Practice Management
A 42-year-old woman presented to urgent care early in the morning saying that she felt a stinging sensation on her arm while she was cleaning her basement the previous day. She thinks it might be a bite but didn’t see anything. She had subsequent marked pain at the site and over the past few hours developed nausea and muscle aches. On physical examination, the patient had a temperature of 101.3°F (38.5°C). There were reddish-brown reticulate …
Read More
A 57-year-old man presents to urgent care with progressive dyspnea for 1 month. The patient has a history of unmanaged hypertension. 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.
Read More
Urgent Message: Cerebral venous thrombosis is a serious cause of headache that can present in a variety of manners, including sudden-onset or “thunderclap” fashion. Caroline S. Mifsud, OMS-IV; Jordan L. Jones, OMS-IV; Michael B. Weinstock, MD Citation: Mifsud C, Jones J, Weinstock M. Expanding the Differential of Thunderclap Headache Beyond Subarachnoid Hemorrhage: A Case Report. J Urgent Care Med. 2024; 18(8):21-24 Key Words: dural sinus thrombosis, cerebral venous thrombosis, headache, thrombophilia, case report Abstract Introduction: …
Read More
Urgent Message: Mycoplasma species, most notably Mycoplasma genitalium are an increasingly recognized etiology of persistent urethral discomfort and non-gonococcal urethritis in males. These infections are commonly asymptomatic and can also have significant consequences in females. Antibiotic resistance is a common concern and treatment recommendations differ significantly from those for other sexually transmitted infections. Joseph Something, PA-C; Greg Smithers, PA-C; Ina Park, MD, MS Citation: Something J, Smithers G, Park I. A Review of Genital Mycoplasma …
Read More
Encouraging Shorter Course Antibiotic Prescribing Take Home Point: In this quality improvement project, both education with performance feedback in combination with clinical decision support (CDS) were effective in modifying clinician behavior surrounding antibiotic prescribing. Citation: Vernacchio L, Hatoun J, Patane L, et al. Improving Short Course Treatment of Pediatric Infections: A Randomized Quality Improvement Trial. Pediatrics.2024;153(2): e2023063691 Relevance: There is increasing evidence that shorter courses of antibiotics for the treatment of pediatric pneumonias (CAP) and …
Read More
Urgent Message: Boxer’s fractures are among the most common hand fractures and should be suspected in cases of closed fist injury. Additionally, a laceration that accompanies a boxer’s fracture may represent a fight bite, which should be treated to reduce the risk of infection. Jennifer Hicks, DO; Bradley Strauch, MD Citation: Hicks J, Strauch WB. Urgent Care Evaluation and Management of Boxer’s Fractures. J Urgent Care Med. 2024; 18(8):32-36 Editor’s Note: While the images presented …
Read More
Urgent Message: This narrative review of non-steroidal anti-inflammatory drugs (NSAIDs) characterizes the specific evidence-based indications, previous studies on dosing and route, and side effects of these medications. It supports NSAIDs as an important class of medications in the management of acute pain in urgent care and emergency settings. Campbell Belisle Haley, MD; Andy T. Hsueh, MD; Chih-Hsuan Chen, MD; Ariana M. Nelson, MD Citation: Belisle Haley C, Hsueh AT, Chen CH, Nelson A. NSAIDs in …
Read More
David Hourani, MD; Bradley M. Golden, DO; Daniel McCollum, MD; John R. Barrett, MD Urgent Message: Mistaking traumatic facial paralysis for Bell’s palsy can delay treatment and have lifelong consequences. Prompt imaging and otolaryngology consultation are critical in determining disposition and management. Citation: Hourani D, Golden BM, McCollum D, Barrett JR. Delayed-Onset Facial Nerve Palsy Following Post-Auricular Gunshot Wound: A Case Report. J Urgent Care Med. 2024; 18(x):13-16. Keywords: facial nerve palsy; cranial nerve VII …
Read More
A 38-year-old man present to urgent care complaining of pain around his entire pelvis after a fall on a slippery floor at home. Imaging is obtained. Review the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.
Read More
A 21-year-old man presents to urgent care concerned about a painless blackish lesion that had developed on his left heel. On examination, a stippled, deeply violaceous, blackish patch with overlying scale was seen on his plantar heel. He had no history of dermatological disease but mentioned he played in a basketball tournament last week. View the image above and consider what your diagnosis and next steps would be. Resolution of the case is described on …
Read More