Journal of Urgent Care Medicine

Urgent Care Assessment of Patients with Possible Diverticulitis

Urgent Message: Diverticulitis is a prevalent condition characterized by localized inflammation most commonly of the sigmoid colon. It is often diagnosed with a computed tomography scan with intravenous contrast. Uncomplicated cases are most common and require only monitoring, however complicated cases can require hospitalization and emergent surgical intervention. Urgent care clinicians should be comfortable assessing patients with possible diverticulitis and recognizing features that suggest the possibility of more complicated disease. Naushair Hussain DO; Shahmeer Hussain …

Major Adverse Cardiovascular Events in Patients with Chest Pain And Moderate Heart Risk Scores Who Were Referred For An Expedited Outpatient Cardiology Evaluation: A Multi-Center Descriptive Study

Urgent Message: Patients with a moderate-risk HEART score referred from an urgent care center for an expedited outpatient cardiology evaluation were found to have a very low rate of MACE and no occurrence of ischemic cardiac deaths. Citation: Thomson N, Barbarash S, Lebron-Gallagher D, Julson H, Weinstock M. Major Adverse Cardiovascular Events in Patients with Chest Pain And Moderate Heart Risk Scores Who Were Referred For An Expedited Outpatient Cardiology Evaluation: A Multi-Center Descriptive Study. …

Escalating Back Pain Leading to a Diagnosis of ST-Elevation Myocardial Infarction (STEMI) in Urgent Care: A Case Report

Urgent Message: Acute coronary syndromes (ACS), including ST-elevation myocardial infarction (STEMI), may present with predominant back pain or other non-chest-pain symptoms. Additionally, electrocardiogram findings in cases of coronary occlusion may not always meet STEMI criteria. It is important to include myocardial ischemia and ACS in the differential for back pain presentations, especially when the pain is not reproducible. Sarah Mannon OMS-3; Lauren Schuermann OMS-3; Michael B. Weinstock, MD Citation: Mannon S, Schuermann L, Weinstock M. …

Return Visits and Hospitalization Rates of Adult Patients Discharged with Tachycardia After an Urgent Care Visit: A Retrospective Cohort Study

Urgent Message: Patients discharged from an urgent care clinic with tachycardia were found to have significantly higher odds of return visits to the urgent care and emergency department as well as higher odds of being admitted to the hospital within 7 days compared to non-tachycardic patients. Vitoria Regina Nunes Maia, MD; Ryan Loh, PhD; Michael Weinstock, MD; Lindsey E. Fish, MD Citation: Maia VRN, Loh R, Weinstock M, Fish L. Return Visits and Hospitalization Rates …

Dyspnea in the Urgent Care: Differentiating Benign From ‘Can’t Miss’

Urgent Message: Patients commonly present with respiratory symptoms in the urgent care setting and not infrequently complain of some degree of shortness of breath—or dyspnea. It is critical for clinicians to have comfort with the clinical assessment and appropriate use of diagnostic resources for the dyspneic patient. Identifying patients requiring immediate emergency department referral is an important skill. Evan Price, DO; Eric Patten, MD; Shakil Hossain, DO; Michael Weinstock, MD Citation: Price E, Patten E, …

Expanding the Differential of Thunderclap Headache Beyond Subarachnoid Hemorrhage: A Case Report

Urgent Message: Cerebral venous thrombosis is a serious cause of headache that can present in a variety of manners, including sudden-onset or “thunderclap” fashion. Caroline S. Mifsud, OMS-IV; Jordan L. Jones, OMS-IV; Michael B. Weinstock, MD Citation: Mifsud C, Jones J, Weinstock M. Expanding the Differential of Thunderclap Headache Beyond Subarachnoid Hemorrhage: A Case Report. J Urgent Care Med. 2024; 18(8):21-24 Key Words: dural sinus thrombosis, cerebral venous thrombosis, headache, thrombophilia, case report Abstract Introduction: …

Urgent Care Evaluation and Management Of Proximal 5th Metatarsal Fractures

Urgent Message: It’s important to recognize the difference between a proximal 5th metatarsal fracture of the tuberosity alone and a proximal metaphyseal fracture, commonly referred to as a “Jones fracture.” A Jones fracture requires full immobilization with urgent surgical referral. Michael B. Weinstock, MD; Kelly Moore, BS Citation: Weinstock M, Moore K. Urgent Care Evaluation and Management Of Proximal 5th Metatarsal Fractures. J Urgent Care Med. 2024 18(7):25-28 Editors’ Note: While the images presented here …

An Atypical Cause of Fever and Confusion: A Case Report of Delayed Pulmonary Embolism Diagnosis

Francesca Cocchiarale, DO; Alexa Bailey, MS-3; Michael Weinstock, MD Urgent Message: Pulmonary embolism can be frequently missed as a diagnosis because it can present with a variety of signs and symptoms. Understanding clinical decision rules and myriad presentations can help urgent care providers determine when patients benefit from immediate referral to an emergency department. Citation: Cocchiarale F, Bailey A, Weinstock M. An Atypical Cause of Fever and Confusion: A Case Report of Delayed Pulmonary Embolism …

Case Report of Renal Cell Carcinoma Presenting to Urgent Care with Indolent Back Pain: A Wolf in Sheep’s Clothing

Urgent message: Although back pain is often due to benign etiologies, symptoms of progressive pain, weakness, and near syncope in one patient ultimately led to a diagnosis of renal cell carcinoma. Citation: Hamazaspyan A, Kedia A, Weinstock M. Case Report of Renal Cell Carcinoma Presenting to Urgent Care with Indolent Back Pain: A Wolf in Sheep’s Clothing. J Urgent Care Med. 2024;18(5): 17-22. Anahit Hamazaspyan DO; Ayush Kedia DO; Michael Weinstock MD Abstract Introduction Back …

Pediatric Knowledge Needs Assessment: A Pilot Study

Urgent Message: Pediatric emergency medicine researchers have an opportunity to enhance collaboration with general emergency medicine and acute care clinicians to bridge the gap between research and dissemination of evidence-based care recommendations. Bashar S. Shihabuddin, MD, MS, FAAP, FACEP; Jessica Fritter, MACPR, ACRP-CP; Charmaine B. Lo, PhD MPH; Rachel Stanley MD, MHSA; Michael Weinstock, MD Citation: Shihabuddin B, Fritter J, Lo C, Stanley R, Weinstock M. Pediatric Knowledge Needs Assessment: A Pilot Study. J Urgent …

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