Journal of Urgent Care Medicine

The Implementation of Nurse-Intiated Ankle and Foot X-rays in an Urgent Care Setting

Urgent message: Nurse-initiated protocols (NIPs) have been found to be beneficial in emergency department settings. Nurse-initiated x-rays for ankle and foot injuries can reduce patients’ length of stay while improving staff satisfaction. Utilization of NIPs in an urgent care setting can bring positive benefits to patients, staff, and the organization. Allison Usset Gilles, DNP, FNP-C, RN; Der Xiong, DNP, FNP-C, RN; and Jenny A. Prochnow, DNP, MBA, RN INTRODUCTION Background Overcrowding and long wait times …

Failure to Get Mass Numbers of People Vaccinated Against COVID-19 Will Be Catastrophic

With half a million Americans dead and new cases on the rise in many states, the urgency of getting as many people vaccinated against COVID-19 as quickly as possible should be obvious. However, new data from a small international survey of epidemiologists, virologists, and infectious disease specialists suggest that low vaccine coverage could leave every corner of the globe as vulnerable as ever, if not more so, in short order. Two-thirds of the 77 experts …

New Data on COVID-19 Vaccine After-Effects—What’s Expected, and What’s Cause for Concern

As more Americans get the COVID-19 vaccine, there’s a growing body of data on what after-effects patients are likely to experience—some of which may be so concerning to them that they visit your urgent care center. Recognizing those concerns, the Centers for Disease Control and Prevention has published patient-friendly guidance on what can be expected post-shot, as well as self-care recommendations and advice on when it makes sense to see a healthcare provider. Pain, redness, …

Warn Patients: Post-Coronavirus Immunity May Last 5 Months—but Transmissibility Continues

Patients who recover from COVID-19 infection may be comforted by new data suggesting their antibodies could provide at least 5 months of protection from new infection. The Sarscov2 Immunity & Reinfection EvaluationN (SIREN) study indicates that recovered individuals have at least 83% protection from reinfection over that time period, if not longer. However, as noted in an article posted by Medscape, some of those patients may still be capable of transmitting the virus to people …

No Matter What ‘Wave’ of the Pandemic We’re In, Tell Patients to Keep Wearing a Mask

Internationally, public health experts are in disagreement over the prospects of a second wave of widespread COVID-19 infection—though not because they think the pandemic is sputtering to a halt anytime soon. Some (such as Anthony Fauci, MD, head of the National Institutes of Health’s National Institute of Allergy and Infectious Diseases) say it’s premature to think about a second wave because we don’t know when the first wave will end. Others, such as a group …

A 53-Year-Old Male with Wrist Pain After a Fall

The patient is a 53-year-old man who presents with wrist pain after tripping over a fallen tree while on a hike, landing on his outstretched arm. There is pain on palpation. You find decreased range of motion of the distal wrist. Neurovascular status is intact. View the image taken and consider your next steps, along with possible diagnoses.

A 14-Year-Old Boy with Elbow Pain After a Fall on an Outstretched Hand

The patient is a 14-year-old boy who is brought to your urgent care center with lateral right elbow pain after falling on his outstretched hand (FOOSH) while ice skating. The pain worsens when he attempts to straighten his arm. View the image taken and consider what your diagnosis and next steps would be.

Study Lists Ways to Ensure a Positive Experience for Kids with Autism Spectrum Disorder

Children wind up in the urgent care center when they’re not at their best—sickly, often cranky, and not necessarily in the most compliant frame of mind. And that’s “typical” kids. The challenges can increase exponentially for children with autism spectrum disorder (ASD). How staff and clinicians deal with the patient and family in the urgent care center or emergency room can make all the difference in the world, though, facilitating a better clinical experience and …

A 40-Year-Old Veterinarian with Scaly Lesions

Case The patient is a 40-year-old man who presents with annular, scaly lesions on his arm which appeared over the past week. The patient is a veterinarian, and was diagnosed with type 2 diabetes last year. View the photo and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 44-Year-Old Man with Intermittent Dizziness

Case A 44-year-old man presents to your urgent care center complaining of intermittent dizziness. He denies shortness of breath, fever, chest pain, and syncope. Upon exam, you find: General: Alert and oriented Lungs: CTAB Cardiovascular: RRR without murmur, rub, or gallop Abdomen: Soft and NT without r/r/g View the ECG and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.

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