Practice Management
Urgent message: Syncope in pediatric patients may be attributed to a wide variety of sources. As such, it is essential to keep a broad differential and to eliminate potentially life-threatening etiologies. Nehal Bhandari, MD, FAAP and Abbas Zaidi, MD, FAAP CASE PRESENTATION A 12-year-old previously healthy female presents to urgent care with several episodes of “blacking out” over the past 4 days. Each episode has occurred when she stands up from a sitting or supine …
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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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Urgent message: Rashes are a common ailment, and their etiology can have overlapping appearances. In a case where rash does not improve with treatment, it is often necessary to reconsider the differential. Sergio Ramoa MD, MS INTRODUCTION It is common for providers to have difficulty diagnosing patients who present with rash due to the diverse appearances, as well as overlapping similarities, of different etiologies. Due to the extensive nature of rashes, this article will focus …
Read MoreFaster Diagnosis of STIs Reduce ED Referrals for SVT Kids’ Dental Pain and Quality of Life Ultrasound-Guided Blocks and Renal Pain EI as a Leadership Attribute in Physicians Avijit Barai, MBBS, FACEM, FRNZCUC, MRCS, MSc (Critical Care), PgCertCPU Rapid Testing for Sexually Transmitted Infections Take-home point: A point-of-care (POC) test for chlamydia and gonorrhoea proved useful for rapid diagnosis of STI in both men and women. Citation: Van Der Pol B, Taylor SN, Mena L, et …
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Urgent message: Anovulatory cycles are the most common cause of heavy menstrual bleeding (HMB) in adolescent patients. Just as with adult patients in the urgent care setting, it is most important to identify unstable patients and those with life-threatening causes for HMB. Shikha Nigam, MD, MPH and Amy Pattishall, MD Case Presentation A 14-year-old female presents with 6 weeks of menstrual bleeding. Her cycles are irregular but she generally has 4 to 6 weeks of …
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Urgent message: While alarming to parents, febrile seizures in children typically are benign and self-limited. However, the possibility of a life-threatening etiology mandates that the urgent care provider determine the type of seizure and employ appropriate assessments based on factors specific to each case. Tiffany Addington, MD CASE A previously healthy 3-year-old boy presented to urgent care after having a seizure at home. He had a fever that morning and was given ibuprofen. His mother …
Read MoreNeuro Effects of COVID-19 Melatonin and Children with Postconcussive Symptoms Pediatric, Sports-Related Concussion Acute Migraine in Children and Adolescents Emily Montgomery, MD and Kelsey Riggs, MS3 Neurologic Manifestations of COVID-19 Take-home point: COVID-19 has a variety of presentations that include neurologic manifestations—most commonly, headaches. Citation: Niazkar HR, Zibaee B, Nasimi A, Bahri N. The neurological manifestations of COVID-19: a review article. Neurol Sci. 2020 Jul;41(7):1667-1671. Relevance: More than 1/3 of patients with COVID-19 experience neurologic …
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Children whose parents ensure they get flu shots stand a significantly lower risk for death from influenza than children who are not vaccinated, according to new data from the Centers for Disease Control and Prevention. In fact, the CDC says between 2010 and 2014 flu vaccinations reduced the risk of flu-associated death by half among children with underlying high-risk medical conditions, and by nearly two-thirds among healthy children. The study, published in Pediatrics, is thought …
Read MoreModification of Wells criteria in cancer, previous DVT Key point: Wells criteria for deep venous thrombosis (DVT) may need modification for patients with cancer or previous DVT. Citation: Geersing GJ, Zuithoff NP, Kearon C, et al. Exclusion of deep vein thrombosis using the Wells rule in clinically important subgroups: individual patient data metaanalysis. BMJ. 2014;348:g1340. Possible DVT is an important diagnosis to make, however, many urgent cares do not have access to ultrasound. A combination …
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Urgent message: Fever in pediatric patients, while frequent, is rarely the result of a serious illness. Urgent care practitioners must be able to consistently distinguish between serious and benign causes with a minimum of invasive testing. BRENDAN KILBANE, MD, FAAP Introduction Ever is one of the most common chief complaints in pediatric patients who present for urgent evaluation. A surprising number of families continue to suffer from “fever phobia,” with one study noting that 91% …
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