Journal of Urgent Care Medicine

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 …

A Novel Pediatric Resuscitation Course Designed for the Urgent Care Setting

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 …

A 67-Year-Old Male with Chest Pain, Dyspnea, and a History of Lung Cancer

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.

A 23-Year-Old with a Pruritic, Spreading Rash

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 …