Practice Management
Joshua Russell, MD, MSc, FACEP Until recently, I’ve had the rare luxury of working in busy urgent care centers where I was virtually always working side-by-side with another provider. However, with changes in my career and UC staffing models in the wake of the pandemic, I find myself working in single coverage situations the majority of the time nowadays. While I do miss the camaraderie of multi-coverage practice, I miss the unfettered access to a …
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POCUS in Ocular Presentations Experiencing—and Handling—Patient Biases Self-Swabbing for STIs CAM Boots for Toddler’s Fracture? Treating Children with Bronchiolitis Azithromycin in COVID-19 Point-of-Care Ultrasound for Eye Examination Take-home point: Ocular ultrasound (OUS) can be a quick, safe, and effective way to assess eye complaints and complements the clinical exam. Citation: Manton J, Henry C. Benefits to utilising ultrasound in examining the eye. Emerg Med Australas. 2021;33:745–747. Relevance: As availability of point-of-care ultrasound (POCUS) becomes more …
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John DesMarais, MD and Samidha Dutta, DO Urgent message: Screening patients with suspected DVT using the Well’s criteria is an efficient tool that would be even more impactful with access to point-of-care, high-sensitivity D-dimer testing in the urgent care setting. Citation: DesMarais J, Dutta S. Urgent care diagnosis and management of deep vein thrombosis. J Urgent Care Med. 2021;15(2):13-17. Case Presentation A 37-year-old woman presents to urgent care with 3-day history of right leg swelling …
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Dianne Treacy Lore DNP, FNP-BC, CPNP-PC and Marlena Seibert Primeau DNP, FNP-BC, NHDP-BC, BSHEC Citation: Lore DT, Primeau MS. Investigation and assessment of urine culture importance in the evaluation of uncomplicated urinary tract infections in an urgent care setting. J Urgent Care Med. 2021;16(2):37-41. ABSTRACT Purpose Urinary tract infections negatively affect over 150 million individuals globally each year. Traditional management encompasses evaluating a urine culture and sensitivity (C&S). Although the guidelines set forth by the …
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Urgent message: Shorter urgent care visits are correlated with higher experience scores. The presence of learners does not negatively impact patient experience scores. David Skoglund, MD, MS; Brian Lee, PhD, MPH; and Amanda Montalbano, MD, MPH Citation: Skoglund D, Lee B, Montalbano A. Learner presence does not negatively impact patient experience in pediatric urgent care. J Urgent Care Med. 2021;16(2):30-36. ABSTRACT Objective The number of trainees seeking pediatric educational opportunities in community outpatient settings is …
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The patient, a 6-year-old boy, presented to a pediatric urgent care center for a well-child visit. In the exam room, the father pointed out a red lesion on the helical rim of the patient’s ear. The papule was smooth and well-defined and didn’t seem to bother the boy. The father reports that he and the boy’s mother have grown concerned as they’ve noticed it develop over several months. View the image and consider what your …
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A 65-year-old male with a history of heart failure presents to an urgent care center with shortness of breath of 2 days duration. He denies chest pain, nausea, or vomiting. He reports that he ran out of his medications about a week ago. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. (Case presented by Catherine Reynolds, MD, McGovern Medical School, …
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The patient is a 75-year-old male who presents with a primary complaint of pressure in his chest. He denies chest pain, dizziness, or “anything like a heart attack.” View the x-ray taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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It’s 8 pm and I’m 9 hours into a 10-hour shift when four new patients walk in. Even though I’m feeling drained, I smile warmly as each passes my workstation. I “eyeball” them each as they walk by; my grin persists because they all seem stable and my “TUR” for this shift in the emergency department is now only 45 minutes away. TUR (or “time until relief”) is a metric I continuously track with ruthless …
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Urgent message: Not all GI complaints can be attributed to gastrointestinal pathology; symptoms of dyspepsia, vomiting, early satiety, weight loss, and abdominal pain may also be from a pelvic etiology. Fabrizia Faustinella, MD, PhD and L. Alexandre Frigini, MD INTRODUCTION Gastrointestinal complaints are common in ambulatory centers, urgent care, and in emergency departments. The symptoms of abdominal pain, nausea, and vomiting account for 12% to 15% of ED visits.1 Several non-GI intra-abdominal, endocrine, and pelvic …
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