Journal of Urgent Care Medicine

Epistaxis: A Clinical Review

Urgent message: Epistaxis is a common chief complaint representing a wide spectrum of severity. Key features such as the vital signs, location of the bleeding, and patient history, as well as practice and facility with certain procedures, can assist significantly with patient outcomes and dispositions. Lindsay Ballard, MD; Stephanie Fernandez, MD; and Joshua Kornegay, MD Citation: Ballard L, Fernandez S, Kornegay J. Epistaxis: a clinical review. J Urgent Care Med. 2021;15(10):13-18. Introduction Epistaxis is a …

Abstracts in Urgent Care – July/August 2021

Faster Diagnosis of STIs Reduce ED Referrals for SVT Kids’ Dental Pain and Quality of Life Ultrasound-Guided Blocks and Renal Pain EI as a Leadership Attribute in Physicians Avijit Barai, MBBS, FACEM, FRNZCUC, MRCS, MSc (Critical Care), PgCertCPU Rapid Testing for Sexually Transmitted Infections Take-home point: A point-of-care (POC) test for chlamydia and gonorrhoea proved useful for rapid diagnosis of STI in both men and women. Citation: Van Der Pol B, Taylor SN, Mena L, et …

Active COVID-19 Infection Is Indicated by WBC ≤7.0 and PLT ≤200 at Presentation

Yijung Russell, MD; Casey Collier, MD; Steve Christos, DO; and Shu B. Chan MD, MS Citation: Russell Y, Collier C, Christos S, Chan SB. Active COVID-19 infection is indicated by WBC 7.0 and PLT 200 at presentation. J Urgent Care Med. 2021;15(10):35-38. Introduction The impact coronavirus disease of 2019 (COVID-19) has had on individuals, businesses, and governments is unprecedented in many ways. Though widespread and frequent screening is recommended for better containment,1 limited availability of …

Actinomyces neuii as a Cause of Vulvar Abscess

Urgent message: While abscesses are seen commonly in the urgent care setting, location and presenting complaints can offer essential clues as to the causative organism—and inform timely diagnosis and treatment decisions. Tracey Q. Davidoff, MD, FCUCM Introduction Abscesses are common in urgent care and emergency medicine and are easily treated with drainage, and in some cases antibiotics. The majority of cases are caused by Staphylococcus aureus and Streptococcal sp. Rarely, gram-negative bacilli can be found …

Heavy Menstrual Bleeding: Important Considerations for Adolescent Patients in the Urgent Care Setting

Urgent message: Anovulatory cycles are the most common cause of heavy menstrual bleeding (HMB) in adolescent patients. Just as with adult patients in the urgent care setting, it is most important to identify unstable patients and those with life-threatening causes for HMB. Shikha Nigam, MD, MPH and Amy Pattishall, MD Case Presentation A 14-year-old female presents with 6 weeks of menstrual bleeding. Her cycles are irregular but she generally has 4 to 6 weeks of …

A 70-Year-Old Female with Nonradiating Chest Pain

A 70-year-old female with history of coronary artery disease presents to urgent care with nonradiating chest pain of 2 days’ duration. She has a known history of left bundle branch block. Baseline ECG: View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. (Case presented by Benjamin Cooper, MD, McGovern Medical School, Department of Emergency Medicine, The University of Texas …

An 8-Year-Old Boy with Scaly Papules on the Knees and Elbows

During a regular check-up, a mother remarks that her 8-year-old son had developed clusters of follicular, scaly papules bilaterally on his knees and elbows “over the past few weeks.” They didn’t seem to bother him, but because her son is prone to allergies the mother wondered if changes in household substances like soap or laundry detergent could be responsible. View the photo and consider what your diagnosis and next steps would be. Resolution of the …

Neck Pain in a 17-Year-Old

The patient is a 17-year-old female who presents with neck pain a day after attending a rock concert. She denies cigarette smoking, vaping, use of illicit substances, or physical trauma. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Breakthrough COVID Infection in a Vaccinated person from a Possible Vaccinated Exposure

Sergio Ramoa MD, MS Urgent Message: With variant COVID-19 mutations, incomplete herd immunity, and less restrictive government regulatory statues, it is important to remain vigilant with continued testing and prevention even with a full vaccinated history. Introduction In the United States, cases of COVID-19 have passed 32,000,000 and 570,000 for deaths. 141,000,000 cases and 3,000,000 deaths have afflicted the world. Approximately 9.6% of infected individuals are hospitalized and a majority have mild to moderate symptoms.1 …

More Timely Care: Effect of Online Queuing vs Change in Hours of Operation on Hourly Arrival Volumes. A Practice Management Reflection

Urgent message: Hours of operation changes may have more effect on leveling patient arrival volumes in a pediatric urgent care compared with an online queueing system alone. Aimy Patel, MD; Jennifer Johnson, MD; Brian R. Lee, PhD, MPH; Amanda Montalbano, MD, MPH Citation: Patel A, Johnson J, Lee BR, Montalbano A. More timely care: effect of online queuing vs change in hours of operation on hourly arrival volumes. a practice management reflection. J Urgent Care …