bnapolitano, Author at Journal of Urgent Care Medicine

CDC Ponies Up $1.8 Million for an Urgent Care-Based Antibiotic Initiative

Intermountain Healthcare and University of Utah Health have received a $1.8 million contract from the Centers for Disease Control and Prevention to conduct an antibiotic stewardship program in their urgent care centers. Around 700,000 patients visit Intermountain urgent care centers annually, with the number continuing to climb every year. The first step in the initiative will be trying to refine how patients view prescriptions themselves. For example, more patients who come in expecting to get …

Free JUCM Webinar: 20 Questions—What You Can’t Afford to Miss in a Chest X-Ray

The consequences of missing something on a chest x-ray can be deadly. And yet, if you don’t review them frequently it can be difficult to pick up on subtle findings. JUCM is hosting a free webinar that will provide examples of easy-to-miss presentations that you can’t afford to miss on Tuesday, December 10, from 2 to 3 pm (Eastern). In Chest X-Rays—What the Urgent Care Clinician Needs to Know, Drs. David Cohen and Michael Weinstock …

A 51-Year-Old Woman with Multiple Dermatological Symptoms and Muscle Weakness

The patient is a 51-year-old woman who presented to urgent care complaining of a rash, pruritus, myalgias, and muscle weakness. The rash was an erythematous blanching patch spread across her chest in a V shape. She had also noticed that her fingernail folds were red and swollen. The patient can’t recall when she first noticed her symptoms, but reports that they’ve started affected her everyday life (such as having difficulty rising from a chair) within …

A 65-Year-Old Man with Epigastric Pain, Dyspnea, and a ‘Clammy’ Feeling

Figure 1. Case The patient is a 65-year-old man with symptoms of epigastric pain over the last 2 hours, with some dyspnea and a “clammy feeling.” He has a history of GERD and has used both an oral antacid and omeprazole within the past hours without relief. Upon exam, you find: General: Alert and oriented. Skin cool and moist Lungs: CTAB Cardiovascular: Regular rate and rhythm without f/r/g Abdomen: Soft and nontender without rigidity, …

A 57-Year-OId Man with Rib Pain with Deep Breathing

The patient is a 57-year-old man who reports to urgent care complaining of right-sided pain in his ribs when taking deep breaths. He reports that he worked out at his health club that morning before work, but denies any pain at the time or potential cause of injury related to that. Rather, he said the pain began suddenly a couple of hours later while he was at work. View the images taken and consider what …

Abstracts in Urgent Care-December

More Advice on Inquiring About—and Assessing—Vaping and EVALI Key points: Citation: Siegel DA, Jatlaoui TC, Koumans EH, et al. Update: Interim Guidance for Health Care Providers Evaluating and Caring for Patients with Suspected E-cigarette, or Vaping, Product Use Associated Lung Injury—United States, October 2019. MMWR Morb Mortal Wkly Rep. 2019;68:919–927. Key point: Physicians should inquire about e-cig or vaping use in a nonjudgemental but thorough manner. Ask about specific products, frequency, and associated drug use. …

Abstracts in Urgent Care-November

What’s New in Flu Vaccine Information New First-In-Class Pleuromutilin Antibiotic for CAP Abdominal Pain in Patients with IUDs—Watch Out for Ectopic Pregnancy Cancer-Causing Chemical Found in Ranitidine Measles Cases and Outbreaks Cooling Pediatric Burns Occ Med: Severe Silicosis in Stone Fabrication Workers An Update on Vaccine the 2019-2020 Flu Season Key points: The CDC recommends annual influenza vaccination for everyone 6 months of age and older, with any licensed influenza vaccine that is appropriate …

Flu Season is Nearly Synonymous with Rapid Test Season—Are You Ready?

Flu Season is Nearly Synonymous with Rapid Test Season—Are You Ready? Patients come to urgent care because they know they can get excellent care without an appointment, and without languishing in the waiting area of the ED. So, it stands to reason that if they need lab tests they want to get them on site, at your facility, with the same degree of efficiency that drew them in to begin with. This is never truer …

Updated IDSA Guidelines Stress Early, Appropriate Treatment for Community-Acquired Pneumonia + Influenza

Urgent message: Just as what is predicted to be a brutal flu season picks up steam, the Infectious Diseases Society of America has released new guidelines stressing the need for timely, dual treatment in adults with community-acquired pneumonia who also test positive for influenza. Cornelius O’Leary, Jr., MD After more than a decade, the Infectious Diseases Society of American has published new guidelines on community-acquired-pneumonia—noteworthy for both its switch from narratives to a Grading of …

Can Urgent Care Patients be Treated Anonymously?

Urgent message: Due to the perceived “acute nature” of the urgent care setting, many patients falsely believe that they can be treated anonymously. On the contrary, legal implications, insurance practices, and the integration of technology with medical records mean that delivering anonymous care is nearly impossible. Alan A. Ayers, MBA, MAcc is Chief Executive Officer of Velocity Urgent Care and is Practice Management Editor of The Journal of Urgent Care Medicine. Healthcare is intensely personal, …