JOHN SHUFELDT, MD, JD, MBA, FACEP It sounded like a great job. You saw the ad in the back of JUCM and contacted the person listed at the bottom. He seemed pleasant enough on the phone and the pay was what you thought was the market rate for the area. The next day, you drove over for the interview, which consisted of only four questions (the first being “If you were a tree…” and the …
Read MoreAbstracts in Urgent Care: July/August, 2007
Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department with Syncope Key point: Syncope is a common presentation to the emergency department. These recommendations help stratify low- versus high-risk patients. Citation: Huff JS, Decker WW, Quinn JV, et al. Ann Emerg Med. 2007;49:431-444. American College of Emergency Physicians Issues Guidelines for Treatment of Syncope Citation: Barclay L. Medscape News. April 30, 2007. URL: http://www.medscape.com/viewarticle/ 555843?src=mp Syncope accounts …
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Challenges in Assessing and Treating Insect Bites and Stings
Urgent message: When presented with a patient who has experienced an insect bite or sting, the most crucial role for the urgent care clinician is to triage for anaphylaxis, venom toxicity, and local tissue damage. Kent A. Knauer, MD Now that summer is here, it is likely that urgent care practitioners—especially those practicing in suburban and rural areas—will see an increasing number of patients who have experienced an insect bite or sting. Though data are …
Read MoreIt’s the Journey, Not Just ‘The Win’
Lee A. Resnick, MD, FAAFP Brian Sipe’s “Red Right 88.” John Elway’s “The Drive.” Earnest Byner’s “The Fumble.” Michael Jordan’s “The Shot.” Jose Mesa’s “The Choke.” And now, the Cavs’ and “The Sweep.” You’ve just read an abridged version of the History of Cleveland Sports. For those of you who have no interest in sports, fear not; there’s an analogy in here somewhere. Growing up a Cleveland sports fan has been a roller coaster ride …
Read MoreJuly/August 2007
Clinical Challenge 2: June 2007
The patient is a young child with three days of constipation with a non-specific history of abdominal pain. On exam, the child was asleep. The abdomen was easily palpable and soft. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described below.
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The Case of an 18-Year-Old Male with Hand Pain
Urgent message: A thorough history and physical exam are essential to positive outcomes and risk reduction when managing patients with hand injuries. Michael B. Weinstock, MD and Ryan Longstreth, MD, FACEP Bouncebacks, in which we recount scenarios of actual patients who were evaluated in and discharged from an emergency department or urgent care facility and then “bounced back” for further treatment, appears semi-monthly in JUCM. Case presentations on each patient, along with case-by-case risk management …
Read MoreUCA: A Vision for the Future
Lee A. Resnick, MD, FAAFP The UCA National Conference, held last month in Daytona Beach, FL, was an important milestone in the organizational evolution of UCA: The elections conducted at the meeting marked the second rotation of board seats since our founding in 2004, and the first board election of a new president. It is critical to the success of our organization to have a rotating leadership at the board and officer levels. Our bylaws …
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Management of Patients Presenting with symptoms of Vulvovaginitis
Urgent message: As the cause of approximately 10 million office visits in the United States annually, vulvovaginitis remains a common but important complaint seen in the urgent care setting. Jansen Tiongson, MD, Samuel Keim, MD, and Peter Rosen, MD Although numerous etiologies account for vulvovaginitis, the vast majority of cases are due to bacterial vaginosis (BV), trichomoniasis, and vulvovaginal candidiasis (VVC). BV causes 40% to 50% of all cases, while candidiasis and trichomoniasis account for …
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