Journal of Urgent Care Medicine

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 …

Pediatric Elbow Assessment: An Urgent Care Approach

Urgent message: While pediatric elbow injuries can be a simple fix in an urgent care setting, understanding mechanism of injury and recognizing cases where referral is warranted help ensure positive outcomes. Pediatric musculoskeletal injuries comprise approximately 12% of the 10 million annual visits to urgent care centers and emergency departments in the United States. History, physical exam and proper imaging remain the mainstay of diagnosis and treatment of many orthopedic related chief complaints. The purpose …

Urgent Care Evaluation of Pneumonia

Urgent message: The incidence of community-acquired pneumonia (CAP) is seasonal in nature, with a peak during the winter months and a trough in the summer months. In the urgent care setting, primary concerns are risk factors for CAP, as well as current treatment and testing guidelines. Overview Pneumonia is an acute alveolar lung infection that presents with infiltrates upon chest imaging and is often accompanied by fever, cough, sputum production, shortness of breath, and physical …

An Urgent Care Approach to Malignancy Complications

Urgent message: The prevalence of cancer is increasing—and along with it, malignancy-associated complications. Early recognition and management of these conditions is vital to alleviating patient morbidity and maximizing quality of life. Introduction Cancer is a leading cause of morbidity and mortality throughout the world, accounting for over 580,000 deaths in 2013 in the U.S.1 With an aging population and more effective forms of treatment, the overall prevalence of cancer is increasing. Consequently, acute cancer-related complications …

Original Research: HIV Screening in the Urgent Care Setting

Urgent message: Increasingly, Americans do not know their human immunodeficiency virus (HIV) serostatus. Implementing rapid HIV testing can allow your center to play a key role in identifying new cases of HIV and linking patients to care. Abstract Background: Data from the Centers for Disease Control and Prevention (CDC) suggest that an increasing number of Americans do not know their human immunodeficiency virus (HIV) serostatus. The CDC recommends routine screening for all patients 13 to …

Urgent Evaluation of Traumatic Neck Pain

Urgent message: Clinicians must be able to determine the cause and severity of injury in patients with neck pain, especially in the very young, whose symptoms vary according to their developmental status, and in the elderly, who have weaker bones and degenerative changes. Introduction Avariety of patients from children to the elderly will present to an urgent care Center with the chief symptom of neck pain. Cervical spine (C-spine) injuries occur in 3.7% of adults …

Pediatric Oral Lesions in the Urgent Care Setting

Urgent message: Being able to recognize the distinct oral lesions of common illnesses in children is essential, but it can be difficult to conduct an oral examination in frightened young children. Introduction Inspecting intraoral lesions in children will often confirm a diagnosis, but getting uncooperative patients to let the clinician visualize such lesions is challenging. Here we provide helpful examination tips and review common pediatric infectious and allergic oral lesions and their treatment. Techniques for …

Original Research: Early Diabetes Screening in the Urgent Care, Part 2

Urgent message: Various methods have been suggested for screening for type 2 diabetes mellitus in the asymptomatic population, although more consensus about the best approach, especially in settings outside primary care, is required. The usefulness of a diabetes-screening pathway for the early detection of undiagnosed diabetes was assessed in a quality-improvement study of a convenience sample from an urgent care center. How this article/column helps you: by analyzing findings on how screening all adults for …