Journal of Urgent Care Medicine

Approach to Ingested Foreign Bodies in Children

Urgent message: Less than one out of a hundred cases of children ingesting foreign bodies requires surgical intervention. Identifying which children that could apply to, which need endoscopic removal, and those who can wait for spontaneous passage is an essential role for the urgent care provider. Herlene Chatha, MD and Hansel Otero, MD The case: An otherwise healthy 2-year-old boy is brought to your urgent care center by his parents, who are concerned that he …

The Potential Role of Urgent Care in Addressing the Opiate Epidemic

Urgent message: Opioid abuse, addiction, and resultant deaths have drawn the attention of both the medical community and legislative bodies from the local health department to the White House. Urgent care is a frequent destination for addicts trying to secure drugs illicitly—but it also has the potential to be the first stop on the road to recovery. Jason M. Ramos and Robert S. Crausman, MD, MMS Case Presentation Manny is a middle-aged white male who …

Approach to the Child with Chest Pain

Urgent message: Chest pain is both more common and, typically, less concerning in children than in adults. If anything, however, this underscores the importance of guarding against a false sense of safety in low-risk causes, and maintaining vigilance for life-threatening etiologies. SABAH F. IQBAL, MD, FAAP and HANSEL OTERO, MD The case: A 12-year-old healthy African-American boy presents to urgent care with 2 days of midsternal chest pain, which is worse when he’s taking big …

Urgent Care Evaluation for Snakebite Envenomation

Urgent message: Snakebite envenomation is relatively rare, but immediate action upon presentation to the urgent care center—including quick and accurate identification, appropriate care, and sound decisions regarding transfer to the ED—maximize the chance for optimal outcomes. Andrew Vang, DO Introduction Snake venom poisoning is a complex medical emergency that is seen infrequently, but when encountered requires rapid recognition and urgent management. The following discussion will focus on appropriately identifying snakebites from indigenous venomous species in …

Quality Improvement Report: Improving Telephone Follow-Up in an Urgent Care Setting

Urgent message: Follow-up after a patient visit is essential to the continuum of care and to the perception of customer service. Especially in the urgent care setting, where providers may have no ongoing relationship with a patient, the most basic office practices (eg, collecting accurate and accessible contact information) can seem deceptively simple but are of critical importance. Jimmie Toler, MSN, NP-C, Emily E. Johnson, PhD, and Barbara J. Edlund, PhD, ANP, BC Introduction Continuum …

The Red-Hot Joint

Urgent message: Septic arthritis can lead to significant morbidity if not treated in a timely manner. Bacteria within the synovial space can lead to rapid joint destruction and irreversible loss of function. When patients present to the urgent care center with a red, hot, swollen, painful joint, every attempt must be made to rule out this disease entity to prevent significant morbidity and mortality. Introduction Patients frequently present to urgent care with a red, swollen, …

Quality Improvement Report: Elevated Blood Pressure Referrals in an Urgent Care Setting to Increase Follow-Up Appointments with Primary-Care Providers

Urgent message: Urgent care providers are valued for their ability to treat nonemergent acute healthcare needs efficiently, but in so doing they are also well positioned to identify other, underlying healthcare issues such as hypertension. Introduction Heart disease is the leading cause of death in the United States and accounts for approximately 24% of all deaths.1 Many known risk factors are associated with heart disease, including high blood pressure. The Centers for Disease Control and …

Improving Appropriate Antibiotic Use for Common Clinical Conditions in Urgent Care

Urgent message: Increasingly, patients with symptoms of acute infection run to their nearest urgent care center. As such, urgent care clinicians can contribute greatly to national efforts to save lives by stemming the growth of antibiotic resistance through good antibiotic stewardship. Introduction Despite being a recent healthcare phenomenon, urgent care centers are responsible for a growing percentage of outpatient healthcare, with an estimated 160 million total annual visits at more than 9,300 sites in the …

A Multimodal Intervention to Reduce Antibiotic Use for Common Upper Respiratory Infections in the Urgent Care Setting

Urgent message: Upper respiratory infections (URIs) are the most common presenting complaint in urgent care. Regardless of etiology or provider specialty, antibiotics are prescribed 60% of the time for the treatment of URIs, contributing to drug-resistant respiratory organisms. Employing a multimodal intervention, the authors we were able to appreciate a modest, statistically significant decrease in the rate of antibiotic prescribing among urgent care providers. Introduction Antimicrobial resistance is arguably one of the greatest risks to …

Acute Compartment Syndrome—An Urgent Care Review

Urgent message: Acute compartment syndrome (ACS) is an important high-risk diagnosis to exclude when evaluating peripheral extremity injury. Providers must maintain a high clinical index of suspicion with careful attention to the history and mechanics of injury in an urgent care setting to preclude the devastating, rapidly developing sequela of ACS. Missing a case of ACS may result in significant morbidity—and even mortality. Awareness of both subtle and overt signs will ensure the best care …