Journal of Urgent Care Medicine

Building the Body Up Just to Break the Body Down: A Look Into Black Market Substance Use Among Young Athletes and Bodybuilders

Urgent message: Many performance-enhancing medications not currently approved by the FDA remain undetectable in basic urine specimens collected in the urgent care setting. If there is suspicion of any form of illicit substance use, the inquiry of specific supplements/agents is key, as side effect profiles are often vast and wide. Rachael M. Poff, PA-C and Christina E. Gardner, DHSc, MBA, PA-C INTRODUCTION Selective androgen receptor modulators (SARMs) constitute a class of medication that has become …

Practice Review: Patients Presenting with Symptoms of Odontogenic Infection

Urgent message: Odontogenic infections can pose life-threatening risk when swelling occurs in close proximity to the airway. It is essential that the urgent care provider is able to differentiate cases of relatively straightforward infection that can be managed in the urgent care setting vs true airway emergencies. Amandeep Kaur Bains, BDS(Hons) MFDS RCPS (Glasg); Awais Safdar Ali, BDS MJDF RCSEng; and Pavan Padaki, BDS, MFDS RCPS (Glasg), MBChB, MRCS, FRCS (OMFS) INTRODUCTION While odontogenic or …

If Not Otitis Externa…Then What?

Urgent message: Complaints of ear pain in children are among the most common presentations in the urgent care setting. While acute otitis media and acute otitis externa are high on the list of possible causes, it is essential that the urgent care provider be prepared to differentiate these from other possible etiologies. Elizabeth Flasch, MSN, APNP, PNP; Sadia Ansari, MD; Timothy Martin, MD Citation: Flasch E, Ansari S, Martin T. If not otitis externa…then what? …

Vaping-Associated Lung Injury (EVALI) Presenting to Urgent Care

Urgent message: Respiratory complaints due to use of e-cigarettes or vaping may be difficult to distinguish from those associated with influenza and other common respiratory illnesses. It is essential for the urgent care provider to ask patients who present with any respiratory complaint about vaping history, and to have a sound understanding of next steps for patients suspected of having e-cigarette or vaping-associated lung injury (EVALI). Marco Propersi, DO and Anand Swaminathan, MD, MPH Citation: …

Urgent Care Provider Awareness of the Canadian Computed Tomography Head Rule: A Descriptive Cross-Sectional Survey Study

Urgent message: As visits to urgent care after possible traumatic brain injury continue to rise, so does the importance of understanding which patients require a CT scan. Assessing the value of the Canadian Computed Tomography Head Rule in making that determination can raise the urgent care provider’s ability to make informed decisions in this regard, reducing the risk of unnecessary radiation exposure in patients who are determined to not need a CT. Jessicah Ray, DHSc, …

Necessity (or Not) for Patient Transfer from Urgent Care to the ED Following Traumatic Brain Injury

Urgent message: With patients who have sustained head injuries related to both sports- and non–sports-related activities presenting to urgent care more than ever before, it’s essential for the provider to have a nuanced understanding of which patients truly require transfer or referral to a high-acuity level of care, and which can be managed successfully and safely in the urgent care setting. Anthony P. Doran, PsyD; Robert G. Graw, Jr., MD; Marc Weber, MD; Stanford Coleman, …

Streptococcal Pharyngitis and Its Sidekicks: Common and Uncommon Etiologies

Urgent message: Pharyngitis is a common chief complaint in urgent care, but not all sore throats are streptococcal (strep) pharyngitis. Delayed diagnosis and treatment of some causes of sore throat can lead to catastrophic outcomes. Epidemiology Acute pharyngitis accounts for 1%-2% of all visits in the ambulatory setting.1 Most pharyngitis seen in urgent care is viral in etiology. The most common bacterial cause of pharyngitis is group A beta hemolytic Streptococcus (GABHS), which is responsible …

Antibiotic Stewardship in Pediatric Acute Otitis Media—Pearls and Pitfalls

Urgent message: Acute otitis media (AOM) is the leading diagnosis for antibiotic prescribing in pediatric patients. As antibiotic stewardship becomes more essential in preventing antibiotic resistance, safe and effective management of AOM becomes all the more important in urgent care. The treatment path should reflect nuances in management to inform decisions regarding the necessity of antibiotics—and if they are deemed necessary, targeting the type, delivery vehicle, and duration to keep a narrow treatment effect. When …

High Prevalence of Asymptomatic COVID-19 in the Pediatric Population

Urgent message: As understanding of COVID-19 in the pediatric age group evolves, it has come to light that children may contract the virus, yet be asymptomatic, more commonly than we initially believed. We have found a high prevalence of asymptomatic pediatric patients testing positive for COVID-19 in our urgent care clinics in the NY metro region. Katharine Miao MD, Frank Illuzzi MD, and Alexander C. Hwang IMPORTANCE SARS-CoV-2 is the novel virus that causes COVID-19. …

A POCUS-Based Approach to Acute Renal Colic in the Urgent Care Center

Urgent message: Recent expert opinion has reshaped initial management for suspected acute renal colic. Clinicians often utilize computerized tomography imaging to diagnose acute renal colic; however, there is an increasing role for clinicians to instead use point-of-care ultrasound (POCUS) as the initial imaging modality when acute renal colic is suspected. Renal ultrasound is time and cost effective, radiation-free and completed by the clinician at the bedside. Chelsea M. Burgin, MD, FAAFP; James Frederick W. Pike, …