Practice Management
The patient is a 31-year-old woman who presents with new-onset cough and decreased breath sounds to the lower lobes. View the image 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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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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The patient is a 57-year-old female with a history of coronary artery disease, congestive heart failure, and left ventricular thrombus on warfarin who presents with shortness of breath. She denies any bleeding, bruising, dark-colored stools, chest pain, fever, cough, or leg pain. On evaluation, the patient’s vital signs are normal. She is breathing comfortably and speaking in complete sentences. View the ECG and consider what your next steps and diagnosis would be. Resolution of the …
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Urgent message: Many pediatric urgent care centers lack 24/7 pediatric radiologist coverage and rely on the urgent care provider for initial interpretation and subsequent clinical management. If misdiagnosed, this could represent a potential patient safety concern. Allison Wood, DO; Anne McEvoy, MD; Paul Mullan, MD, MPH; Lauren Paluch, MPA, PA-C; Brynn Sheehan, PhD; Jiangtao Luo, PhD; Turaj Vazifedan, DHSc; Theresa Guins, MD; Jeffrey Bobrowitz, MD; and Joel Clingenpeel, MD Citation: Wood A, McEvoy A, Mullan …
Read MoreIn the May issue of JUCM, we outlined what we were seeing with E/M coding levels utilizing the new AMA guidelines vs 2020 and 2019 levels. As COVID-19 visits steadily declined from January through June, we began to see a return to more “normal” urgent care visits. That was short-lived. July’s sharp increase in visit volumes was again driven by COVID-19! Here’s the update we promised. As a reminder, we saw E/M levels decline in …
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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 …
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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 …
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The patient is a 27-year-old male who presents to your urgent care center with left wrist pain after falling from his dirt bike. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreIn the words of Red Adair, “If you think it’s expensive to hire a professional to do the job, wait until you hire an amateur.” Credentialing dictates how you bill. Do I bill as a group? Should I credential my nonphysician practitioners (NPP)? Which place of service (POS) should I bill with based on my contract? These are all important questions. Did you know that in April of this year, an urgent care chain reached …
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