Practice Management
Urgent message: Urgent care centers play a vital role as a gateway into the health system for many children with acute care needs. Some of these needs require identification by the urgent care team, who may then need to stabilize the patient and initiate transfer to optimize clinical outcomes. Nikhil B. Shah, MD INTRODUCTION Pediatric office emergencies can be challenging for urgent care staff to manage. These high-stakes events do not occur frequently enough to …
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Click Here to download the article PDF. A 67-year-old male presents to urgent care complaining of pleuritic chest pain and dyspnea. He has a history of lung cancer, but denies known cardiac history. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is describe on the next page.
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Click Here to download the article PDF. A 23-year-old woman presents with a severely pruritic rash that developed on her leg and is spreading. The patient reports that 2 days prior to onset, she had gone hiking with her dog. She recalls going off-trail and brushing up against “woody vines and shrubs.” She denies sustaining insect bites and notes that the sun was particularly intense that day, so she wonders if this may be a …
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Click Here to download the article PDF. A 45-year-old man presents with “asthma-like symptoms” that he says have “come and gone” for several years. He denies chest pain or a sense of racing heartbeat. A chest deformity is clear from observation. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.
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Urgent message: Low-dose naltrexone (LDN) is becoming more common as a treatment option for pain and thus will be increasingly prevalent in patients presenting to the urgent care setting. A thorough medication history, prioritization of non-opioid treatment options, and timely referral or transfer for severe uncontrolled pain are important considerations in the management of patients using low-dose naltrexone. Ting-Hsuan Chiang, MD; Kenneth Schmitt, BS; Ariana Nelson, MD INTRODUCTION Naltrexone is an opioid receptor antagonist approved …
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Click Here to download the article PDF. Lyme Disease Diagnosis in Children of Different Racial Groups Take-home point: Black children with Lyme disease were more likely to have arthritis rather than cutaneous findings at the time of diagnosis. Citation: Hunt K, Michelson K, Balamuth M, et al. Racial differences in the diagnosis of Lyme disease in children. Clin Infect Dis. 2023;76(6):1129-1131. Relevance: Erythema migrans (EM) is commonly felt to represent the first clinical finding in …
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Click Here to download the article PDF. Urgent message: Coinfection with COVID-19 and other respiratory pathogens can lead to a worsening clinical picture and requires careful assessment in the urgent care center. Marcia Taylor, MD, MSCR, FAAFP Citation: Taylor M. COVID-19 and RSV: coinfection requiring hospitalization. J Urgent Care Med. 2023;17(10):28-29. Key words: COVID-19, SARS-CoV-2, RSV, coinfection, pandemic ABSTRACT Patients who present with symptoms suspicious for COVID-19 and other respiratory conditions, regardless of vaccination status, …
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Click Here to download the article PDF Urgent message: Urinary tract infection is a common diagnosis in pediatric urgent care. As such, efforts must be made to ensure antibiotics are prescribed only when necessary and to decrease the rate of unnecessary prescribing. Benjamin Klick, MD; Tammy Speerhas, DNP, FNP-C; Jessica Parrott, DNP, CPNP-PC, CNE; Jeffrey Bobrowitz, MD; Anne McEvoy, MD; Debra Conrad, MD, Jade Eves, PA-C; Theresa Guins, MD Citation: Klick B, Speerhas T, Parrott …
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Click Here to download the PDF A 30-year-old male with history of polysubstance use presents after a motor vehicle collision. He reports chest and leg pain, and denies nausea, vomiting, or shortness of breath. He has no known cardiac history. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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Click Here to download the article PDF A 59-year-old woman presents with a painful skin lesion near her fingernail which has developed over the past week. She reports a history of advanced non-small cell lung cancer, for which she was recently started on erlotinib. On examination you observe a glistening, hemorrhagic papule at the lateral nail fold with surrounding erythema and edema. The patient denies trauma or exposure to skin irritants. View the image taken …
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