvovaginitis

Management of Patients Presenting with symptoms of Vulvovaginitis

Urgent message: As the cause of approximately 10 million office visits in the United States annually, vulvovaginitis remains a common but important complaint seen in the urgent care setting. Jansen Tiongson, MD, Samuel Keim, MD, and Peter Rosen, MD Although numerous etiologies account for vulvovaginitis, the vast majority of cases are due to bacterial vaginosis (BV), trichomoniasis, and vulvovaginal candidiasis (VVC). BV causes 40% to 50% of all cases, while candidiasis and trichomoniasis account for …

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