Journal of Urgent Care Medicine

Focus on Pediatrics

Neuro Effects of COVID-19 Melatonin and Children with Postconcussive Symptoms Pediatric, Sports-Related Concussion Acute Migraine in Children and Adolescents Emily Montgomery, MD and Kelsey Riggs, MS3 Neurologic Manifestations of COVID-19 Take-home point: COVID-19 has a variety of presentations that include neurologic manifestations—most commonly, headaches. Citation: Niazkar HR, Zibaee B, Nasimi A, Bahri N. The neurological manifestations of COVID-19: a review article. Neurol Sci. 2020 Jul;41(7):1667-1671. Relevance: More than 1/3 of patients with COVID-19 experience neurologic …

Outpatient Management of COVID-19 in the Urgent Care Clinic: Administering Monoclonal Antibodies

Urgent message: The approved use of monoclonal antibodies to treat patients who have COVID-19 may signal a shift from inpatient to outpatient care of infected individuals who do not require hospitalization. Urgent care facilities may be ideally suited to serve as treatment centers and to become destinations of choice for such patients. Lindsey Fish, MD Now that COVID-19 has been with us for over a year, we are in a much different position regarding the …

Pretravel Consultations in the Urgent Care Setting

Urgent message: A pretravel consultation assesses the patient’s fitness for travel in the context of anticipated risks associated with their journey. This individualized counseling takes into account not just age or destination, but also general health and other factors such as past travel experience. Given the proliferation of single-specialty travel medicine clinics, with appropriate training and preparation, these assessments can easily be performed in the urgent care setting. Benjamin Silverberg, MD, MSc, FAAFP, FCUCM Citation: …

Managing Concussions in Acute Care

Jordan Wackett MD, MPH, Joshua Kornegay, MD, Craig Rudy, MD The most recent recommendation from the Concussion in Sport Group calls for 24-48 hours of rest and a graded return to activity (unrestricted once asymptomatic)2. Unfortunately, asymptomatic from a concussion standpoint is not always obvious, which can make the new recommendation difficult to implement as patients may remain symptomatic while adhering to rest. Symptomatology is often multifactorial and they may be instructed to rest despite …

A 46-Year-Old Woman with a Painful, Erythematous Plaque on Her Leg

The patient is a 46-year-old female who presents with a painful, erythematous, indurated plaque on her lower leg. She reports that it developed over the past month. At first she attributed the pain to “a bump” of unknown origin, but as the area of red skin expanded she became concerned that she became concerned, as she reports a history of deep-vein thrombosis. View the image taken and consider what your diagnosis and next steps …

A 34-Year-Old Female with a Syncopal Episode but No Remarkable History

A 34-year-old female with no reported medical history presents to urgent care after a syncopal episode. She describes standing up rapidly to answer the phone, followed by a sensation of lightheadedness and nausea with subsequent collapse. On evaluation, her vital signs are normal, she appears well, and she is currently asymptomatic. View the ECG taken and consider what your diagnosis and next steps would be. (Case presented by Tom Fadial, MD, The University of Texas …

A 13-Year-Old Boy with Knee Pain After a Fall

The patient is a 13-year-old boy who presents with knee pain after an awkward fall while playing basketball on an asphalt court. He is unable to walk due to pain and has a swollen knee. View the x-rays taken and consider what your diagnosis and next steps would be.

Do Respiratory Outpatient Clinics Decrease Bronchiolitis Reevaluation Rates? Observational Data from a Quality Improvement Project

Urgent message: Establishing respiratory outpatient clinics has been shown to decrease reevaluation rates for patients with bronchiolitis, especially in children aged <12 months and/or those who receive suctioning during their initial urgent care encounter. Prema D. Souza, MD; Aimy Patel, MD; Brian Lee, PhD; and Amanda Nedved, MD Citation: Souza PD, Patel A, Lee B, Nedved A. Do Respiratory Outpatient Clinics Decrease Bronchiolitis Reevaluation Rates? Observational Data for a Quality Improvement Project. J Urgent Care …

IgA Vasculitis in Children: Beyond the Rash

Urgent message: This is the urgent message about a truly urgent case presentation concerning a pediatric patient in an urgent care center. Diana Sofia Villacis Nunez, MD; Amit Thakral, MD, MBA; and Pareen Shah, MD CASE PRESENTATION A 12-year-old previously healthy female presents with a 5-day history of lower extremity rash and low-grade fever (100.6°F). A month earlier, she had a self-resolving viral upper respiratory infection. The rash is described as mildly pruritic, dark red …

A Crisis of Trust

The conversation was going nowhere. After 15 minutes of explaining my concerns about the possibility of COVID-19, the lack of indication for antibiotics, the unreliability of rapid testing, I was no closer to satisfying my patient, Mrs. Fletcher, than when I first introduced myself. Joan Fletcher was a 40-something working mother of three who came to urgent care on a mission, as many patients do. The reason for her visit: an antibiotic prescription and a …