Spotlight on Original Research in Pediatric Urgent Care: Excerpts from the 2020 Pediatric Urgent Care Conference (PUCC). Los Angeles, CA David J. Mathison, MD, MBA Decreasing Length of Stay in the Pediatric Urgent Care with Electronic Discharge Instructions* Wooster J, Patel A, Nedved A, Lee B The aim of this research was to determine if an electronic discharge process could decrease length of stay by an average of 10 minutes per patient. An electronic discharge …
Read More
An 8-Year-Old Girl with Lesions on Her Arms
The patient is an 8-year-old girl with a smattering of brown to black lesions on her arms. They’re not painful or causing discomfort, but her mother is concerned because they look darker than the average freckle. Exam reveals small (less than 0.5 mm), round, hyperpigmented macules. 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 More
A 60-Year-Old Woman with a 4-Day History of Intermittent Exertional Chest Pain
The patient is a 60-year-old female with no past medical history presents with intermittent exertional chest pain for 4 days. She reports the pain is substernal with radiation to her left arm, is associated with nausea and diaphoresis, and is worsened by exertion. The patient says she experiences pain every 4-5 hours, but currently is pain-free. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case …
Read More
A 46-Year-Old Woman with Wrist Pain After Hearing a ‘Snap’
The patient is a 46-year-old female with pain in her wrist. She reports that she heard a “snap” when she put all her body weight on her left hand during an exercise class. View the images taken and consider what your diagnosis and next steps would be.
Read MoreMIS-C: What to Look for—and the Consequences of Missing It
At the outset of the COVID-19 pandemic, it appeared that children were somehow less susceptible to becoming infected and, if they did get sick, had some unexplained level of protection against becoming severely ill. Like many “facts” about the virus, however, our understanding has changed since then. While it still appears that children are getting sick at lower rates than adults, we now know COVID-19 can have dire consequences for younger patients. In fact, …
Read More
The Role of Aseptic Technique During Repair of Traumatic Lacerations in the Urgent Care Center
Urgent message: The goal for urgent care clinicians tasked with treating patients presenting with traumatic lacerations is rapid and cosmetic resolution of the injury. Using aseptic technique while repairing traumatic lacerations will minimize the risks of infections. INTRODUCTION Myriad advances in wound repair have emerged since the pioneer of antiseptic medicine, British surgeon Joseph Lister, transformed the field of surgery by incorporating his research in bacteriology and wound infections to improve patient outcomes. Today large …
Read More
A 45-Year-Old Man with Thumb Pain After a Fall
The patient is a 45-year-old man who presents as your first patient of the day, with thumb pain after taking a fall in the middle of the night. He tripped walking to the bathroom and tried to catch himself on the doorknob as he went down. His pain worsens with movement or when he tries to grip anything. View the image taken and consider what your diagnosis and next steps would be.
Read More
A 28-Year-Old Woman with Foot Pain After a 10-Foot-Fall
The patient is a 28-year-old female who presents with foot pain after experiencing a fall of 10 feet while rock climbing. On exam, you find midfoot dorsal and plantar tenderness, as well as bruising across the top of the foot. Review the image taken and consider what your diagnosis and next steps would be.
Read More
Best Practices for LGBTQ-Friendly Care in Urgent Care
Urgent message: LGBTQ individuals are subject to implicit and explicit biases in our society, ranging from antagonistic legislation and microaggressions to overt harassment. This can inhibit willingness to seek medical care—and, subsequently, lead to worse health outcomes. Understanding how word choice and other subtle cues communicate competency in working with LGBTQ patients can help us engender trust. Benjamin Silverberg, MD, MSc, FAAFP, FCUCM INTRODUCTION The goals for treating LGBTQ patients (lesbian, gay, bisexual, transgender, and …
Read More
Evaluation of a Point-of-Care COVID-19 Testing Platform Using Self-Collected Nasal Swabs in an Urgent Care Setting
Urgent message: A validated platform effective in performing rapid point-of-care tests for SARS-CoV-2 would be ideal for use in urgent care centers. While reports of false negative results with one system called the viability of such a platform into question, results of this study support the use of POC testing using self-collected nasal swabs. Bronson Elizabeth Delasobera, MD; Amanda Joy, PA; Masashi Waga; Rita Malley, MS; Anisha Patel, MS; Sarah Greenwood, PA; Jerry Creighton, RN; …
Read More