Journal of Urgent Care Medicine

Practice Review: Patients Presenting with Symptoms of Odontogenic Infection

Urgent message: Odontogenic infections can pose life-threatening risk when swelling occurs in close proximity to the airway. It is essential that the urgent care provider is able to differentiate cases of relatively straightforward infection that can be managed in the urgent care setting vs true airway emergencies. Amandeep Kaur Bains, BDS(Hons) MFDS RCPS (Glasg); Awais Safdar Ali, BDS MJDF RCSEng; and Pavan Padaki, BDS, MFDS RCPS (Glasg), MBChB, MRCS, FRCS (OMFS) INTRODUCTION While odontogenic or …

A Hand Wound Caused by a Pressure Washer

Urgent message: Injuries caused by pressure washers often require debridement or, in severe cases, amputation. Immediate assessment and appropriate management, where feasible, can preclude the need for surgical intervention while effecting a positive outcome. Ellen Hancock, MD; Julie Park; MD, FACS; and Kendall Wermine INTRODUCTION Pressure washer injuries tend to involve the lower extremities and abdomen and usually require a form of surgical intervention such as debridement of tissue and, in severe cases, amputation.1-4 The …

A Novel Method for Blinding Reviewers to Gender of Proceduralists for the Purposes of Gender Bias Research

Urgent message Gender bias, whether overt or subconscious, may be to blame for disparities in hiring practices, salary, and advancement in medical schools, the urgent care setting, and any healthcare workplace. Recognizing the value of gender-neutral assessment may not only “even the playing field,” but increase the likelihood of identifying the best candidates for clinical positions. Michael Pallaci, DO; Jennifer Beck-Esmay, MD; Adam R. Aluisio, MD, MSc; Michael Weinstock, MD; Allen Frye, NP; Ashley See, …

A 7-Year-Old Girl with White Patches on Her Toenails

Case A mother brought her 7-year-old daughter to the pediatric urgent care center after noticing that several of the girl’s toenails on each foot had white patches and appeared short and broken. They seemed to be lifting off the nail beds and looked thinner than usual. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Prolonged Duration of Pediatric COVID-19

Urgent Message: Many Institutions have established guidelines regarding when individuals can return to their regular activities after recovering from COVID-19. Where children and schools are concerned, it’s unclear what the role of testing is (or should be). Katharine Miao, MD, FACEP; Frank Illuzzi, MD, FACEP, CPE; and Alexander Hwang Citation: Miao K, Illuzzi F, Hwang A. Prolonged duration of pediatric COVID-19. J Urgent Care Med. 2021;15(5):23-25. Introduction Since the outbreak of the SARS-CoV-2 virus within …

A 60-Year-Old Woman with Hypertension, Diabetes, and Sudden Fatigue and Weakness

A 60-year-old female with a history of hypertension and diabetes presents to urgent care with fatigue and weakness for 1 day. Her son states she has not been able to get out of bed today because she’s “too tired to walk.” She denies any complaints of chest pain, nausea, vomiting, shortness of breath, or fever. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described …

A 32-Year-Old Male with Thumb Pain After a Ski Fall

The patients is a 32-year-old man who presents with pain in his left thumb after skiing. He reports that he took a fall, instinctively extending his left arm out to cushion the blow. View the thumb x-ray taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Most Clinicians Are Still Not Comfortable Sending Chest Pain Patients Home with a Very Low Risk of 30-Day Major Adverse Cardiac Event (MACE)

Michael B. Weinstock, MD; Michael Pallaci, DO; Amal Mattu, MD; Cameron Berg, MD; Paul Jhun, MD; and Jeff Riddell, MD. Urgent message: Patients who present with chest pain but tests indicate there is little risk for a major event can leave providers uncertain as to what next steps are appropriate, and raise concerns for bad outcomes and litigation. Citation: Weinstock MB, Pallaci M, Mattu A, Berg C, Jhun P, Riddell J. Most Clinicians Are Still …

If Not Otitis Externa…Then What?

Urgent message: Complaints of ear pain in children are among the most common presentations in the urgent care setting. While acute otitis media and acute otitis externa are high on the list of possible causes, it is essential that the urgent care provider be prepared to differentiate these from other possible etiologies. Elizabeth Flasch, MSN, APNP, PNP; Sadia Ansari, MD; Timothy Martin, MD Citation: Flasch E, Ansari S, Martin T. If not otitis externa…then what? …

Abstracts in Urgent Care – February 2021

Septic Knee Joints in Adults Recurrent Cellulitis Analgesics and Risk for Fracture Nonunion Assessing for MACE with and without a Troponin IV Fluids in Headache Management COVID-19 and Telemedicine COVID-19: The Second Wave Dr Avijit Barai, MBBS, MRCS, MSc (Critical Care), PgCertCPU, FRNZCUC Diagnostic Dilemma: Septic Arthritis of Knee Joints in Adult Patients Key point: Synovial fluid white cell count and Gram stain are the most useful laboratory markers for septic arthritis. Clinical evaluation, synovial …