Journal of Urgent Care Medicine

Increased Incidence of Pneumonia in Pediatric Urgent Care

Urgent Message: Pediatric after‑hours care clinics experienced a significant rise in radiographically confirmed pneumonia over a 2‑year period, paralleling national increases in Mycoplasma pneumoniae infections. Morgan McBee, MD; Leslie Spence, MD; Jeanne Hill, MD; Leah S. McBee, MD Keywords: pediatrics; community-acquired pneumonia; mycoplasma pneumonia; after-hours care; radiography, thoracic Abstract Introduction: Pediatric community-acquired pneumonia typically occurs at a rate of approximately 20 visits per 1,000 children in the population. Multiple reports and data from the Centers …

Pneumonia Patients Rarely Tested For Possible Fungal Disease

Adult outpatients with unspecified community-acquired pneumonia (CAP) rarely receive diagnostic testing for blastomycosis, coccidioidomycosis, or histoplasmosis, however repeat visits seem to drive this testing, according to a retrospective study of commercial insurance claims published in JAMA Network Open. Among 573,994 CAP patients seen from 2017–2023, only 5% underwent diagnostic testing for blastomycosis, coccidioidomycosis, or histoplasmosis, and those tests typically occurred after a median of 3 patient visits. Of those tested, 3% received a fungal disease …

Corticosteroids Can Reduce Pneumonia Deaths

Corticosteroids for patients hospitalized for community-acquired pneumonia (CAP) can lower the risk of death within 30 days by 28%, as published in The Lancet Respiratory Medicine. Researchers in the Netherlands analyzed 8 published trials that used risk-and-effect modeling and intent-to-treat to compare adjuvant corticosteroid treatment with a placebo in 3,224 hospitalized CAP patients. Of those studied, 7.6% (246 patients) died within 30 days of diagnosis (6.6% of 1,618 in the corticosteroid group vs 8.7% [140 …

Abstracts in Urgent Care – January 2025

Hematoma Blocks Effective for Closed Forearm Reduction Take Home Point: Hematoma blocks are an effective method of achieving analgesia to facilitate closed reduction of forearm fractures. Citation: Pitman G, Soeyland T, Popovic G, et al. Hematoma block is the most efficient technique for closed forearm fracture reduction: a retrospective cohort study. Emerg Med J. 2024; 41:595–601 Relevance: Adequate closed reduction of wrist and forearm fractures acutely after injury is important to reduce risk of complications …

Mycoplasma Pneumoniae Infections Rising Among Children

Just as urgent care centers across the nation prepare for peak flu season, the Centers for Disease Control and Prevention (CDC) is also taking note of a rise in Mycoplasma pneumonia cases that’s been going on for the past 6 months. The analysis is based on data from patients discharged from emergency departments with a diagnosis of Mycoplasma pneumonia-associated pneumonia or acute bronchitis. According to the agency, there was a peak in August of this …

Pneumonia Diagnoses in EDs, Hospitals Demonstrate Wide Uncertainty

According to a study in the Annals of Internal Medicine, pneumonia diagnoses made in emergency departments (EDs) and hospitals show particular swings in diagnostic uncertainty. Researchers found that in 57% of patients hospitalized for pneumonia in 118 Veterans Affairs hospitals, the diagnosis of pneumonia changed one way or the other between initial presentation and discharge. Of the patients who were initially diagnosed with pneumonia, 36% did not have a pneumonia diagnosis when discharged. Clinical notes, …

Abstracts in Urgent Care – April 2024

Rehabilitation in Post-Acute Anterior Shoulder Dislocation Take Home Point: This study suggests that routinely referring patients to a program of physical therapy is not superior to a single session of advice, supporting materials, and option to self-refer to physical therapy. Citation: Kearney R, Ellard D, Parsons H, et. al. Acute rehabilitation following traumatic anterior shoulder dislocation (ARTISAN): pragmatic, multicentre, randomised controlled trial. BMJ. 2024 Jan 17:384: e076925. doi: 10.1136/bmj-2023-076925. Relevance: Shoulder dislocations commonly present to …

Comparing Urgent Care and Hospital Pneumonia Diagnoses

A retrospective study conducted across 28 urgent care clinics in Utah found an estimated rate of pneumonia overdiagnosis in urgent care clinics of 30%. The authors arrived at the estimate by examining a group of 7,214 patients’ pneumonia diagnoses recorded from January 2019 through December 2020 in the urgent care centers and comparing them with subsequent diagnoses in an emergency department (ED) or hospital. Of the urgent care patients who were later seen in an …

Abstracts in Urgent Care – July/August 2022

Colchicine in Acute Gout POCUS and Necrotizing Fasciitis Assessing Patient Satisfaction Misinterpreting Pediatric Radiographs Lung Ultrasound and Pediatric Pneumonia Diagnosing Pneumothorax A Review of the Evidence for Colchicine in Acute Gout Take-home point: Colchicine appears to be no more effective than NSAIDs for acute gout flares and evidence does not indicate greater efficacy at higher doses. Citation: Gottlieb M, Rabah W, Long B. Colchicine for acute gout. Acad Emerg Med. 2022;29(3):387-388. Epub ahead of print …

Abstracts in Urgent Care – March 2022

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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