Journal of Urgent Care Medicine

Abstracts in Urgent Care – May 2023

Click Here to download the PDF Does My Patient Have a Testicular Torsion? Take-home point: Symptoms most suggestive for testicular torsion (TT) are adolescent/pubertal age, palpated hard testicle, and the presence of nausea and vomiting associated with acute scrotal pain. Citation: Lukosiute-Urboniene A, Nekrosius D, Dekeryte I, et al. Clinical risk factors for testicular torsion and a warning against falsely reassuring ultrasound scans: a 10-year single-centre experience. Emerg Med J. 2023;40:134–139. Relevance: As symptoms of TT …

It’s Time to Think Differently about Follow-up

Click Here to download the PDF In the macro and “dot phrase” era, there are many refrains that appear in the electronic medical record (EMR) with such regularity that we don’t even notice them anymore. Statements like All questions were answered prior to discharge, The patient verbalizes understanding and is comfortable with the plan, and Symptomatic care and over-the-counter treatments discussed are so commonly tacked onto charts that our eyes have been trained to gloss …

A 61-Year-Old Female with History of Hypertension and New Palpitations and Shortness of Breath

A 61-year-old female with a past medical history of hypertension presents to urgent care with palpitations and shortness of breath for 3 days. She also reports cough and fever, and denies nausea or vomiting. View the initial ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 7-Year-Old Male with Lesions on His Knees

A mother brings her 7-year-old son to your urgent care center because she’s concerned about asymptomatic lesions that have developed on his knees over the past couple of weeks. On examination, you observe smooth, crusted and scaly, erythematous and whitish papules and nodules on both knees. There was no history of recent trauma. The patient had a history of dermatomyositis. View the image and consider what your diagnosis and next steps would be. Resolution of …

A 12-Year-Old Boy with a Crush Injury

The patient is a 12-year-old boy who presents with pain after his foot became wedged in an escalator at the mall. The image on the left was taken upon presentation; the one on the right is from a 2-week follow-up. Review each and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

How Useful Is Ultrasound in Abnormal Uterine Bleeding?

Urgent message: Ultrasound can provide essential data in the evaluation and urgent care of abnormal uterine bleeding, by facilitating a rapid diagnosis and immediate and appropriate decisions regarding management. Andrew Alaya, MD, MSc Citation: Alaya A. How useful is ultrasound in abnormal uterine bleeding? J Urgent Care Med. 2023;17(7):13-18. Key words: abnormal uterine bleeding, AUB polyp, adenomyosis, leiomyoma, uterine malignancy ABSTRACT Abnormal uterine bleeding (AUB) is one of the most common gynecological conditions presenting at …

Point of Care Ultrasound Diagnosis of Ruptured Ectopic Pregnancy in an Urgent Care Setting

Urgent message: Though use of point-of-care ultrasound in the evaluation of first trimester pregnancy complaints is not as common in the urgent care setting as it is in th ED, its use can expedite diagnosis and, potentially, lifesaving treatment. Benjamin Mati MD and Richard Rutherford, MD Citation: Mati B, Rutherford R. Point-of-care ultrasound diagnosis of ruptured ectopic pregnancy in an urgent care setting. J Urgent Care Med. 2023;17(7):19-21. Key words: ultrasound, POCUS, ectopic pregnancy, urgent …

Abstracts in Urgent Care – April 2023

Ivan Koay MBChB, MRCS, FRNZCUC, MD Clinician Training to Optimize Antibiotic Choice and Duration for Uncomplicated Skin/Soft Tissue Infections Take-home point: Maintenance of certification (MOC) project participation was associated with improvement in evidence-based practice and was sustained after the intervention period. Citation: Wiltrakis S, Jaggi P, Lu L, et al. Optimizing antibiotic treatment of skin infections in pediatric emergency and urgent care centers. Pediatrics. 2022 Oct 1;150(4): e2021053197. Relevance: Antibiotic stewardship remains one of the …

Evaluating Abandonment of Urgent Care Prescriptions Sent to an Automated Drug Dispenser vs a Community Pharmacy: A Retrospective Cohort Study

Urgent message: Urgent care and emergency department visits focus on acute clinical conditions, with an emphasis on timely administration of medications. Patients discharged outside the typical service hours of a community pharmacy may not have access to a 24-hour pharmacy and have to return home without their prescription medication, creating additional barriers to prescription adherence for patients. Emilie M. Collongette, PharmD, BCMTMS; Sara Panella, PharmD, BCPS; Michael A. DeCoske, PharmD, BCPS; Ernesto Sanz Martinez, MD …

A Consolidation of Signs of Symptoms of Pediatric Pneumonia

Urgent message: While pneumonia in general continues to be a common diagnosis in children in the United States, relatively few studies have sought to determine the signs and symptoms that help to predict occult bacterial pneumonia. Awareness of associated signs and symptoms may assist the urgent care provider in proceeding more quickly to a correct diagnosis. Alyssa Whited, PA-C and Christina Gardner, PA-C CASE PRESENTATION A 5-year-old male with no significant past medical history presented …