Journal of Urgent Care Medicine

Cost-Effective Management of Deep-Vein Thrombosis

Urgent message: Utilization of validated scoring systems and clinical decision-making tools can enable the urgent care provider to manage many patients presenting with symptoms of deep-vein thrombosis in the urgent care center, reducing the need for costly referral to the emergency room. Daniel Eisner, DMSc, PA-C ABSTRACT Management of venous thromboembolism accounts for $10 billion in medical spending annually, with much of the cost attributable to emergency room visits. Conversely, managing VTE patients in the …

Abstracts in Urgent Care – January 2023

Ivan Koay MBChB, MRCS, FRNZCUC, MD Kinesiology Taping for Shoulder and Chest Wall Injuries Take-home point: Kinesiologytaping (KT) combined with standard care appears to be more effective for acute pain reduction in patients with uncomplicated traumatic injury of the shoulder or chest wall. Citation: Bakker M, Bon V, Hubrechts B, et al. Kinesiotaping for acute pain due to uncomplicated traumatic injury of the shoulder or chest wall. Am J Emerg Med. 2022;58:197-202. Relevance: KT offers …

Abstracts in Urgent Care – December 2022

Ivan Koay MBChB, MRCS, FRNZCUC, MD Applying the Ottawa Ankle Rule to Pediatric Patients Take-home point: Application of the Ottawa Ankle Rule (OAR) limits unnecessary imaging in children without missing clinically relevant fractures. Citation: de Almeida S, Rios J, Lima S, et al. Applying the Ottawa Ankle Rule in a pediatric emergency department. Pediatr Emerg Care. 2022;38(3):e1123-e1126. Relevance: Ankles fractures in children are common.Use of the OAR, a simple clinical decision rule, by UC providers …

Antibiotic Duration for Skin and Soft Tissue Infections in Pediatric Urgent Care

Urgent message: Approximately one quarter of pediatric ambulatory visits result in antibiotic prescriptions, with over one third of those exceeding guideline-recommended durations. Factors that influence urgent care providers toward longer durations have not been studied previously. Megan Hamner, MD; Amanda Nedved, MD; Holly Austin, MD; Donna Wyly, RN, MSN, CPNP-AC, PPCNP-BC; Alaina Burns, PharmD, BCPPS; Brian Lee, PhD, MPH; and Rana E. El Feghaly MD, MSCI Citation: Hamner M, Nedved A, Austin H, Wyly D, …

The Rising Importance of Urgent Care in the Fight Against the STI Epidemic

Urgent message: After a brief hiatus during the peak of the COVID-19 pandemic, the rate of new sexually transmitted infections has resumed at epidemic rates in the United States. With many specialty STI clinics having closed, urgent care may be better positioned than ever to help curb their spread. Glenn Harnett, MD Citation: Harnett G. The rising importance of urgent care in the fight against the STI epidemic. J Urgent Care Med. 2022;16(3):15-20. Key words: …

A 79-Year-Old Male with Left Shoulder Pain and a History of Hypertension and CAD

A 79-year-old male with past medical history of hypertension and coronary artery disease presents to urgent care with left shoulder pain that is worse with movement. He reports intermittent nausea and vomiting, but denies dizziness, chest pain, shortness of breath, or history of trauma. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 32-Year-Old with Fever, Cough, Arthralgia, and Photophobia

A 32-year-old immunocompetent male presents with fever, cough, arthralgia, and photophobia for a few days. On examination, he had a temperature of 100°F (37.8°C) and conjunctival injection. There was a widespread erythematous macular rash on his wrist. When asked about travel, the patient mentioned that he recently visited his family in the Dominican Republic. During his travels, he drank local water and sustained a few mosquito bites. His symptoms began approximately 4 days after his …

A 42-Year-Old with Swelling After a Kick to the Face

The patient is a 42-year-old male who presents with nose and facial swelling after being kicked in the face while wrestling with his teenage son. View the images taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Managing Cough Without Codeine in the Urgent Care Setting

Urgent message: Opioid prescribing and opioid-related deaths have risen during the COVID-19 pandemic. Although supported by the CHEST Diagnosis and Management of Cough and NICE COVID-19 guidelines, it is time to reevaluate the appropriateness of using codeine in suppressing cough. Megan Penner, PharmD and Hojung Jang, PharmD Candidate CLINICAL SCENARIO A 54-year-old female with a past medical history of diabetes, hypertension, and depression presents to the urgent care center with congestion, nasal discharge, fatigue, and …

Which ED Referrals Are Appropriate? The Problem of Perspective

Joshua Russell, MD, MSc, FCUCM, FACEP I didn’t want to send her to the ER, but what else could I do? Mrs. C was a gaunt 72-year-old Chinese-American woman who had never been to our clinic before. Her son carried her in at 7:56 pm like a bride across the threshold. “She cannot walk,” he said, startling the MA sitting at the front desk. “Has she been seen here before?” our MA asked …