Urgent message: The capability to identify patients with COVID-19 before they undergo a surgical procedure is essential to the safety of the patient, the surgical team, and postoperative staff. Given the fact that many patients with the virus never exhibit symptoms, proactive preoperative testing in the urgent care center may lower the risk of spread and help quantify the rate of asymptomatic infection. Sarah Greenwood, PA; Bronson Elizabeth Delasobera, MD; Amanda Joy, PA; Rita Malley, …
Read MoreUrgent 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, …
Read MoreNecessity (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, …
Read MoreAntibiotic Stewardship and Sinusitis: A Quality Improvement Project
Urgent message: Acute sinusitis poses frequent challenges in urgent care where patient volumes are high and patient satisfaction is valued. An educational session and an algorithmic clinical decision-support tool were implemented in a multisite urgent care quality improvement project which resulted in a statistically significant reduction in antibiotic prescribing for acute sinusitis. ABSTRACT Background Sinusitis is a common upper respiratory condition seen in urgent care centers, as it is in primary care practices and, increasingly …
Read MoreHigh 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. …
Read MorePreparedness for Emergencies in Pediatric Urgent Care Settings
Urgent message: While standards for pediatric emergency care have been defined for outpatient offices and emergency departments, guidelines have not been published for urgent care centers. This study assesses the presence of equipment, supplies, and medications necessary to manage emergencies in pediatric urgent care centers. Amanda Montalbano, MD, MPH, FAAP and Brian Lee, PhD, MPH Results from this project were presented in poster format the Pediatric Urgent Care Conference in Orlando, FL in 2018. No …
Read MoreEvaluation of a Point-of-Care COVID-19 Testing Platform Using Self-Collected Nasal Swabs in an Urgent Care Setting
Urgent message: A validated platform effective in performing rapid point-of-care tests for SARS-CoV-2 would be ideal for use in urgent care centers. While reports of false negative results with one system called the viability of such a platform into question, results of this study support the use of POC testing using self-collected nasal swabs. Bronson Elizabeth Delasobera, MD; Amanda Joy, PA; Masashi Waga; Rita Malley, MS; Anisha Patel, MS; Sarah Greenwood, PA; Jerry Creighton, RN; …
Read MoreA Multicenter Study of the Rate of MACE in Chest Pain Patients with a Moderate HEART Risk Score Referred from Urgent Care for an Expedited Outpatient Cardiology Evaluation
ABSTRACT Background: The HEART Score is an effective method of risk-stratifying emergency department patients with chest pain. The rate of major adverse cardiovascular events (MACE) in patients with moderate HEART score referred from an urgent care center (UC) for an expedited outpatient cardiology evaluation is unknown. Purpose: The primary outcome of this study was to examine the rate of MACE when patients with moderate HEART score were referred for expedited outpatient cardiology follow-up after evaluation …
Read MoreChest X-Ray Findings Among Urgent Care Patients with COVID-19 Are not Affected by Patient Age or Gender: A Retrospective Cohort Study of 636 Ambulatory Patients
Joshua Russell, MD, MSc, FACEP MD; Ana Echenique, MD, DABR; Steven R. Daugherty, PhD; and Michael Weinstock, MD Abstract Background/Objective A prior study of patients presenting to urgent care (UC) centers with COVID-191 showed that only a small proportion of these ambulatory patients demonstrated significant pathology on chest x-ray (CXR). In this secondary analysis of 636 ambulatory patients with confirmed COVID-19 from greater New York City (NYC), our primary objective was to determine whether the …
Read MoreThe 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 …
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