Ivan Koay MBChB, MRCS, FRNZCUC, MD Are Urine Dipsticks Accurate in Diagnosing UTIs in Infants? Take-home point: Point-of-care (POC) urinalysis (ie, urine dipstick) is moderately sensitive and highly specific for diagnosing urinary tract infection in febrile infants. The optimum cut-point for excluding UTI is leucocytes (1+), and the optimum cut-point for confirming UTI is nitrites (trace). Citation: Waterfield T, Foster S, Platt R, et al. Diagnostic test accuracy of dipstick urinalysis for diagnosing urinary tract …
Read MoreAbstracts in Urgent Care – February 2023
Ivan Koay MBChB, MRCS, FRNZCUC, MD Quinolone Eardrops and Achilles Tendon-Related Outcomes Take-home point: Quinolone eardrops were associated with an increased risk of all-type tendon rupture, including Achilles tendon (AT), but not AT tendinitis. Citation: Tran P, Antonelli P and Winterstein A. Quinolone ear drops and Achilles tendon rupture. Clin Infect Dis. 2022; ciac709. Epub ahead of print September 6, 2022. Relevance: Systemic quinolones have been known to increase the risk of tendon rupture. Prior …
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Abstracts in Urgent Care – January 2023
Ivan Koay MBChB, MRCS, FRNZCUC, MD Kinesiology Taping for Shoulder and Chest Wall Injuries Take-home point: Kinesiologytaping (KT) combined with standard care appears to be more effective for acute pain reduction in patients with uncomplicated traumatic injury of the shoulder or chest wall. Citation: Bakker M, Bon V, Hubrechts B, et al. Kinesiotaping for acute pain due to uncomplicated traumatic injury of the shoulder or chest wall. Am J Emerg Med. 2022;58:197-202. Relevance: KT offers …
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Abstracts in Urgent Care – December 2022
Ivan Koay MBChB, MRCS, FRNZCUC, MD Applying the Ottawa Ankle Rule to Pediatric Patients Take-home point: Application of the Ottawa Ankle Rule (OAR) limits unnecessary imaging in children without missing clinically relevant fractures. Citation: de Almeida S, Rios J, Lima S, et al. Applying the Ottawa Ankle Rule in a pediatric emergency department. Pediatr Emerg Care. 2022;38(3):e1123-e1126. Relevance: Ankles fractures in children are common.Use of the OAR, a simple clinical decision rule, by UC providers …
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Abstracts in Urgent Care – November 2022
Fever: To Treat or Not to Treat? Distinguishing Viral from Bacterial Conjunctivitis Scapular Fractures and Blunt Chest Trauma in Children Sterile vs Nonsterile Gloves for Laceration Repair Bronchiolitis Care: An Update Antibiotic Stewardship and Children Post Paxlovid Rebound Ivan Koay MBChB, FRNZCUC, MD What Are the Consequences of Treating Adult Fever? Take-home point: Fever therapy in adults does not seem to affect the risk of death and serious adverse events. Citation: Holgersson J, Ceric A, …
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Abstracts in Urgent Care – October 2022
Ivan Koay MBChB, FRNZCUC, MD Achilles Tendon Rupture Predictive Value of Seamen’s Sign PT and Meniscus Tears Managing ACS in Rural Areas Following Up on Radiology Recommendations Syncope and Motor Vehicle Accidents Surgical vs Nonoperative Management of Achilles Tendon Rupture Take-home point: Surgery at 12 months postinjury was not associated with better outcomes compared with nonoperative treatment of Achilles tendon rupture. Citation: Myhrvold S, Brouwer E, Andersen T, et. al. Nonoperative or surgical treatment of …
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Abstracts in Urgent Care – September 2022
Vapocoolant and Digital Nerve Blocks Dosing Dexamethasone in Pediatric Asthma Infant Clean-Catch Urine Contamination Antibiotic-Associated Diarrhea in Children Treating Acute Diverticulitis Torus Wrist Fractures in Children Efficacy of Antiviral Treatment in COVID-19 Vapocoolant for Pain Reduction in Digital Nerve Blocks Take-home point: Application of vapocoolant prior to digital nerve blocking can reduce pain associated with skin puncture and local anesthetic infiltration. Citation: Selvi F, Bedel C, Akçimen M. Evaluation of vapocoolant spray effect on pain …
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Abstracts in Urgent Care – July/August 2022
Colchicine in Acute Gout POCUS and Necrotizing Fasciitis Assessing Patient Satisfaction Misinterpreting Pediatric Radiographs Lung Ultrasound and Pediatric Pneumonia Diagnosing Pneumothorax A Review of the Evidence for Colchicine in Acute Gout Take-home point: Colchicine appears to be no more effective than NSAIDs for acute gout flares and evidence does not indicate greater efficacy at higher doses. Citation: Gottlieb M, Rabah W, Long B. Colchicine for acute gout. Acad Emerg Med. 2022;29(3):387-388. Epub ahead of print …
Read MoreAbstracts in Urgent Care – June 2022
Maximizing the Value of Urine Dipstick Testing Screening for Intimate Partner Violence Antibiotics for Children with RTI Azithromycin in Pediatric Viral Infection Self-Monitoring BP with Unvalidated Devices Modified Valsalva Maneuver in SVT To Mix or Not to Mix COVID-19 Vaccines? Ivan Koay, MBChB, FRNZCUC, MD Nitrofurantoin Resistance Take-home point: Proteeae group bacteria, which are often resistant to nitrofurantoin, normally result in alkaline (ie, high pH) urine on dipstick testing. Citation: Sheele J, Libertin C, Fink …
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Physical Therapy as Nonsurgical Management and Presurgical Management of Most Common Knee Pathologies
Urgent message: Appreciation for the cause of knee pain, along with an understanding of potential nonoperative rehabilitation therapies that could be provided in urgent care, can enhance patient care and improve patient satisfaction while minimizing the need for referral. Dr. Eva Delgado Martinez MBChB, GP, MScCN and Dr. Ivan Koay MBChB, FRNZCUC, MD INTRODUCTION Knee injuries in adults and children are common presentations to urgent care and emergency rooms.1 Rehabilitation of those injuries is essential …
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