Lee A. Resnick, MD, FAAFP Have you ever wondered how many urgent care centers there are in the U.S.? So did UCA. Partnering with researchers at Harvard University and Massachusetts General Hospital, UCA has completed the first-ever sampling frame of urgent care centers across the country. Our goal was to produce an objective, scientifically valid assessment of the size of the urgent care industry. Estimates have flown around the industry for years, but until now …
Read MoreClinical Challenge 2: December 2007
The patient is a 10-year-old boy who received a blow to the forearm when he fell at home. He presented with local swelling and tenderness on exam, complaining of severe pain in his wrist. View the x-rays taken (Figure 1 and Figure 2) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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A 20-Year-Old Male with Chest Pain
Urgent message: Atypical chest pain in a young male offers a challenge solved by ordering—and assessment—of the appropriate imaging. Shannon Dowler, MD The patient is a 20-year-old white male who presented to urgent care with a two-week history of mild dyspnea, with the onset of chest pain in the prior 24 hours. He denied wheezing, vomiting, and recent trauma, and reported that he has tried no medications for his symptoms. Further discussion with the patient …
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The Limping Child in the Urgent Care Center
Urgent message: The ability to evaluate children presenting with a limp—and to recognize red flags that help distinguish those to treat from those requiring immediate referral—should be within the purview of the urgent care clinician. Raymond W. Liu, MD, Hadeel Abaza, MD, and Allison Gilmore, MD A limping child without a clear traumatic history or diagnosis is a common presentation to an urgent care center. The broad differential diagnosis can be daunting, with causes that …
Read MoreThe International Face of Urgent Care
You thought you were alone on an island trying to navigate through the trials of urgent care. You thought you were the only one faced with the clinical and financial challenges. Hopefully, you have discovered the Urgent Care Association (UCA), attended one of the conferences, and shared in the delight of collaborating with colleagues who share your questions, your challenges, and your desire to make a difference one patient at a time. Hopefully, you recognize …
Read MoreAbstracts in Urgent Care: January, 2007
Modes of Administration of Antibiotics for Symptomatic Severe Urinary Tract Infections Key point: There is no evidence suggesting that oral antibiotic therapy is less effective for treatment of severe UTI than parenteral or initial parenteral therapy. Citation: Pohl A. Modes of administration of antibiotics for symptomatic severe urinary tract infections. Cochrane Database of Systematic Reviews. 2007, Issue 4. Urinary tract infection, worldwide, is a major source of disease in children and adults. Although standard management …
Read MoreAbstracts In Urgent Care: December, 2007
A 14-year-old who took a fall two hours prior to presenting to the urgent care clinic
The patient is a 14-year-old who took a fall two hours prior to presenting to the urgent care clinic. The left ankle is swollen and unable to bear weight, but the patient is otherwise  healthy. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreAbstracts In Urgent Care: November, 2007
Effectiveness of Oxycodone, Ibuprofen, or the Combination in the Initial Management of Orthopedic Injury-Related Pain in Children Key point: Oxycodone, ibuprofen, and the combination all provide effective and similar analgesia for mild-to-moderate orthopedic injuries in children. Ibuprofen, alone, is a legitimate and effective choice. Citation: Koller DM, Myers AB, Lorenz D, et al. Pediatr Emerg Care. 2007;23(9):627-633. Orthopedic injuries comprise a majority of the indications for analgesia in the emergency department. Oxycodone and ibuprofen have …
Read MoreClinical Challenge: November, 2007
Case The patient is a 10-year-old boy who experienced a direct blow to the elbow approximately six hours prior to presentation. He had incomplete range of motion with minimal local swelling and considerable pain. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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