StuWilli, Author at Journal of Urgent Care Medicine

Assessment and Management of Asthma Exacerbation in Urgent Care: Part 1

Urgent message: Asthma is increasing in prevalence and so, too, presentations of asthma in ambulatory settings. Urgent care providers have an important role to play in identifying and treating acute asthma exacerbations, including providing a written asthma action plan at discharge to improve long-term outcome. BRADLEY M. TURNER MD, MPH, MHA, FCAP, FASCP and JANET M. WILLIAMS, MD, FACEP Patients often seek assistance in urgent care centers for acute presentations of asthma. This provides unique …

21-year-old man with a blow to his right shoulder

This x-ray was taken on a 21-year-old man with a blow to his right shoulder. View the image taken (Figure 1) and consider what your diagnosis would be.

59-year-old diabetic with pain and swelling in foot

The patient, a 59-year-old man with diabetes, presented with pain and swelling over his lateral right foot. View the image taken (Figure 1) and consider what your diagnosis would be.

Clinical Challenge 2: January, 2014

THE CASE This x-ray was taken on a 29-year-old man with a blow to his left elbow. View the image taken (Figure 1) and consider what your diagnosis would be.

Developing Data: February, 2014

These data from the 2012 Urgent Care Industry Benchmarking Study are based on a sample of 1,732 urgent care centers; 95.2% of the respondents were UCA members. Among other criteria, the study was limited to centers that have a licensed provider onsite at all times; have two or more exam rooms; typically are open 7 days/week, 4 hours/day, at least 3,000 hours/year; and treat patients of all ages (unless specifically a pediatric urgent care).

Abstracts in Urgent Care: February, 2014

Pyuria Poor Predictor of UTI in Nephrolithiasis Key point: Classic symptoms and urine culture are the best indicators of infection in patients with acute nephrolithiasis. Pyuria proved a poor predictor. Citation: Abrahamian FM, Krishnadasan A, Mower WR, Moran GJ, Talan DA. Association of pyuria and clinical characteristics with the presence of urinary tract infection among patients with acute nephrolithiasis. Ann Emerg Med 2013;62(5):526-533. Infection can complicate the diagnosis of acute nephrolithiasis. Patients with both a …

Clinical Challenge: February, 2014

THE CASE The patient, a 47-year-old woman, twisted her left ankle while playing badminton 24 hours ago and was unable to bear weight on the left foot since then. Examination revealed moderate swelling of the lateral malleolus, no bruise, marked tenderness, slight ankle supination, inversion and adduction. View the image taken (Figure 1) and consider what your diagnosis would be.

Pulse Oximetry, Oral Medication

Q. I am reviewing documentation for a freestanding urgent care center that performs pulse oximetry on every patient they see, regardless of the reason. Is this typical? In some cases, they are billing the case rate code, S9083. Please let me know if this is standard operating procedure. A.Medicare will allow payment for pulse oximetry under two conditions: 1) when it is linked to an appropriate diagnosis code; and 2) if it considered as being …

Treating the Self-Harming Patient in the Urgent Care

JOHN SHUFELDT, MD, JD, MBA, FACEP He watched her walk through the door at the end of a long, busy day. She was an attractive, well dressed, athletic-looking young lady with a warm smile, the kind of girl he’d want his teenage son to date someday. “Slam dunk,” he thought. “This will be a quick visit and I’ll still get out on time.” The front office team registered her quickly. He suspected that they, too, …

Sacral Tumor

Urgent message: Each case—and patient presentation—in urgent care must be evaluated on its own merits. Rare diagnoses are possible and “benign” back pain complaints sometimes are not. HEATHER VARLEY, PA-C, and WILLIAM GLUCKMAN, DO, MBA, FACEP Introduction Each day in the urgent care setting, we are presented with a range of various pain complaints, from headaches, to back pain, to extremity pain. These complaints may be the result of injury, overuse, infection, arthropathy, or have …