Journal of Urgent Care Medicine

An Approach to Care of Injured Workers

Urgent message: Appropriate treatment of workplace injuries and illnesses minimizes long-term disability while promoting rapid return to work and safer work environments. David M. Rosenberg, MD, MPH Physicians rendering care to injured workers must be knowledgeable regarding these injuries and the necessary types of treatment. Also, they must provide this care in an empathetic and caring manner, coupled with aggressive intervention to promote prompt healing. However, physicians must also realize that early return to work …

The Dizzy Patient in the Urgent Care Setting

Urgent message: “Dizziness” can prove to be one of the more vexing complaints encountered in urgent care. To provide appropriate care, the clinician must understand whether the patient is experiencing near-syncope, disequilibrium, ill-defined light-headedness, or vertigo. Martin Samuels, MD, DSc (hon), FAAN, MACP The problem of dizziness can be one of the most exasperating in the practice of medicine. Physicians all know that sinking feeling elicited by the patient who sits down and, when one …

Clinical Challenge: April, 2007

The patient is a 3-year-old female who presented after a fall while running and complaining of pain over the foot. There was minimal local tenderness over the foot and minimal limp, but no other remarkable findings. View the x-ray taken (Figure 1) and consider what your next steps would be. Resolution of the case is described on the next page.

Lessons Born of Missteps

Lee A. Resnick, MD, FAAFP This month’s issue of JUCM heralds an important addition to the journal. “Bouncebacks” will be a new regularly occurring contribution from Dr. Michael Weinstock and Dr. Ryan Longstreth. This department will take a unique approach that combines the formats of a morbidity & mortality conference, risk management lecture, and clinical review article. The result is a one-of-a-kind look at relevant clinical cases seen in the urgent care or emergency department …

Clinical Challenge 2: March, 2007

The patient is a healthy 37-year-old who reports falling on his hand, with his thumb outstretched. Upon examination, you find local mild swelling and tenderness and decreased range of motion of the thumb. There is no snuffbox tenderness, however. View the x-rays taken (Figure 1) and consider what your next steps would be. Resolution of the case is described on the next page.

Abstracts in Urgent Care: March, 2007

Acute Pain Management in Urgent Care Medicine

Urgent message: Urgent care practitioners are called upon daily to alleviate pain. A thorough understanding of the various pain syndromes and the pharmacology and analgesic potencies of various medications will aid in their safe and appropriate use. Marc R. Salzberg, MD, FACEP and Paolo T. Coppola, MD, FACEP Pain, either chronic or acute, is the main reason patients seek medical care. In this article, we will discuss acute pain management in an urgent care setting, …

Clinical Challenge: March, 2007

The patient is a healthy 30-year-old male who presents with pain shortly after “twisting” his ankle while playing soccer. Pain is severe enough to prevent him from putting weight on the ankle. There are no other remarkable findings from exam or patient history. View the x-rays taken (Figure 1) and consider what your next steps would be. Resolution of the case is described on the next page.

Abstracts In Urgent Care: March, 2007

Single-Dose Oral Dexamethasone in the Emergency Management of Children with Exacerbations of Mild-to-Moderate Asthma Citation: Altamimi S, Robertson G, Jastaniah W, et al. Pediatr Emerg Care. 2006;22(12):786-793. URL: http://www.pec-online.com/pt/re/pec/home.htm Key point: Singe-dose dexamethasone is equivalent to five days of oral prednisone for kids with mild/moderate asthma. The purpose of this study was to compare the efficacy of a sin- gle dose of oral dexamethasone (dex) versus five days of twice-daily prednisolone (pred) in the management …

Filling Your Emotional Tank

Lee A. Resnick, MD, FAAFP Nothing like a frigid winter day to inspire a discussion on emotional well-being; the final reserves of endorphins and serotonin that I stored away for the winter are almost depleted, flu season is upon us, wait-times are long, and everyone is cranky. Times like these remind me of the importance of refueling the emotional tank. This is not just a matter of feeling good, though that’s important, too. But physical …