Journal of Urgent Care Medicine

When It’s More Than Just A Cough

Urgent message: Take vital signs and physical examination of the chest with the utmost importance when evaluating a patient with a cough. The common complaint of “cough” in the urgent care setting can be a symptom of a life-threatening pathology. Frank Schaller, DNP, APRN, FNP-C and Lauren Dunn, MSN, APRN, FNP-C INTRODUCTION Cough is a common complaint across healthcare settings including the emergency department (ED), urgent care, and primary care arenas—especially during influenza season.1 Cough …

Be Aware: Hoping to Head Off a Twindemic, FDA Has Approved a ‘New’ Drug to Prevent Flu

Baloxavir marboxil (Xofluza) was approved to help patients in the early stages of influenza infection. However, as the reinvigorated COVID-19 pandemic now coincides with flu season, the Food and Drug Administration has approved it as a preventive measure for patients who have simply been exposed to influenza. As with the original indication, it is approved for patients 12 years of age and older. In a statement accompanying the FDA announcement, Debra Birnkrant, MD, director of …

What’s New for RCM? Updates on Coding for COVID-19 Testing

As lab testing for COVID-19 continues to evolve, new products—and new CPT codes—continue to emerge. The latest tests combine COVID-19 testing with a test for influenza A and B. There are two types: one includes the polymerase chain reaction (PCR) test, the other includes the antigen test. The new CPT codes are: 87636 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) and influenza virus …

Don’t Forget about the Road Behind

If you’re reading this, you’ve survived 2020. Congratulations!—although it probably doesn’t feel like there’s much success to revel in at the moment. Indeed, this has been a year of hardship for everyone in some form and certainly, for many, it still may feel like there’s no end in sight. And it doesn’t seem like much cause for celebration to have dodged a bullet when you’re still staring down the barrel of a loaded gun. However, …

Your Clinical Team May Not Be as Healthy as You Think They Are

It would stand to reason that people who work in urgent care centers are exposed to a higher viral load of whatever’s going around at any given time—including COVID-19. The larger problem, according to a study published by JAMA Network, is that the virus goes undetected in healthcare workers too often. Conjecture is that they have mild or no symptoms, and even in a healthcare setting testing isn’t thorough enough. The study, conducted by the …

Antibiotic Stewardship and Sinusitis: A Quality Improvement Project

Urgent message: Acute sinusitis poses frequent challenges in urgent care where patient volumes are high and patient satisfaction is valued. An educational session and an algorithmic clinical decision-support tool were implemented in a multisite urgent care quality improvement project which resulted in a statistically significant reduction in antibiotic prescribing for acute sinusitis. ABSTRACT Background Sinusitis is a common upper respiratory condition seen in urgent care centers, as it is in primary care practices and, increasingly …

Can Employers Mandate the COVID-19 Vaccine?

Urgent message: Based on precedent, urgent care operators and other employers can mandate the COVID-19 vaccine when available, subject to reasonable accommodation for exemptions, which are limited when an employee’s role is public- or patient-facing. As we strain our eyes to see the light at the end of the tunnel in this pandemic, many urgent care centers will continue to have front office staff, medical assistants, and providers interacting with the public. In fact, research …

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) …

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