Practice Management
A 61-year-old female with a past medical history of hypertension presents to urgent care with palpitations and shortness of breath for 3 days. She also reports cough and fever, and denies nausea or vomiting. View the initial ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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A mother brings her 7-year-old son to your urgent care center because she’s concerned about asymptomatic lesions that have developed on his knees over the past couple of weeks. On examination, you observe smooth, crusted and scaly, erythematous and whitish papules and nodules on both knees. There was no history of recent trauma. The patient had a history of dermatomyositis. View the image and consider what your diagnosis and next steps would be. Resolution of …
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The patient is a 12-year-old boy who presents with pain after his foot became wedged in an escalator at the mall. The image on the left was taken upon presentation; the one on the right is from a 2-week follow-up. Review each and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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Urgent message: Ultrasound can provide essential data in the evaluation and urgent care of abnormal uterine bleeding, by facilitating a rapid diagnosis and immediate and appropriate decisions regarding management. Andrew Alaya, MD, MSc Citation: Alaya A. How useful is ultrasound in abnormal uterine bleeding? J Urgent Care Med. 2023;17(7):13-18. Key words: abnormal uterine bleeding, AUB polyp, adenomyosis, leiomyoma, uterine malignancy ABSTRACT Abnormal uterine bleeding (AUB) is one of the most common gynecological conditions presenting at …
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Urgent message: Though use of point-of-care ultrasound in the evaluation of first trimester pregnancy complaints is not as common in the urgent care setting as it is in th ED, its use can expedite diagnosis and, potentially, lifesaving treatment. Benjamin Mati MD and Richard Rutherford, MD Citation: Mati B, Rutherford R. Point-of-care ultrasound diagnosis of ruptured ectopic pregnancy in an urgent care setting. J Urgent Care Med. 2023;17(7):19-21. Key words: ultrasound, POCUS, ectopic pregnancy, urgent …
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Ivan Koay MBChB, MRCS, FRNZCUC, MD Clinician Training to Optimize Antibiotic Choice and Duration for Uncomplicated Skin/Soft Tissue Infections Take-home point: Maintenance of certification (MOC) project participation was associated with improvement in evidence-based practice and was sustained after the intervention period. Citation: Wiltrakis S, Jaggi P, Lu L, et al. Optimizing antibiotic treatment of skin infections in pediatric emergency and urgent care centers. Pediatrics. 2022 Oct 1;150(4): e2021053197. Relevance: Antibiotic stewardship remains one of the …
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Urgent message: Urgent care and emergency department visits focus on acute clinical conditions, with an emphasis on timely administration of medications. Patients discharged outside the typical service hours of a community pharmacy may not have access to a 24-hour pharmacy and have to return home without their prescription medication, creating additional barriers to prescription adherence for patients. Emilie M. Collongette, PharmD, BCMTMS; Sara Panella, PharmD, BCPS; Michael A. DeCoske, PharmD, BCPS; Ernesto Sanz Martinez, MD …
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Urgent message: Urgent care operators must be mindful of costs and labor efficiency to navigate the challenges of rising and falling revenue in what’s been a highly seasonal business. Alan A. Ayers, MBA, MAcc, is President of Experity Consulting and is Senior Editor of The Journal of Urgent Care Medicine. For much of 2020 and 2021, the COVID-19 pandemic drove both uncertainty and higher volumes (and thus profits) to urgent care centers. With the 2022-2023 …
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Eric Ellis, MD Something is amiss in how smaller urgent care operators are reimbursed these days. This, likely, is not news to you and I’m sure my situation is not unique, but in the process of having opened a group of urgent care centers around Sacramento, CA over the past few years, I’ve been shocked about just how bad things are. When we opened our first center, I used a management company to help with …
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Urgent message: While pneumonia in general continues to be a common diagnosis in children in the United States, relatively few studies have sought to determine the signs and symptoms that help to predict occult bacterial pneumonia. Awareness of associated signs and symptoms may assist the urgent care provider in proceeding more quickly to a correct diagnosis. Alyssa Whited, PA-C and Christina Gardner, PA-C CASE PRESENTATION A 5-year-old male with no significant past medical history presented …
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