Journal of Urgent Care Medicine

Upper Gastrointestinal Disorders in Urgent Care, Part 1: Gastritis, Peptic Ulcer Disease, and Helicobacter pylori

Urgent message: Gastritis and peptic ulcer disease are a spectrum of diseases that can range from mild to serious; urgent care providers must be on the alert for these conditions. Early diagnosis and treatment, along with recommendations for follow-up care with appropriate specialists, can help prevent long-term sequelae. TRACEY Q. DAVIDOFF, MD Gastritis and peptic ulcer disease (PUD) represent a continuum along a path of inflammation of the gastric mucosa, from superficial irritation of the …

Urgent Care Evaluation of Fatigue

Ever heard the old (and not so funny) joke about two health-care providers having a conversation at the urgent care center? First provider: “Ever seen a case of _____?” Second provider: “Turns out I have seen plenty of cases . . . just never diagnosed any!” With a nonspecific presenting condition such as fatigue, it is difficult to obtain an adequate medical history and to perform a thorough physical examination unless the differential diagnosis is …

Medication Issues in Urgent Care

Urgent message: Polypharmacy—taking multiple medications to treat several chronic medical problems—puts patients at increased risk of developing additional health issues when they are prescribed even more medications for acute conditions in an urgent care center. JASMEET SINGH BHOGAL, MD It is not uncommon for patients, especially elderly patients, presenting to an urgent care center to have multiple medical problems. This makes it more likely that they are taking multiple medications as well. In fact, according …

Repair of Lacerations of the Face and Scalp: Part 2

Urgent message: Evaluation and treatment of injuries of the cheek, ear, nose, lips and tongue are explored to help urgent care clinicians more confidently manage these presentations. TOYIN FAPOHUNDA-ADEKOLA MD, MBA In Part 1 of this series, we covered the evaluation and management of scalp, brow, and eyelid lacerations. In Part 2, we will explore injuries of the cheek, ear, nose, lips and tongue. As previously discussed, careful evaluation of neurovascular function and appreciation of …

Repair of Lacerations of the Face and Scalp: Part 1

Urgent message: Management of face and scalp lacerations requires an appreciation of the unique anatomy, sound repair technique, and consideration of patient expectations for cosmesis. TOYIN FAPOHUNDA-ADEKOLA MD, MBA Lacerations of the scalp and face are commonly seen in the urgent care setting. While these injuries can cause anxiety for both patient and practitioner, the basic tenets and techniques for repair are already well known. Following a systematic approach and appreciating the unique anatomic considerations …

Antibiotic Management of Acute Uncomplicated Cystitis and Pyelonephritis in Women

Urgent message: Proper empiric antibiotic treatment in women with acute uncomplicated cystitis and pyelonephritis can prevent unnecessary morbidity and provide urgent relief from these common genitourinary infections. MOZELLA WILLIAMS, MD Genitourinary infections in women are encountered frequently in the urgent care setting. Timely diagnosis and proper empiric antibiotic treatment will usually forestall serious complications and provide speedy relief. Over a lifetime, 50% of women will experience an acute uncomplicated cystitis, also known as a lower …

An Urgent Care Approach to Joint and Soft-Tissue Injection/ Aspiration: Part 2

Urgent message: Injection/aspiration therapy for selected musculoskeletal complaints is becoming more common in urgent care practice. Part 2 of this series offers step-by-step guidance on treatment of conditions from “tennis elbow” to bursitis and cysts. THOMAS V. GOCKE, III, MS, ATC, PA-C, DFAAPA The focus of Part 1 of this series, in the September issue of JUCM, was on understanding the inflammatory response, use of corticosteroids and anesthetic agents (Table 1), pre- and post-aspiration/injection considerations, …

An Urgent Care Approach to Joint and Soft-Tissue Injection/ Aspiration: Part 1

Urgent message: Injection/aspiration therapy for selected musculoskeletal complaints is becoming more common in urgent care practice. Providers need a thorough understanding of injection/aspiration procedures and associated risks to be equipped to deliver rescue therapy to patients. THOMAS V. GOCKE, III, MS, ATC, PA-C, DFAAPA Joint pain, joint effusion, and recurrent soft-tissue trigger point irritation are common presentations in urgent care. As more and more patients present seeking immediate relief of such symptoms, it’s important that …

Evaluation of Headaches in Urgent Care Part 2: Non-Emergent Headaches

Urgent message: Headaches are challenging chief complaints and being able to identify and differentiate among the non-emergent types of headaches will help with medical decision making and patient care. JACQUALINE DANCY, PA-C, MPAS In the conclusion of a two-part series, this article focuses on non-emergent headaches. For the purpose of this article, non-emergent headaches are classified as those that are not life-threatening and pose little to no risk of permanent functional disability. Most non-emergent headaches …

Outpatient Management of Deep Venous Thrombosis

Urgent message: Urgent care providers are on the frontline in diagnosis of DVT. Outpatient management is a consideration for carefully selected patients. SABRINA SOOD, MD Deep venous thrombosis (DVT) is formation of a clot in the deep venous system, usually in a lower extremity. Half of untreated patients with DVT will go on to develop the fatal complication pulmonary embolism (PE). Approximately 300,000 to 600,000 Americans die each year due to venous thromboembolism (VTE).1 Urgent …