Journal of Urgent Care Medicine

Febrile Seizure: An Urgent Care Overview

Urgent message: While alarming to parents, febrile seizures in children typically are benign and self-limited. However, the possibility of a life-threatening etiology mandates that the urgent care provider determine the type of seizure and employ appropriate assessments based on factors specific to each case. Tiffany Addington, MD CASE A previously healthy 3-year-old boy presented to urgent care after having a seizure at home. He had a fever that morning and was given ibuprofen. His mother …

A 34-Year-Old Man with Pain and Burning in Both Eyes

The patient is a 34-year-old male who presents with bilateral ocular pain and burning. He is noted to have excessive tearing and continuous eye rubbing. He comments that his eyes itch persistently and that both eyes feel as if there is something in them. Scaly plaques and crust are visible along the top and bottom eyelid. View the picture taken and consider what your diagnosis and next steps would be. Resolution of the case is …

A 38-Year-Old Female with Abdominal Pain and Chest Tightness

A 38-year-old female with no past medical history presents to an urgent care with right upper quadrant abdominal pain and chest tightness, worsening for 1 week. She reports that her chest tightness is associated with shortness of breath, and is worse when walking and lying on her side. She denies fever, cough, dysuria, headache, or weakness. View the ECG and consider what your diagnosis and next steps would be. (Case presented by Catherine Reynolds, MD, …

A 24-Year-Old Man with Ankle Pain After a Fall

The patient is a 24-year-old male who reports to urgent care with right ankle pain after falling from a ladder while cleaning out the gutters at his parents’ home. He reports that he was only a few rungs up but that he landed “awkwardly” and immediately felt a sharp pain on the front of the ankle. He is unable to bear weight but denies any numbness or tingling. View the x-ray taken and consider what …

ICYMI: A Rational System for Charting Has Finally Arrived

Remember the fall of last year—when the nation and world pined for an expedient end to 2020, as if such an arbitrary change as turning a page on the calendar could somehow reverse our collective fortune? Unsurprisingly when January 2021 arrived, all our woes were not magically and immediately remedied. In fact, the start of this year was among the most grim in U.S. history: nearly a quarter of a million new cases were being …

A ‘Red Herring’ Chief Complaint

Urgent message: Chief complaints may lead the provider “off the trail” of a more urgent diagnosis. Anchoring bias occurs when relying too heavily on this first piece of information. Providers must remain vigilant for the subtle and nonspecific warning signs of pulmonary embolism. Ryan Hagan, PA-C and Christina Gardner, DHSc, MBA, PA-C INTRODUCTION Chief complaints are used to guide decision-making and may suggest an organ system, but a life-threatening condition may be found in a …

Abstracts in Urgent Care – June 2021

Light Exercise and mTBI Asymptomatic Hypertension—What’s the Risk? Racial Factors in Pain Treatment Supplemental Oxygen in ACS Shorter Courses of Antibiotics for Pediatric CAP Who’s Behind that COVID-19 Mask? COVID-19 Infection in Healthcare Workers Light Exercise for Patients with Mild Traumatic Brain Injury (mTBI) Take-home point: There is no benefit for recovery in patients with mTBI randomized to light exercise compared with standard care. Citation: Varner C, Thompson C, de Wit K, et al. A …

A Patient on Dialysis with Syncope

History: A 67-year-old female presents to urgent care complaining of one episode of syncope earlier in the day. No seizure-like activity was noted by the family and she returned to baseline within a minute. She has a past medical history of end-stage renal disease on scheduled hemodialysis, hypertension, diabetes, coronary artery disease, and chronic nausea. Medications include aspirin, insulin, amlodipine, hydralazine, ondansetron, metoclopramide, and amiodarone. View the ECG taken and consider what your diagnosis …

A 36-Year-Old Man with Wrist Pain After a Traumatic Impact

The patient is a 36-year-old man who presents with wrist pain after “hitting it on something.” Further history reveals that he punched a wall in a fit of anger and felt sharp pain immediately. He has no past medical history and takes no medications. View the images taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 60-year old Male with Dyspnea and Hypoxemia at the Start of a Global Pandemic

Urgent message: The identification and global impact of the novel coronavirus has significantly challenged medical decision-making. Urgent care providers now consider the inclusion of the SARS-CoV-2-causing illness in their differential diagnosis when evaluating patients with signs and symptoms of an acute respiratory infection. Louis Costanzo, MD, MBA Introduction As of March 2021, there have been more than 28.6 million documented cases of COVID-19 in the United States, with the majority of cases those ages 18 …