Journal of Urgent Care Medicine

Utility of POCUS in Skin and Soft Tissue Infection

Urgent message: Point-of-care ultrasound (POCUS), just starting to become more prevalent in the urgent care setting, facilitates improved diagnostic and interventional clinical decision-making by aiding the clinician in discerning between cellulitis, abscess, or both. Chelsea M. Burgin, MD FAAFP and Dustin S. Morrow, MD FACEP INTRODUCTION Each year in the United States around 14 million patient encounters present with skin and soft tissue infections (SSTIs). A detailed history and focused exam differentiate between cellulitis and/or …

Evaluating a Child with Chest Trauma for Pneumothorax in the Urgent Care Setting

Urgent message: The differential diagnosis is broad for patients presenting with chest trauma. Bedside ultrasound can expedite critical diagnoses and intervention(s) when pneumothorax is in the differential. CASE PRESENTATION History A 12-year-old male rolled an all-terrain vehicle (ATV) in the woods, sustaining head, torso, and extremity injuries. He was helmeted, but lost consciousness for an uncertain amount of time. His father found him and provided initial care at home. Because of persistent headache and vomiting, …

The Effect—or Non-Effect—of Rapid Medical Evaluation Programs on Resident Education

Urgent message: With significant overlaps in clinical staff, patient population, and provider training between emergency medicine and urgent care, valuable insights relevant to urgent care can be gleaned from understanding the effect of incorporating provider-in-triage training into emergency medicine resident education. INTRODUCTION Crowding is a major barrier to timely and effective patient care in emergency departments. Crowding occurs when the demand for care exceeds the ability to supply it in an efficient fashion. This is …

Chest X-Ray Findings in 636 Ambulatory Patients with COVID-19 Presenting to an Urgent Care Center: A Normal Chest X-Ray Is no Guarantee

Michael B. Weinstock, MD, Ana Echenique, MD, DABR, Joshua W. Russell, MD, MSc, FACEP, Ari Leib, MD, Jordan A. Miller, DO, David J. Cohen, MD, Stephen Waite, MD, Allen Frye, NP, and Frank A. Illuzzi, MD, FACEP Abstract Background/Objective Patients with COVID-19 commonly present to Urgent Care (UC) centers. Our primary objective was to determine what percentage of UC patients with confirmed COVID-19 had normal vs abnormal chest x-rays (CXR). Secondarily, we aim to describe …

Conducting Preparticipation Sports Physicals in the Urgent Care Center

Urgent message: Youth athletic programs are ubiquitous in the United States, with leagues requiring players to have a physical exam before they’re allowed to take part. Ensuring your urgent care center is ready to be a “go to” resource for a thorough work-up increases young athletes’ chances for a safe experience and bolsters your position as a valued community health resource. INTRODUCTION Millions of juveniles participate in organized athletics the world over every year. In …

Is Pain the Fifth Vital Sign? Higher Triage Patient-Reported Pain Score Does Not Predict Increased Admission or Transfer Rates

Urgent message: Efforts to have pain declared a “fifth vital” sign began nearly 25 years ago. Since then, several national accrediting and governmental agencies have taken up the cause of viewing pain as a distinct problem to be addressed as such. However, few data relevant to emergency and urgent care presentations exist. Mark Pruitt, DO, Ya Wen, DO, Michael Pallaci, DO, and Godwin Dogbey, PhD INTRODUCTION Traditionally, there have been four vital signs: temperature, …

Rhabdomyolysis in the Urgent Care: An Unexpected Case of Myalgias

Urgent message: Rhabdomyolysis has a wide range of presentations, from asymptomatic to life-threatening. The most dramatic presentation can result in acute renal failure, electrolyte imbalances, and/or disseminated intravascular coagulation (DIC). Jordan Miller, DO, Ari Leib, MD, and Andre Bonnet, DO EPIDEMIOLOGY Approximately 26,000 cases of rhabdomyolysis are reported in America yearly, with 10% to 50% progressing to acute renal failure.1,2 Mortality rates range from 7% to 80% and are higher in patients who develop multiorgan …

Bariatric Surgery Complications in the Urgent Care Center

Urgent message: Obesity continues to be a significant health problem in the United States, with more and more patients opting for a surgical solution to their own weight loss challenges. As this trend continues, urgent care providers can expect to see more patients with post bariatric surgery complaints, ranging from the typical and benign to pulmonary emboli, anastomotic leaks, and respiratory failure account. Tracey Quail Davidoff, MD, FCUCM Obesity has become one of the …

Urgent Identification and Management of Postsplenectomy Sepsis

Urgent message: Asplenic individuals have a rate of severe infections 2-3 times higher than the general population. Postsplenectomy sepsis should be considered in patients with impaired splenic function who present with a fever. Megan L. Lawson, PA-C and Christina Gardner, DHSc, MBA, PA-C CASE PRESENTATION A 45-year-old male presented to the urgent care with 18 days of sinus pain and congestion unresponsive to two courses of antibiotics, cefdinir and levofloxacin. Past surgical history revealed a …

Evaluation and Diagnosis of Trigger Finger with Current Management Strategies

Urgent message: Appropriate treatment of “trigger finger” in the urgent care setting starts with differentiating that diagnoses from other disorders of the hand. This is relatively straightforward if one finger is involved, but can become more complex with multiple digits. Shailendra K. Saxena, MD, PhD and Alexander M. Stock, BS INTRODUCTION Trigger finger, also known as stenosing flexor tenosynovitis, is a common hand disorder that affects approximately 2.6% of the general population during their lifetime.1 …

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