Journal of Urgent Care Medicine

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 …

Urgent Care Evaluation of Diarrhea

Urgent message: Diarrheal illness presents with varying degrees of severity and a broad range of etiologies. The urgent care center provider’s ability to gather key information from the medical history and physical examination, determine when laboratory testing is beneficial, and recognize indications for treatment is essential for the effective and efficient treatment of this common symptom. NATHAN M. FINNERTY, MD, and MICHAEL WEINSTOCK, MD Introduction Diarrheal illness is a common presenting complaint to all urgent care centers. In the United …

Impact of a Pharmacist-Provided Comprehensive Medication Review Service for Urgent Care Patients

Urgent message: Urgent care centers are encouraged to meet best practices for communication during transitions of care. Partnering with pharmacists may optimize medication therapy for patients, helping fulfill these best practices. JENNIFER A. FLAVIN, PharmD, CHRISTOPHER G. GREEN, PharmD, STEPHANIE C. COOK, DO, and STUART J. BEATTY, PharmD, BCACP Objective: This study aimed to (1) evaluate the impact of a pharmacist-provided comprehensive medication review (CMR) service on medication therapy appropriateness, safety, efficacy, and adherence for …

An Urgent Care Approach to Burns

Urgent message: Burn injuries present with varying degrees of involvement and severity. It is vital that providers in an urgent care facility understand burn classification, treatments, and, most important, which burn patients can be treated in an outpatient setting and which patients require a higher level of care. DREW LONG, BS, BRIT LONG, MD, and ALEX KOYFMAN, MD Introduction Burn injuries are often devastating and are a leading cause of accidental injury and trauma in …