Check the Temps: A Timely Throwback Key points: Peripheral temperatures (ie, temporal, tympanic, oral, and axillary) are inaccurate and cannot reliably exclude the presence of fever. If absolute certainty regarding febrile status is critical (eg, neonates, immunosuppressed patients), a (gentle) rectal temperature is the preferred method of temperature acquisition in the urgent care setting. For all others, a tympanic temperature reading <37.5°C appears to best exclude true fever with reasonable certainty. Finally, all this comes …
Read MoreThe Finer Points of Video Surveillance in an Urgent Care Center
Urgent message: The increasing use of video surveillance in urgent care requires an awareness of the risks and restrictions of such systems used for patient and employee safety. 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. Security is one of the most significant concerns in the operation of an urgent care facility. In this instance, it’s not …
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A 2-Year-Old with a Nodule on His Face—and Other Concerning Symptoms
A mother and father bring their 2-year-old son to your urgent care center because of a smooth nodule on his face, which they noticed the previous day. They also reveal they noticed a small lump on his testicle about a week ago, and that they’ve been going through diapers faster than usual because he seems to be urinating more frequently over the past few days. View the photo taken, and consider what your diagnosis and …
Read MoreKeeping Occ Med Clients Happy—While Keeping Patients Safe
Urgent message: It’s the aim of every occupational medicine sales and marketing team to get prospective clients’ attention, and ultimately to secure the business. It’s what happens after that, however, that keeps clients happy (and encourages them to remain clients). Max Lebow, MD, MPH, FACEP, FACPM Preparation Before the First Employee Visit Employers come to select a particular occupational medicine practice through a number of different routes. Whether businesses hear about your services through …
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A 10-Year-Old Girl with Foot Pain After Falling from a Tree
Case A 10-year-old girl presents with pain after falling from a tree, landing on her right foot. On examination, the pain emanates from the second through fifth metatarsals and proximal phalanges. View the images taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.
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Study: Antibiotic Stewardship Means Probing When Patients Say They’re Allergic to Penicillin
Some 10% of patients will tell you they’re allergic to penicillin if the subject comes up, so you’d better give them something else if that’s what’s indicated for their diagnosis. The problem is, even those who believe what they’re saying are likely to be mistaken. As noted in an article just published in the Journal of the American Medical Association, less than 5% of the U.S. population actually has an allergy to penicillin. In this …
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As Temperatures Fall, Weather-Related Presentations to Urgent Care Rise
Much of the northeast corner of the U.S. is expected to plunge into a deep freeze this week, raising the likelihood that your urgent care centers will be seeing cold weather-related injuries. Some can be relatively minor, such as acute back pain in the wake of heavy snow shoveling, but that same activity could spark chest pain, especially in older patients. Then there’s frostbite, hypothermia, and orthopedic presentations related to slipping on slick surfaces outside. …
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Amazon May Be Moving One Step Closer to Direct Competition with Urgent Care
We’ve been tracking the confluence of healthcare delivery and private industry, especially among tech companies, for some time now. The latest could be a move that ultimately puts Amazon in direct competition with urgent care centers for some patients. The company has been trying to forge a new link in the healthcare supply chain by getting into the home health test market. Within the past few months, according to CNBC, Amazon was in talks to …
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The Comfort Elephant in the (Waiting) Room
Urgent message: Helping staff understand the difference between true service animals, vs those that merely bring comfort to patients, is a good first step toward ensuring your waiting room is safe and comfortable for all—and that your urgent care operation is in compliance with applicable laws. If the emergency department can claim to have seen everything, the urgent care can claim to have seen almost everything. This includes patients who believe it is their right …
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New Data Show Inappropriate Antibiotic Prescriptions Go Well Beyond Urgent Care
Researchers at the University of Michigan Medical School say inappropriate use of antibiotics is “still rampant,” with only 12.8% of antibiotic prescriptions in their study being given appropriately. Further, their data show a relatively low 6.7% of those prescriptions originated in urgent care centers, far less than suggested in a JAMA Internal Medicine piece published last October. This latest study, published in The BMJ, reflects insurance claims and shows that antibiotics were most commonly overprescribed …
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