Journal of Urgent Care Medicine

Original Research: Early Diabetes Screening in the Urgent Care, Part 1

Urgent message: Undiagnosed type 2 diabetes mellitus affects more than 9 million Americans. This first part of a two-part article focuses on evaluation of diabetes screening for the adult urgent care patient in whom diabetes has not been diagnosed, using effective early disease-detection strategies to reduce the long-term burden of diabetes. How this article helps you: by providing data to assist you in deciding about screening in your center. Introduction There are now more than …

Nonhealing Wounds, Part 2: Treatment in the Urgent Care Center

Urgent message: The etiology of nonhealing wounds is often multifactorial, with the likelihood of healing enhanced if all considerations are addressed, including evaluation and management of the blood supply in patients with peripheral arterial disease or diabetes mellitus, as well as local wound care. The diagnosis of a nonhealing wound is largely clinical, with diagnostic studies tailored to the suspected cause as well as to the underlying process. Part 1 of this article [see “Nonhealing Wounds, Part 1: Diagnosis in the Urgent Care …

Nonhealing Wounds, Part 1: Diagnosis in the Urgent Care Center

Urgent message: Nonhealing wounds not only are prevalent but also are complex in terms of wound management and treating the accompanying comorbid disease. By both recognizing the diagnosis and understanding how to treat these wounds, urgent care providers have the opportunity to differentiate life-threatening illness from lifeinhibiting disease and improve outcomes for patients. An estimated 6 million people in the United States have a nonhealing wound, with a 1% lifetime incidence for the total population.1,2 This number is expected to increase with the …

Diverticulitis in the Urgent Care Setting

Urgent message: Abdominal pain due to acute diverticulitis is commonlyseen in the urgent care setting. This is a clinical update on the management and treatment of acute diverticulitis. Abdominal pain commonly presents in the ambulatory setting, in anywhere from 1.5% to 8% of patients.1,2 With diverticulitis being a common diagnosis in the presence of abdominal pain, the clinical challenge in a nurgent care setting is determining uncomplicated from complicated diverticulitis. Diverticulosis French pathologist Jean Cruveilhier …

Evaluation of Scrotal Pain in the Urgent Care Setting

Urgent message: Evaluating patients with acute scrotal pain can be a challenge for clinicians in the outpatient setting because several conditions indicated by it can cause significant morbidity. Performing a thorough but focused medical history and physical examination and considering certain diagnoses, including testicular torsion, epididymitis, and prostatitis, are imperative when assessing these patients. JEREMY HAWKINS, MD, BRIT LONG, MD, and ALEX KOYFMAN, MD, FAAEM Introduction Evaluation of acute scrotal pain is often challenging for clinicians …

Zika Virus—Near Pandemic Proportions?

Urgent message: The clinical manifestations of Zika virus infection are generally mild in adults; the primary concern is the potential link to microcephaly in children of infected pregnant women. There is no cure, so prevention is paramount. MIZUHO SPANGLER, DO, and MICHAEL B. WEINSTOCK, MD Introduction The Zika virus epidemic is gaining a lot of media attention, deservedly so; there have been large outbreaks of infection in Brazil, South America, and the Caribbean, with numbers …

Evaluation and Management of Ankle Injuries in Urgent Care

Urgent message: Acute ankle injuries can progress to chronic issues. It is essential that the urgent care clinician be aware of the mechanisms of common ankle injuries, their pathophysiology, essential diagnostic tests, and which injuries require transfer for a higher level of care. LISA SCHUERMAN, RN, MSN, APNP Introduction The ankle is one of the most common sites for acute musculoskeletal injuries, with sprains accounting for 75% of ankle injuries. The ankle joint is composed of the tibia, fibula, and talus. …

Urgent Care Management of Geriatric Falls

Urgent message: Falls are a common reason for geriatric patients to present for medical care. In this population, even seemingly minor falls can lead to significant injury, and falls may occur in the first place because of serious underlying medical illnesses. It is critical for the urgent care provider to distinguish which of these patients can be treated in the urgent care setting and which require transfer to a higher level of care. REBEKAH BLICKENDORF, …

Urgent Care Management of Acute Otitis Media in Children

Urgent message: The possibility of ear infection is the most common reason parents seek care for their young children during viral upper respiratory infections with fever. Urgent care providers should know the new criteria for making the clinical diagnosis and how to use technology such as an acoustic otoscope before concluding that antibiotics are necessary. MICHAEL E. PICHICHERO, MD Diagnosing acute otitis media (AOM) is a visual process based on viewing the eardrum and determining …

Urgent Care Diagnosis and Management of Tick-Borne Diseases

Urgent message: As the incidence of tick bites increases, it is imperative for urgent care physicians to be able to recognize various species of ticks and the symptoms of tick-borne illnesses and to know what to do when a patient presents with a tick bite. TOYIN FAPOHUNDA-ADEKOLA, MD, MBA Lyme disease is the most common tick-borne infection in the United States (Figure 1) and Europe. With a total of 279,509 cases reported between 2003 and …