Practice Management
Urgent message: Though patients with posterior and bilateral epistaxis should be admitted to the hospital, the vast majority of epistaxis episodes can be treated safely and effectively in the urgent care setting. Nathaniel Arnone, MD, Samuel M. Keim, MD, MS, and Peter Rosen, MD Epistaxis is a common presenting complaint, with 15 per 10,000 people requiring medical attention each year.1 While the presence of blood in the pharynx can cause concern for both patients and …
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Urgent message: Sore throat is a complaint commonly encountered in urgent care. Proper evaluation and understanding and use of appropriate antibiotics will foster better patient care and understanding while limiting antibiotic resistance. William Gluckman, DO, MBA, FACEP and Jessica Kay, PharmD Pharyngitis refers to the inflammation or irritation of the pharynx, including the tonsils, and can have many etiologies, including a variety of infections, cancer, allergic reactions, gastroesophageal reflux, or toxic inhalations and ingestions. This …
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Urgent message: Working knowledge of anatomy and familiarity with radiograph reading, injury classification, treatment options, and criteria for referral support positive long-term outcomes in patients with acute ankle injuries. Janet D. Little, MD and William E. Saar, DO Acute ankle injury is one of the most common musculoskeletal injuries in the athlete and sedentary person alike. The yearly incidence of ankle injuries varies between resources, but ranges from 1 million to 5 million per year …
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Urgent message: Patients with glucose levels either too high or too low often require immediate, potentially life-saving interventions in the urgent care setting. These patients are often found to be diabetic. Allan F. Moore, MD, Nicolas Abourizk, MD, Jeffrey Collins, MD, MA Diabetes is a common chronic disease affecting approximately 7% of the United States population. Of these individuals, 17.5 million carry a diagnosis of diabetes and over 6 million are undiagnosed. An estimated 54 …
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Urgent message: The urgent care clinic is a prime target for prescription drug abusers seeking possibly inappropriate prescriptions. Clinicians must be vigilant to screen, intervene, and refer such patients. Marcelina Behnam, MD and Mark Rogers, MD Over the past several years, prescription drug abuse has become a problem of epidemic proportions for urgent care centers and emergency departments around the country. There has been an increase both in visits related to the acquisition of these …
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Urgent message: While few data specific to the urgent care setting exist, applying the medical evidence gleaned from other acute care settings can enable the clinician to effect positive outcomes in patients presenting with symptoms indicative of minor TBI. Joseph Toscano, MD Head trauma is among the most important problems evaluated in acute-care medicine. Estimates from the Centers for Disease Control and Prevention indicate that each year in the Unites States, approximately 1.4 million individuals …
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Urgent message: Patients with minor traumatic brain injury can be difficult to assess. Identifying those at risk for poor outcomes is critically important in the urgent care setting. Joseph Toscano, MD The term traumatic brain injury (TBI) describes various injury patterns that result from force being absorbed by the brain after a rapid acceleration or deceleration or head impact. TBIs can span a spectrum from minor changes to fatal catastrophes and can affect patients in …
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Urgent message: Integration of various techniques when performing minor procedures on children can enhance clinical care for patients and families while bringing within reach administrative and financial goals. Emory Petrack, MD, FAAP, FACEP, Lisa S. Perry, CCLS, and Kristine Vehar, RN As the practice of urgent care medicine continues to grow, urgent care centers grapple with several important issues, among them the needs to provide optimal clinical care, reduce medical legal risk, and deliver excellence …
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Urgent message: In the absence of controlled outpatient trials, the author proposes urgent-care specific guidelines for treatment of community-acquired MRSA, informed by clinical experience and local and regional case reports. Michael Dickey, MD The goal of any treatment is to maximize the chance of a positive outcome for a patient. The purpose of a treatment guideline is to maximize the chance of positive outcomes in groups of patients that present with a similar disease states. …
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Urgent message: The ability to evaluate children presenting with a limp—and to recognize red flags that help distinguish those to treat from those requiring immediate referral—should be within the purview of the urgent care clinician. Raymond W. Liu, MD, Hadeel Abaza, MD, and Allison Gilmore, MD A limping child without a clear traumatic history or diagnosis is a common presentation to an urgent care center. The broad differential diagnosis can be daunting, with causes that …
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