Practice Management
Urgent message: Diagnosing UTI in a child is challenging in the urgent care setting. Fever, abdominal or back pain, frequency or new onset of incontinence all should raise your index of suspicion. KIMBERLY GIBSON, MD Cases such as the following are common in urgent care and they present unique challenges: J.S., a 2-year-old girl, presents to an urgent care clinic on a Saturday afternoon for evaluation of low-grade fever and fussiness. Her parents have been …
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Urgent message: Symptoms from stones in the ureter can mimic other conditions, making for a diagnostic dilemma in urgent care. Imaging is the key to accurate assessment and appropriate treatment. WILLIAM GLUCKMAN, DO, MBA, FACEP and KATE ABERGER, MD Ureterolithiasis, which literally translates to stones in the ureter, is sometimes referred to improperly as “kidney stones,” which are properly known as nephrolithiasis. Although stones do form within the kidney, they do not typically cause acute …
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Urgent message: For patients, cosmesis is often the top priority. But for clinicians, ruling out serious or life-threatening injury is paramount. Sean McNeeley, MD Introduction Patients with oral and related facial injuries often present to urgent care providers. Consider JT. He is 25-year-old male who was taken to an urgent care clinic by his friends after falling while mountain biking near his Ohio home. His friends were concerned because the hill was steep, and although …
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Urgent message: Even a seemingly minor hand injury can result in lifelong disability if evaluation and treatment are incorrect. TRACEY QUAIL DAVIDOFF, MD Introduction The hand is a vital part of human anatomy allowing us to interact with our environment in nearly infinite ways. The functional aspects of the hand are a direct extension of the brain, allowing us to initially make stone tools, play musical instruments, make intricate crafts, type, communicate, and appreciate our …
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Urgent message: As the population of seniors swells, more cases of senile dementia, delirium, and psychosis are apt to present in urgent care. Here is how to assess and manage these patients. RAUL E. RODON, MD Introduction Evaluating patients presenting with altered mental status in the urgent care setting requires a modified skill set, one that varies from the assessment of patients with a similar profile in a hospital emergency department. Limited access to standard …
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Urgent message: The patients most prone to sexually transmitted diseases are also mostly likely not to have a primary doctor. Many will turn to urgent care for help. THOMAS SUNSHINE, MD, FACOG As urgent care physicians, we often are presented with patients who are worried that they may have a sexually transmitted disease or infection (STD/I). The number of yearly visits is difficult to estimate because the diagnosis codes of the visits vary. The Center …
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Urgent message: A variety of objects find their way into the ears, noses, and throats of children. Some can be lethal and require ED or specialist referral. Others can be safely removed in an urgent care setting. ANN MARY BACEVICE, MD In children who are brought to an urgent care for treatment, foreign bodies are common. Especially if they are between the ages of 18 months and four years, children will insert objects into their …
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Identifying Risk Factors in Preparticipation Physicals for Young Athletes Urgent message: Doctors in the US and Europe are divided over what the cardiovascular component of a proper sports physical should include. Here is a reasonable approach. NATHAN P. NEWMAN, MD, FAAFP Sudden death in young athletes is not new. In 490 BC, when the Greeks improbably defeated the invading Persians at Marathon, a young herald, Phidippides, ran 25 miles back to Athens to announce the …
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Urgent message: Acute stridor in pediatric patients is alarming to children, parents, and healthcare providers alike. Differential diagnosis is the key to initial evaluation and management of this worrisome symptom. Here is how to think it through. JERRI A. ROSE, MD, FAAP Stridor is an externally audible sound caused by abnormal air passage during breathing.1 It results from turbulent airflow through large airways. When a normal respiratory volume of air passes through narrowed airways, the …
Read MoreUrgent message: Anaphylaxis is a true medical emergency that requires rapid and aggressive treatment. When a patient with a Type 1 hyper – sensitivity reaction is brought to your urgent care, here is how to proceed. DAVID WEIN, MD, MBA, FACEP, and DENNIS DIXON, MD Introduction Anaphylaxis is a severe, whole-body, allergic reaction to a chemical that has become an allergen. Anaphylaxis is a true medical emergency, often with a rapid and unpredictable onset. It …
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