StuWilli, Author at Journal of Urgent Care Medicine

Fractures in ICD-10-CM

Q. We treat a lot of fractures in our urgent care clinic, and I understand there are changes for coding these in ICD-10-CM [International Classification of Diseases, 10th Revision, Clinical Modification]. What will we need to be aware of? A.Most of the changes made in ICD-10-CM were to chapter 19, “Injury, Poisoning, and Certain Other Consequences of External Causes (S00-T88),” because of the need to identify laterality and 7th-character extensions that indicate the type of …

A 34-Year-Old Man with Left Side Pain

In Bouncebacks, which appears periodically in JUCM, we provide the documentation of an actual patient encounter, discuss patient safety and risk-management principles, and then reveal the patient’s bounceback diagnosis. This month’s case reflects the actual documentation from an urgent care visit, and the patient’s bounceback the next day to the emergency department. Can you spot the red flags without knowing the outcome? MICHAEL B. WEINSTOCK, MD, and MIZUHO SPANGLER, DO Introduction Apicture tells a thousand …

Top Classes of Prescriptions Written at U.S. Urgent Care Centers in 2014

Data from the 2014 Urgent Care Chart Survey of 1,778,075 blinded patient visits to more than 800 different urgent care clinics, conducted by the Journal of Urgent Care Medicine, show that for almost half of visits (48.6%) to U.S. urgent care centers, the prescriptions written by health-care providers are for oral antibiotics. The next 4 classes of prescriptions written are as follows, in descending order by percentage of visits: corticosteroids (13.7%), narcotic analgesics (9.9%), cough …

July/August 2015

Clinical Challenge: July/August, 2015

The Case The patient was a rear-seat passenger in a head-on vehicle collision, wearing only a lap seat belt as a safety restraint. View the image taken (Figure 1) and consider what your diagnosis would be.

Hyperbilirubinemia: An Urgent Care Approach

Urgent message: Although frequently overlooked, routine urinalysis results can serve as an important diagnostic indicator of underlying and potentially life-threatening systemic disease states. NATALIE SMITH, MS, PA-C Urinalysis is one of the most common diagnostic tests used in and urgent care medicine. Urinalysis results yield routine clinical information necessary for everyday diagnoses localized to the renal and urologic systems; findings such as pyuria indicative of cystitis or hematuria related to renal calculi are some commonplace …

Acute Severe Thigh Pain While Running

Urgent message: Summer brings increased participation in outdoor activities and sports in which patients are likely to sustain injury. Patients with thigh injuries, such as injury to the quadriceps and patellar tendon, may present to the urgent care center. Timely diagnosis is essential in preserving strength and function of the quadriceps complex. TRACEY QUAIL DAVIDOFF, MD Patients who run and jump are at risk for injuring their quadriceps complex. These activities are common in the …

Abstracts in Urgent Care: July/August, 2015

SEAN M. McNEELEY, MD Sumatriptan Less Effective in Migraine with Aura Key point: Migraine with aura might require additional treatment measures. Citation: Hansen JM, Goadsby PJ, Charles A. Reduced efficacy of sumatriptan in migraine with aura vs without aura. Neurology. 2015;84:1880–1885. This study used pooled data to compare the response of patients with migraines with aura and the response of those with migraines without aura. A total of 3714 patients were compared; 1199 had an …

Eye Redness, Pain, and Light Sensitivity

A 30-year-old woman presents with a red eye, associated with eye pain, light sensitivity, and slightly decreased vision, which started 4 days earlier. She was previously treated with tobramycin, but she has not noticed any change in the condition of her eye. Examination shows an injected conjunctiva and a hypopyon. On further examination with a slit lamp, inflammatory cells are evident in the anterior chamber. View the image taken (Figure 1) and consider what your …

Clinical Challenge 2: June, 2015

The Case A child presents after a fall on an outstretched arm from monkey bars. Pain and voluntary guarding of the elbow are noted. View the image taken (Figure 1) and consider what your diagnosis would be.