Prompt Treatment of Pediatric UTI Prevents Renal Scarring Key point: To avoid renal scarring, don’t wait for urine culture in pediatric patients. Treat within 3 days. Citation: Coulthard MG, Lambert HJ, Vernon SJ, et al. Does prompt treatment of urinary tract infection in preschool children prevent renal scarring: Mixed retrospective and prospective audits. Arch Dis Child. 2013 Dec 18; [e-pub ahead of print]. Investigators in England looked at the relationship between time to treatment and …
Read MoreClinical Challenge – April 2014
THE CASE This patient presented with a painless mass in the leg. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreMedical Malpractice Insurance: Read the Fine Print
JOHN SHUFELDT, MD, JD, MBA, FACEP Our emergency medicine group was informed that a new corporate mandate will force us to nearly double our malpractice coverage from $1 million for each occurrence and $3 million in yearly aggregate ($1M/$3M) to $2M/$4M. This mandate came despite our group’s low malpractice claims history, a higher burden of proof for plaintiffs in the state where we practice, and a very “doctor-friendly” malpractice environment in our county. To my …
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Sarcoidosis
Urgent message: The key to this case was in the details of the presenting symptoms in the patient history: Alarm symptoms including extreme fatigue and weight loss, which warranted further diagnostic work up. ABRAR KHAN, MD, MBA, REVATHY NAIR, MD, and MARIANN MELICHAREK, MD, FACEP Introduction Sarcoidosis is a multisystem granulomatous disorder of unknown etiology. Most patients with sarcoidosis present to urgent care providers with symptoms such as cough, dyspnea, chest pain, eye pain and/or …
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Marketing Strategies: School, Sports, and Camp Physicals
Urgent message: Sports physicals offered by an urgent care center can be a “win” for both the center and the community. The community gets a flexible source for a time-critical service and the center gets another way to attract new and repeat business. ALAN A. AYERS, MBA, MAcc Practice Velocity Schools, camps, inter-league and club sports programs typically require a pre-participation physical examination to evaluate a participant’s general health, fitness level, risk of injury and …
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Assessment and Management of Asthma Exacerbation in Urgent Care: Part 2
Urgent message: The second part in a two-part series offers expert guidance on short and long-term management of the disease in the urgent care setting through the use of pharmacotherapy, protocols for treatment, and a written asthma action plan at discharge. BRADLEY M. TURNER MD, MPH, MHA, FCAP, FASCP and JANET M. WILLIAMS, MD, FACEP Introduction Once the suspicion of an asthma exacerbation exists, short term management is focused on reducing the severity of the …
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Case Series: Stingray Envenomation
Urgent Message: Urgent care providers in coastal areas need to be prepared to treat stingray envenomation. Immersion in water heated to a precise temperature is the key to pain relief. Authors: George Kamajian, DO, and Blake Singletary, OMS3 George Kamajian, DO, is a Medical Director at Largo Clinic and Adjunct Professor of Emergency Medicine at Lake Erie College of Osteopathic Medicine in Largo, FL. Blake Singletary, OMS4, is a 4th year medical student at Lake …
Read MoreRisk Mitigation in Urgent Care: Part I
Lee A. Resnick, MD, FAAFP Editor’s Note: This is the first of a two-part column that examines ways to reduce liability in the urgent care setting. Our discipline is evolving rapidly and best practices are beginning to be defined. Staying abreast of practice standards for urgent care and implementing a disciplined risk mitigation plan will help your practice avoid the disruptive burdens of a medical malpractice lawsuit. The urgent care approach to risk management should …
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April 2014
Incident finding on patients pathology x-ray
The pathology on this x-ray represents an incidental finding in a patient. View the image taken (Figure 1) and consider what your diagnosis would be.
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