Journal of Urgent Care Medicine

Building the Body Up Just to Break the Body Down: A Look Into Black Market Substance Use Among Young Athletes and Bodybuilders

Urgent message: Many performance-enhancing medications not currently approved by the FDA remain undetectable in basic urine specimens collected in the urgent care setting. If there is suspicion of any form of illicit substance use, the inquiry of specific supplements/agents is key, as side effect profiles are often vast and wide. Rachael M. Poff, PA-C and Christina E. Gardner, DHSc, MBA, PA-C INTRODUCTION Selective androgen receptor modulators (SARMs) constitute a class of medication that has become …

An Atypical Presentation of Thyroid Storm: A Stark Yet Potentially Lethal Diagnosis

Urgent message: Unmanaged hyperthyroidism can cause any number of acute conditions that would drive a patient to visit an urgent care center. Further, thyroid storm can mimic several life-threatening events. Early recognition of the correct diagnosis is essential to raising the likelihood of a positive outcome—and protecting the patient from self-harm. Amrita Mahajan, BA and Lindsey Fish, MD INTRODUCTION Thyroid storm is a rare, life-threatening complication of thyrotoxicosis, a condition caused by excess thyroid hormone. …

Abstracts in Urgent Care – April 2021

Acetaminophen vs Ibuprofen in Children Optimizing Podcasts for Learning Dosing Ketorolac IV in Renal Colic Torus Distal Radius Fractures Avulsion Fractures of the Fifth Metatarsal Base COVID-19 and ECGs Long-Term Sequelae of COVID-19 COVID-19, Zinc, and Vitamin C Use of Acetaminophen and Ibuprofen for Fever and Pain in Young Children Take-home point: Acetaminophen and ibuprofen are both safe for short-term treatment of pain and fever in children under 2 years of age. Ibuprofen produces more …

Chin Lacerations in Children—A Call for Caution

Urgent message: Adhesive repair for skin lacerations in pediatric patients is a viable (sometimes preferable) option—under the right circumstances. Careful consideration is warranted when the wound is to the chin. Joshua Sherman, MD and David Mathison, MD, MBA INTRODUCTION The use of adhesive repair in lieu of sutures for the management of minor lacerations has become increasingly commonplace.1 When used correctly, cosmetic outcomes are similar and may be superior to suture repair in certain situations. …

Implementing Clinical Practice Guidelines in Adults with Hypertension: An Effective Practice Change in Urgent Care

Urgent message: Too often, patients first learn that they have hypertension secondary to an unrelated presenting complaint—often, in the urgent care setting. Improving adherence to treatment guidelines may improve management and, ultimately, outcomes. Jennifer Iacovo, DNP, APRN, FNP-C; Bonni Cohen, PhDc, DNP, APRN, ANP-C, FNP-C, CHFN, CNE, FAANP; and Judith Butler, DNP, CNM, WHNP, CNE Abstract Background: There are approximately 100 million adults in the U. S. with hypertension (HTN); almost half go undiagnosed. The …

A 96-Year-Old Male with Palpitations and a History of CAD

The patient is a 96-year-old man who is brought to your urgent care center by his daughter, with whom he lives. She reports that he has been feeling light-headed for “a few days.” The patient confirms this, adding that he has felt his heart “fluttering,” as well. He denies chest pain and shortness of breath, but acknowledges a history of coronary artery disease. View the ECG and consider what your diagnosis and next steps would …

A 13-Year-Old Girl with Scaling and Fissures on Her Lips

The patients is a 13-year-old girl who presents to a pediatric urgent care clinic with 1 month of scaling and fissures on her lips which began after she started using a retinoid cream prescribed for acne. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 71-Year-Old Woman with Femur Pain After a Fall

The patient is a 71-year-old female who presents with proximal femur pain after losing her balance and sustaining a “soft” fall onto a carpeted surface. She has a past history of hypertension, hypercholesterolemia, and osteoporosis. She takes a statin, an ACE inhibitor, and a bisphosphonate. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Abstracts in Urgent Care – March 2021

‘Seat Belt’ Signs Post MVA Pain Control in Corneal Abrasions Analgesia with Reduction of Shoulder Dislocation Can Early PT Help with Sciatica? How Vaping Compromises Breathing COVID-19 in the Country Pandemic Depression—A Real Thing? Avijit Barai, MBBS, MRCS, MSc (Critical Care), PgCertCPU, FRNZCUC Workup for “Seat Belt” Sign in Trauma Patients Take-home point: The presence of a “seat belt” sign has a high association with intraabdominal organ injury. Citation: Shreffler J, Smiley A, Schultz M, et …

Why Don’t You Take A Break?

I took up smoking for about 6 months in college, but not for the reasons you’d guess. This was during my freshman year shortly after I got a job waiting tables. It was a hard job. There was always work to be done—refill a drink, check how the food was cooked, and, most importantly, bring the check post-haste when the customers wanted to leave. The shifts always seemed like a blur. I’d run around non-stop …