Journal of Urgent Care Medicine

Consider Follow-Up Screening for Hypertension Among COVID-19 Patients

A retrospective study of 45,000 patient records presented in Hypertension found an association between the SARS-CoV-2 virus and the development of hypertension among adults who had no past history of high blood pressure. It’s unknown if the virus could be triggering the development of hypertension or worsening preexisting hypertension, according to the study’s lead author. But the association is significant. Among the records, 21% of those hospitalized with COVID-19 developed high blood pressure. By comparison, only 16% …

Skewed Pulse Oximeter Readings Delayed Care For Patients With Darker Skin

Research presented in JAMA Network Open found that pulse oximeters more commonly overestimated arterial oxygen saturation for Black and Hispanic patients hospitalized with COVID-19 when compared with White patients. Blood oxygen levels were measured with fingertip pulse oximeters, followed by a blood draw. Researchers found Black patients were nearly 50% more likely than White patients to experience undetected low blood-oxygen saturation. Hispanic patients were 18% more likely to experience an issue. The overestimation was associated …

Improving Adherence to Clinical Practice Guidelines for the Treatment of Acute Otitis Media in Pediatric Patients

Urgent message: The treatment of acute otitis media is a common problem throughout healthcare. Many national provider organizations have emphasized the significance of proper diagnosis and treatment is essential for a full, uncomplicated recovery. Jessica M. Crandall, DNP, ARNP-FNP-BC and Misty Schwartz, PhD, RN Citation: Crandall JM, Schwartz M. Improving adherence to clinical practice guidelines for the treatment of acute otitis media in pediatric patients. J Urgent Care Med. 2023;17(11):25-34. Click Here to download the …

Myotendinous Rupture of Pectoralis Major: A Case Report

Urgent message: Nonspecific presentation and time lapsed between injury and presenting to urgent care can delay diagnosis and initiation of proper management in patients ultimately diagnosed with myotendinous rupture of pectoralis major, a relatively rare injury that is becoming more common. E. Casey Anders, Chinedum Nkemakolam, MA, and Lindsay Tjiattas-Saleski, DO Citation: Anders EC, Nkemakolam C, Tjiattas-Saleski L. Myotendinous rupture of pectoralis major: a case report. J Urgent Care Med. 2023;17(11):21-23. Click Here to download …

A 75-Year-Old Female with Dizziness and a Slow Heartbeat

The patient is a 75-year-old female who presents with dizziness and a slow heartbeat. She has a history of hypertension. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case begins on the next page.

A 49-Year-Old with a 4-Week-Old Lesion on Her Toe

A 49-year-old woman presents with a lesion that developed over her right toe over the past 4 weeks. It is painless, but has begun to bleed. On examination, a smooth, pink, friable, eroded nodule is seen on the nail bed. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 69-Year-Old with Neck Pain After a Car Crash

A 69-year-old man presents with “neck pain” after a care crash. Lateral and oblique views of the lower cervical spine are ordered. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

Abstracts in Urgent Care – September 2023

How Long Should We Prescribe Antibiotics for Pediatric UTI? Take-Home Point: Children receiving 5 days of antibiotics for urinary tract infection (UTI) had a higher rate of treatment failure that children receiving 10-day courses. However, absolute treatment failure rates were low in both groups. Citation: Zaoutis T, Shaikh N, Fisher B, et. al. Short-Course Therapy for Urinary Tract Infections in Children: The SCOUT Randomized Clinical Trial. JAMA Pediatr. 2023 Jun 26; e231979. Relevance: There have …

Analogy: A Powerful and Underutilized Bedside Tool

Joshua Russell, MD, MSc, FCUCM, FACEP Click Here to download the article PDF Sophie was back with another one of her kids in tow. This was the fifth time in a month. I could almost hear my staff roll their eyes when she walked through the door. Even though she was a denizen of the clinic, I was about to meet her for the first time because I usually covered other sites. Although I was …

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 …