Journal of Urgent Care Medicine

Streptococcal Pharyngitis and Its Sidekicks: Common and Uncommon Etiologies

Urgent message: Pharyngitis is a common chief complaint in urgent care, but not all sore throats are streptococcal (strep) pharyngitis. Delayed diagnosis and treatment of some causes of sore throat can lead to catastrophic outcomes. Epidemiology Acute pharyngitis accounts for 1%-2% of all visits in the ambulatory setting.1 Most pharyngitis seen in urgent care is viral in etiology. The most common bacterial cause of pharyngitis is group A beta hemolytic Streptococcus (GABHS), which is responsible …

Antibiotic Stewardship in Pediatric Acute Otitis Media—Pearls and Pitfalls

Urgent message: Acute otitis media (AOM) is the leading diagnosis for antibiotic prescribing in pediatric patients. As antibiotic stewardship becomes more essential in preventing antibiotic resistance, safe and effective management of AOM becomes all the more important in urgent care. The treatment path should reflect nuances in management to inform decisions regarding the necessity of antibiotics—and if they are deemed necessary, targeting the type, delivery vehicle, and duration to keep a narrow treatment effect. When …

A 69-Year-Old Female with Hypertension, Dyslipidemia, and a Constellation of Otolaryngologic Symptoms

Urgent message: Epiglottitis is classically viewed as a pediatric disease, but has become increasingly common in the adult population. While symptoms may present as an isolated sore throat, they can quickly progress to complete airway compromise with need for emergency cricothyroidotomy. Due to the high risk for morbidity and mortality, urgent care providers must maintain a high index of suspicion to avoid misdiagnosing a potentially catastrophic disease. Zachary DePriest, MS, PA-C INTRODUCTION Adult epiglottitis (AE) …

Abstracts in Urgent Care November 2020

Antibiotics (or Not?) for Dog Bites Scaring the Quest for Antibiotics Out of Patients Post-Op Antibiotics in Complex Appendicitis How Long Should Sepsis Patients Receive Antibiotics? Times Are Changing for Patients with Allergic Rhinitis Avijit Barai MBBS, MRCS, MSc (Critical Care), PgCertCPU, FRNZCUC Prophylactic Antibiotics for Dog Bites Key point: The majority of the patients presenting to emergency room with dog bites receive prophylactic antibiotics either in the hospital or on discharge. About one quarter …

Flu Vaccination and Reporting Are Under Scrutiny This Year. Are You on Point with State Law?

2020 has seen a new word introduced into the lexicon of healthcare in the United States. With the COVID-19 pandemic stretching on into the foreseeable future and coinciding with the advent of influenza season, public health experts are warning about a possible twindemic—simultaneous widespread outbreaks of both COVID-19 and flu. As such, there’s a lot of emphasis pushing flu shots harder than ever, especially in healthcare settings. According to a blog post by Alan Ayers, …

Flu Shots Are Here, and a COVID-19 Vaccine May Not Be Far Behind. Do You Know What Your State Requires of You?

This is not going to be your typical flu season. At best, patients will flood healthcare facilities to get their flu shots early. The worst-case scenario is that they’ll shy away from immunization under the misguided assumption that it could leave them in a weakened state or expose them to people with COVID-19. Recognizing the overlap, as well as the reality that people who work in urgent care centers and other healthcare facilities are not …

To Flu or Not to Flu

It’s flu season again and this year patients have two viruses to worry about: COVID-19 and influenza. Now is the time patients will come in to get their flu vaccine and (hopefully) take the flu possibility out of the equation. Vaccinations are usually billed with two CPT codes: one for the vaccine and one for the administration of the vaccine. If the practice did not pay for the vaccine, only the CPT code for the …

Abstracts in Urgent Care – October 2020 (PUCC)

Spotlight on Original Research in Pediatric Urgent Care: Excerpts from the 2020 Pediatric Urgent Care Conference (PUCC). Los Angeles, CA David J. Mathison, MD, MBA Decreasing Length of Stay in the Pediatric Urgent Care with Electronic Discharge Instructions* Wooster J, Patel A, Nedved A, Lee B The aim of this research was to determine if an electronic discharge process could decrease length of stay by an average of 10 minutes per patient. An electronic discharge …

Wildfires Turn Up the Heat on Efforts to Slow COVID-19 and Prevent a Severe Flu Season

Mounting cases of COVID-19 (and associated deaths), coupled with concern that the U.S. could experience a severe flu season this year, may have given some people the sense that “things just couldn’t get any worse” from a public health standpoint. Wrong. A study published in the journal Environment International reports a link between intense wildfire seasons—like the one going on right now in western U.S. states right now—and higher incidence of influenza. Based on study …

The Challenge of Inequity in Urgent Care Medicine: A Call to Action

Lindsey E. Fish, MD The young black couple walked into our urgent care clinic, eyes wide and filled with fear, hope, and expectation. Wrapped in her mother’s arms was their 3-day-old beautiful baby girl, a child born in the midst of two scourges—the COVID-19 pandemic that was sweeping our country and world, and the pandemic of racial inequity that was surfacing due to peaceful protests and violent riots occurring throughout our cities and rural communities …