Journal of Urgent Care Medicine

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. …

Abstracts in Urgent Care – July/August 2024

Use of NEXUS II Clinical Decision Tool for Blunt Head Injuries in Elderly Patients Take Home Point: Older patients with blunt head-injury are at high risk of sustaining serious intracranial injuries even with low-risk mechanisms of injury, such as ground-level falls. Citation: Mower W, Akie T, Morizadeh N, et. al. Blunt Head Injury in the Elderly: Analysis of the NEXUS II Injury Cohort. Ann Emerg Med. 2024 May;83(5):457-466. doi: 10.1016/j.annemergmed.2024.01.003 Relevance: Older adults are known …

Fast Track Improves Patient Flow and Wait Times in the Pediatric Urgent Care: A Quality Improvement Project

Urgent Message: Fast trackmodels aim to improve patient throughput metrics for low-acuity patients. In this quality improvement project, a process for fast track in the pediatric urgent care significantly improved patient flow. Hayley L. Ross, MD; Sandra P. Spencer, MD; Traci Ertle, MSN, RN, CPEN; Anthony Watkins, MSN, RN, NE-BC; Mark Feldman, MD; Derrek Massanari, MD, MPH; Bernadette Johnson, MD; Alexandria J. Wiersma, MD Citation: Ross HL, Spencer SP, Ertle T, Watkins A, Feldman M, …

Atypical Chest X-ray Appearance in a Patient with Cough: A Case Report

Urgent Message: The azygos lobe may be apparent on a chest x-ray and is a relatively uncommon, yet benign finding, that is important to distinguish from other etiologies. The azygos lobe is an embryological remnant and is usually incidental in nature. Citation: Richmond C, Mancuso A. Atypical Chest X-ray Appearance in a Patient with Cough: A Case Report. J Urgent Care Med. 2024; 18(10):23-25 Keywords: azygos lobe, normal variant, chest x-ray Abstract Introduction: Recognition of …

Fever of Unknown Origin: A Case Report of Babesiosis Infection

Batsheva R. Sholomson, DO; Danielle Langan, DO; Abbas Husain, MD; Shorok Hassan, DO Urgent Message: With the incidence of babesiosis rising, clinicians are encouraged to consider the totality of presentation including risk factors based on endemic region, recent travel or tick bite, and clinical signs and symptoms. Citation: Sholomson BR, Langan D, Husain A, Hassan S. Fever of Unknown Origin: A Case Report of Babesiosis Infection. J Urgent Care Med. 2024; 18(10):17-21 Key Words: Babesiosis, …

Urgent Care Management of Scaphoid Fracture

Naushair Hussain, DO; Shahmeer Hussain, DO; Clinton A. Hartz, MD Urgent Message: Scaphoid fractures most frequently occur at the mid aspect, or “waist,” of the scaphoid, and require about 10 weeks of prolonged immobilization before slow return to normal function. Such fractures have high risk of complications and subsequent chronic pain and/or disability if not appropriately immobilized. Citation: Hussain N, Hussain S, Hartz C. Urgent Care Management of Scaphoid Fracture. J Urgent Care Med. 2024; …

‘As Little as Necessary…’– A Mantra for Urgent Care

“Do as little as necessary, not as much as possible.” This is the mantra I recite throughout every urgent care shift without fail—that’s how mantras work after all. Hearing the word “mantra” might conjure images of a placid-faced yogi seated in the lotus position for some, but a mantra needn’t serve only spiritual practice. A well-conceived mantra can also prove useful when deployed in any context where we might benefit from being reminded frequently to …

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, …

Abstracts in Urgent Care – June 2024

Using AI to Detect Myocardial Infarction Take Home Point: The use of an occlusive myocardial infarction (OMI) artificial intelligence (AI) electrocardiogram (ECG) model has the potential to improve identification of acute coronary syndrome (ACS) by enabling timely and accurate detection of OMI regardless of the presence ST-segment elevation. Citation: Herman R, Meyers H, Smith S, et. al. International evaluation of an artificial intelligence-powered electrocardiogram model detecting acute coronary occlusion myocardial infarction. Eur Heart J Digit …

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