Journal of Urgent Care Medicine

Could This Young Patient Really Have a STEMI? A Case Report of a Spontaneous Coronary Artery Dissection

Urgent Message: It is important to quickly obtain an electrocardiogram in patients presenting with chest pain or other symptoms suggestive of acute coronary syndrome, even for those who are young and without traditional coronary risk factors. Citation: Krauss WC. Could This Young Patient Really Have a STEMI? A Case Report of a Spontaneous Coronary Artery Dissection. J Urgent Care Med. 2024; 19 (1):21-23 Key Words: chest pain, spontaneous coronary artery dissection, acute coronary syndrome Abstract …

30-Year-Old With Foot Inversion Injury

A 30-year-old man presents to urgent care with lateral ankle pain and swelling after a foot inversion injury he sustained while hiking. A mortise view x-ray of the ankle is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

16-Year-Old With History Of Orchiopexy

A 16-year-old male with a history of orchiopexy presents with syncope. He denies chest pain or shortness of breath. An ECG is obtained. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

38-Year-Old With Foot Rash

A 38-year-old man presents to urgent care for a pruritic rash that developed on his feet over the last week. The rash is worse on his left foot than the right. He frequently works out and showers at the gym before going to work. On examination, fine, powdery, scaly plaques are seen on his soles and insteps. He otherwise appears well and has no systemic symptoms. View the image below and consider what your diagnosis …

Development and Implementation of a Headache and Migraine Pathway in Pediatric Urgent Care: A Quality Improvement Initiative

Urgent Message: There are an estimated 250,000 visits annually associated with pediatric headaches in the United States, 84% of which are not treated according to best evidence-based practice (EBP). The development of an EBP headache and migraine pathway in a pediatric urgent care improved access to evidence-based guidelines and increased clinician confidence and knowledge regarding the diagnosis and management of headaches in children. Sarah J. Nembu, DNP, APRN, FNP-C, CPNP-AC; Melissa R. Penkalski, DNP, APRN, …

Recognition and Management of Achenbach Syndrome (Paroxysmal Finger Hematoma)

Urgent Message: By understanding the symptoms of paroxysmal finger hematoma, clinicians can reduce patient anxiety and decrease unnecessary testing, as the condition is generally mild and has a favorable prognosis. Citation: Sanz Martinez E, Kranichfeld WH, Ceballos Y. Achenbach Syndrome: Diagnosis of Paroxysmal Finger Hematoma. J Urgent Care Med. 2024; 19(1): 25-29 Introduction Paroxysmal finger hematoma (PFH), also known as Achenbach syndrome, is a vascular disorder of unknown etiology characterized by subcutaneous bleeding in the …

Emesis Ad Nauseum: A Case Report of Cannabinoid Hyperemesis Syndrome in Urgent Care

Urgent message: Frequent cannabis use can lead to a syndrome characterized by severe and cyclical vomiting without other clear triggers. Termed “cannabinoid hyperemesis syndrome,” this disorder is often refractory to conventional antiemetic pharmacotherapy. Citation: Ramos J, Russell J. Emesis Ad Nauseum: A Case Report of Cannabinoid Hyperemesis Syndrome in Urgent Care. J Urgent Care Med. 2024; 18 (11): 13-18 John Ramos, MMS, PA-C, CAQ-EM, Joshua Russell, MD, MSc, ELS, FACEP, FCUCM Abstract Introduction: Cannabinoid hyperemesis …

Abstracts in Urgent Care – September 2024

Can Large Language Models Help in Assessing Acuity of Patients Presenting to ED? Take Home Point: Integration of large language models (LLMs) in the emergency department (ED) could enhance triage processes. This warrants further investigation particularly in the urgent care (UC) space. Citation: Williams C, Zack T, Miao B, et. al. Use of a Large Language Model to Assess Clinical Acuity of Adults in the Emergency Department. JAMA Netw Open. 2024 May 1;7(5): e248895. doi: …

Major Adverse Cardiovascular Events in Patients with Chest Pain And Moderate Heart Risk Scores Who Were Referred For An Expedited Outpatient Cardiology Evaluation: A Multi-Center Descriptive Study

Urgent Message: Patients with a moderate-risk HEART score referred from an urgent care center for an expedited outpatient cardiology evaluation were found to have a very low rate of MACE and no occurrence of ischemic cardiac deaths. Citation: Thomson N, Barbarash S, Lebron-Gallagher D, Julson H, Weinstock M. Major Adverse Cardiovascular Events in Patients with Chest Pain And Moderate Heart Risk Scores Who Were Referred For An Expedited Outpatient Cardiology Evaluation: A Multi-Center Descriptive Study. …

Urgent Care Recognition and Management of Maisonneuve Fractures

Urgent Message: Clinicians should inquire about the mechanism of injury when a patient presents with ankle pain and consider x-ray that includes the ankle, tibia, and fibula to evaluate for the possibility of Maisonneuve fracture, especially when pain in the inferiolateral knee is also present. Willie O’Neal, MD; Bradley Strauch, MD Citation: O’Neal W, Strauch B. Urgent Care Recognition and Management of Maisonneuve Fractures. J Urgent Care Med. 2024; 18 (11): 21-28 Editor’s Note: While …