Journal of Urgent Care Medicine

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 …

Managing Hypertensive Emergencies in the Urgent Care Setting

Urgent message: Health-care practitioners frequently see patients in urgent care centers who have elevated blood pressure. It is vital that they be able to identify hypertensive emergencies to immediately start lowering such patients’ blood pressure and then transfer them to an emergency department, to avoid hypertensive damage to the brain, heart, and kidneys. JON JUHASZ, MD Introduction Elevated blood pressure (BP) is very common in the urgent care setting, oftentimes from pain or from chronic …

Fever Phobia: Urgent Fears in Urgent Care

Urgent message: Fear of fever leads many parents to seek urgent care. Addressing their fears should be part of the care of febrile children. DEENA R. ZIMMERMAN, MD, MPH, IBCLC; NAHUM KOVALSKI, MD; BARUCH HAIN, BA; and JOSHUA LIPSITZ, PHD In several studies, researchers have found that a large percentage of parents have fever phobia, or inaccurate beliefs about the harmfulness of an elevated body temperature. Those studies were conducted in primary-care settings, so we …

Delayed Prescribing of Antibiotics for Respiratory Tract Infections

Urgent message: Respiratory tract infections are a common complaint in the urgent care setting. Many patients present with the expectation of receiving antibiotics because they have usually done so. The rise of anti biotic-resistant infections requires that we take a close look at our prescribing habits and the need to reeducate patients on the harm of overusing antibiotics. Delayed prescribing offers a way to both satisfy patients and reduce the use of antibiotics in respiratory …

Urgent Care Management of Animal Bites and Stings

Urgent message: Because bite and stings can be sustained in a variety of settings from many different animals and can transmit a wide variety of infectious agents, urgent care providers should have specific knowledge about treating wounds from mammals, nonmammals, and marine animals. ALEXANDER NATHANSON, MD Practitioners at urgent care centers often see patients who have sustained animal bites or stings. In addition to causing structural damage to tissues, bites and stings expose patients to …

Hyperbilirubinemia: An Urgent Care Approach

Urgent message: Although frequently overlooked, routine urinalysis results can serve as an important diagnostic indicator of underlying and potentially life-threatening systemic disease states. NATALIE SMITH, MS, PA-C Urinalysis is one of the most common diagnostic tests used in and urgent care medicine. Urinalysis results yield routine clinical information necessary for everyday diagnoses localized to the renal and urologic systems; findings such as pyuria indicative of cystitis or hematuria related to renal calculi are some commonplace …

Shoulder Pain in the Urgent Care

Urgent message: Shoulder pain is not always “just another musculoskeletal complaint.” It may be referred pain indicating life-threatening conditions. Many patients use urgent care centers as sources of primary care. Thus when we make an important diagnosis because of our methodical, stepwise approach to examination, we have the opportunity to be the providers who ultimately expedite diagnosis and care for these patients. MIZUHO SPANGLER, DO, and MICHAEL B. WEINSTOCK, MD Shoulder pain is the third …

Upper Gastrointestinal Disorders in Urgent Care, Part 2: Biliary Tract and Pancreatic Disease

Urgent message: Upper abdominal pain is a common presentation in urgent care practice. Narrowing the differential diagnosis is sometimes difficult. Understanding the pathophysiology of each disease is the key to making the correct diagnosis and providing the proper treatment. TRACEY Q. DAVIDOFF, MD Part 1 of this series focused on disorders of the stomach—gastritis and peptic ulcer disease—on the left side of the upper abdomen. This article focuses on the right side and center of …