Journal of Urgent Care Medicine

Systemic Steroid Stewardship in Urgent Care: Recognizing Indication Creep to Limit Avoidable Harms

Urgent Message: Steroid overprescribing is a universal urgent care issue. While systemic steroids have several indications in which the preponderance of evidence supports their use in the urgent care setting, indication creep has led to their use outside of these scenarios resulting in significant risk for avoidable and unjustifiable adverse reactions. Citation: Hansen P. Systemic Steroid Stewardship in Urgent Care: Recognizing Indication Creep to Limit Avoidable Harms. J Urgent Care Med. 2023;18(3);29-32 Author Affiliation: Paul …

Detection and Management of Urinary Calculi in the Urgent Care Setting

Andrew Alaya MD MSc Urgent Message: Abdominal pain is a common urgent care complaint that may result from a variety of benign to life-threatening etiologies, which can pose diagnostic and therapeutic difficulty for the clinician. Ureteral calculi are able to be diagnosed and managed in the urgent care setting. Citation: Alaya A. Detection and Management of Urinary Calculi in the Urgent Care Setting. J Urgent Care Med. 2023;18(2); 31-38 Introduction/Epidemiology Formation of calculi in the …

Differentiating Acute Conjunctivitis Presentations in Children

Urgent message: Make the distinction between viral and bacterial conjunctivitis to ensure children receive appropriate treatment and to avoid the negative consequences of antibiotic overuse. Julian P. Ponsetto MD, Momoko K. Ponsetto MD Download the article PDF Here Citation: Ponsetto JP, Ponsetto MK. Differentiating acute conjunctivitis presentations in children. J Urgent Care Med. 2023;17(11):15-20. Infectious conjunctivitis or “pink eye” is common in the pediatric population, accounting for 2.7% of diagnoses in pediatric urgent care.1 However, …

HbA1c as Screening/Diagnoses for Early or Asymptomatic Diabetes in the Urgent Care Facility

Urgent message: The use of all-inclusive kits with compact, table-top analyzers provides a rapid quantification of HbA1c levels in patients. The use of these tests for in-house screening has the potential to increase the diagnoses of early or asymptomatic diabetes in young adults and under-served or overlooked populations. Jay H. Shubrook, DO; Jane M. Caldwell, PhD; and Lindsey E. Fish, MD Citation: Shubrook JH, Caldwell JM, Fish LE. HbA1c as screening/diagnosis for early or asymptomatic …

Management of Patients on Low-Dose Naltrexone: A Clinical Review for Urgent Care Providers

Urgent message: Low-dose naltrexone (LDN) is becoming more common as a treatment option for pain and thus will be increasingly prevalent in patients presenting to the urgent care setting. A thorough medication history, prioritization of non-opioid treatment options, and timely referral or transfer for severe uncontrolled pain are important considerations in the management of patients using low-dose naltrexone. Ting-Hsuan Chiang, MD; Kenneth Schmitt, BS; Ariana Nelson, MD INTRODUCTION Naltrexone is an opioid receptor antagonist approved …

Six Tips to Bulletproof Your Chart: Lessons from the Exam Room and the Court Room

Click Here to download the article PDF Urgent message: In the event that you are taken to court over care that is alleged to have been insufficient, negligent, or otherwise poor, your own documentation at the time care is provided can be your saving grace or your undoing. William Sullivan, DO, JD INTRODUCTION Providing proper medical care in urgent care centers is only half of the battle. As the medical record grows in prominence in …

Back Pain, an Urgent Care Visit—and a Devastating Outcome

Click Here to download the PDF Urgent message: By the time an adverse outcome occurs in the urgent care center, it’s too late to go back and ensure the documentation reflects the care the patient received. Lyndsie Pfeifer, DO; Marta Fratczak, Kinkela Harkins, and Michael Weinstock, MD Citation: Pfeifer L, Fratczak M, Harkins K, Weinstock M. Back pain, an urgent care visit—and a devastating outcome. J Urgent Care Med. 2023;17(8):13-17. Key words: back pain, documentation …

How Useful Is Ultrasound in Abnormal Uterine Bleeding?

Urgent message: Ultrasound can provide essential data in the evaluation and urgent care of abnormal uterine bleeding, by facilitating a rapid diagnosis and immediate and appropriate decisions regarding management. Andrew Alaya, MD, MSc Citation: Alaya A. How useful is ultrasound in abnormal uterine bleeding? J Urgent Care Med. 2023;17(7):13-18. Key words: abnormal uterine bleeding, AUB polyp, adenomyosis, leiomyoma, uterine malignancy ABSTRACT Abnormal uterine bleeding (AUB) is one of the most common gynecological conditions presenting at …

Human Trafficking in the Urgent Care Setting: Recognizing and Referring Vulnerable Patients

Urgent message: As it is common for human trafficking victims to present to urgent care, providers should be able to understand and identify common red flags in the patient presentation, history, and physical exam; treat immediate medical concerns; and know how to refer and safely provide resources for suspected cases. Preeti Panda, MD Citation: Panda P. Human trafficking in the urgent care setting: recognizing and referring vulnerable patients. J Urgent Care Med. 2023;17(6):13-22. Key words: …

Key Signs and Symptoms of Severe Illness in Urgent Care: Cervical Necrotizing Fasciitis and Necrotizing Mediastinitis

Urgent message: Cervical necrotizing fasciitis and necrotizing mediastinitis may ultimately occur in patients presenting with symptoms of odontogenic infection. While severe illnesses rarely present in urgent care, it is important to establish a prompt diagnosis and implement rapid medical management for these patients, in order to improve survival. Vitoria Regina Nunes Maia, MS and Lindsey E. Fish, MD ABSTRACT Cervical necrotizing fasciitis (CNF) is a rapidly progressive infection that can be fatal. This condition can …