Use of a Quality Improvement Tool for the Evaluation of Healthcare Disparities in Urgent Care: A Case Example for Bacterial Pneumonia

Urgent message: While healthcare disparities have been studied in several healthcare sites, it is unclear whether these disparities persist in the urgent care setting. This study provides a quality improvement tool to assess whether these disparities persist in an urgent care clinic. Derrick Murcia and Lindsey Fish, MD ABSTRACT Background Bacterial pneumonia is an illness commonly seen across urgent care clinics. Despite several studies that have identified healthcare disparities in treating bacterial pneumonia in general, research is needed to verify if these disparities exist in the urgent care setting. This …
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Weight Loss, Abdominal Pain, and Distension in a 74-Year-Old Woman

Urgent message: Not all GI complaints can be attributed to gastrointestinal pathology; symptoms of dyspepsia, vomiting, early satiety, weight loss, and abdominal pain may also be from a pelvic etiology. Fabrizia Faustinella, MD, PhD and Alexandre L. Frigini, MD INTRODUCTION Gastrointestinal complaints are common in ambulatory centers, urgent care, and in emergency departments. The symptoms of abdominal pain, nausea, and vomiting account for 12% to 15% of ED visits.1 Several non-GI intra-abdominal, endocrine, and pelvic disease processes can manifest with GI symptoms, notably ovarian masses, abdominal aortic aneurisms, diabetic ketoacidosis, …
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Hallux or Metatarsophalangeal Joint Pain, Male Foot Pain

Case Report: Reoccurring Metatarsophalangeal Joint Pain

Urgent message: Acute or chronic hallux pain is a common complaint in urgent care. Due to the structure, several diagnoses can have similar presentation on history and exam. With this discussion, we examine a sesamoid stress injury. Sergio P. Ramoa, MD, MS INTRODUCTION The tibial (medial) and fibular (lateral) sesamoids are contained within the flexor hallucis brevis tendons along the metatarsal head.1 They have several roles such as absorbing weight, helping glide and reducing friction of the tendons, and improving flexion strength. X-rays of injuries can sometimes be nonconclusive. Approximately …
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Case of a Nonhealing ‘Sunburn’ on a Toddler

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 on pediatric rashes that tend to develop in late winter and early spring, as well …
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mydriatic pupil

An Unresponsive Pupil in the Urgent Care: Can A Diagnosis Be Made from the Bedside History and Exam?

Urgent message: Ocular complaints for which there is no immediate, obvious explanation do not necessarily have to be referred to the emergency room or ophthalmology. Employing the process of elimination to narrow down a broad differential, using the available evidence, can expedite the correct diagnosis while allowing the patient to remain in the urgent care. Kayla Penny, BS; Joseph LaRochelle, PharmD, BCPPS, FCCP; Deirdre Hooper, MD; Haley Caire, BS; and Kelsey Rooney, BS CASE PRESENTATION A male in his 40s presented with complaints of an enlarged pupil and blurry vision …
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