Ondansetron Safe During Pregnancy Key point: No significant association between the antiemetic on- dansetron and adverse pregnancy outcomes. Citation: Pasternak B, Svanstrom H, Hviid A. Ondansetron in pregnancy and risk of adverse fetal outcomes. N Engl J Med 2013;368:814-823. In this retrospective cohort study, ondansetron had been prescribed for nausea and vomiting in almost 2000 of some 600,000 pregnancies. Ondansetron users were no more likely than nonusers to experience spontaneous abortion or stillbirth, or to …
Read MoreClinical Challenge: May, 2013
The patient, a 22-year-old woman, presented with a complaint of chest pain. View the image taken (Figure 1) and consider what your diagnosis would be. Resolution of the case is described on the next page.
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A Slowly Healing Leg Wound
Urgent message: Clinical suspicion of CA-MRSA should be high for any skin wound or soft tissue infection with delayed healing, abscess, or persistent cellulitis. RALPH S. BOVARD, MD, MPH, and ANNE REINER, MD, MPH Introduction Caregivers need to remain vigilant and challenge diagnoses to avoid complacency in the treatment of “common” problems. We all need to foster the habit of systematic and meticulous clinical evaluation. As Goethe said: “We see what we know.” Case Presentation …
Read MoreThe ED Utilization Debate: Can a Shell-Game Redirect the Scrutiny?
Lee A. Resnick, MD, FAAFP You might not expect one of our most prestigious medical journals to be susceptible to scientific sleight of hand. But the JAMAeditorial board apparently fell victim to just that in publishing the latest in a string of self-serving, extraordinarily biased “studies” supported by the American College of Emergency Physicians (ACEP), entitled “Comparison of Presenting Complaint vs Discharge Diagnosis for Identifying “Nonemergency” Emergency Department Visits.” The study’s objective was to determine …
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Establishing Your Online Presence: Website Basics for Urgent Care Operators
Urgent message: Establishing a practice website takes careful planning and execution but it can enhance traditional marketing efforts by providing a central repository of relevant information for prospective patients. ALAN A. AYERS, MBA, MAcc Practice Velocity When consumers experience a minor illness or injury, numerous questions arise, such as “What do these symptoms mean?” “Can I do something about this myself?” and “What kind of help do I need, where do I get it, and …
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May 2013
An Urgent Care Approach to Low Back Pain
Urgent message: To better evaluate and treat patients with low back pain, urgent care providers need a good understanding of the anatomy of the back and they must be vigilant for “red flags” that signal a potentially serious condition. SHAILENDRA K. SAXENA, MD, PHD, MIKAYLA SPANGLER, PHARM D, BCPS, and SANJEEV K. SHARMA, MD, MBA Introduction Acute low back pain is a common condition often seen by urgent care providers. An episode of acute low …
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28-year-old male with pain in shoulder after fall
The patient, a 28-year-old male, presented with pain in his left shoulder after a fall. View the image taken (Figure 1) and consider what your diagnosis would be.
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76-year-old male presented after blow to right shoulder
The patient, a 76-year-old male, presented after a blow to his right shoulder. View the image taken (Figure 1) and consider what your diagnosis would be.
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23-year-old male presented after blow to left wrist
The patient, a 23-year-old male, presented after a blow to his left wrist. View the image taken (Figure 1) and consider what your diagnosis would be.
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