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. …
Read MoreEscalating 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. …
Read MoreReturn 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 …
Read MoreDyspnea 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, …
Read MoreExpanding 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: …
Read MoreUrgent 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 …
Read MoreAn 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 …
Read MoreCase 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 …
Read MorePediatric 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 …
Read MoreHeadache and Paranoid Delusions: A Case Report of Missed Neurocysticercosis
Urgent Message: Headaches are common, but when patients present with concurrent psychiatric symptoms, seizures, and signs of increased intracranial pressure, clinical teams might consider asking about recent travel to assess for possible neurocysticercosis. Naail Tariq, Cavan Scheetz, Michael Weinstock, MD Download the article PDF Here Citation: Tariq N, Scheetz C, Weinstock M. Headache and Paranoid Delusions: A Case Report of Missed Neurocysticercosis. J Urgent Care Med. 2023;17(X);31-34. Abstract Introduction Headache is a common urgent care …
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