Journal of Urgent Care Medicine

Whooping Cough on the Rise, Showing Its Cyclical Nature

Data from the Centers for Disease Control and Prevention reported by ABC News shows a significant rise in whooping cough cases across the United States. This year, 4,864 cases have been reported, nearly triple the 1,746 cases recorded at the same time last year. However, the recent case numbers are comparable to 2018-2019, before the COVID-19 era. In Oregon, the local health authority reported 178 cases as of May 29, marking a 770% increase from …

CDC Ramps up H5N1 Surveillance

The Centers for Disease Control and Prevention (CDC) has asked state health officials to keep up with flu surveillance over the summer to watch for human-to-human spread of the H5N1 bird flu virus, according to CIDRAP. Flu surveillance generally wanes during the warmer months when there are fewer seasonal flu virus cases. H5N1 vaccines exist, but the nation is far from ready for a full-scale national vaccine program should the virus become a widespread health …

Dyspnea in the Urgent Care: Differentiating Benign From ‘Can’t Miss’

Urgent Message: Patients commonly present with respiratory symptoms in the urgent care setting and not infrequently complain of some degree of shortness of breath—or dyspnea. It is critical for clinicians to have comfort with the clinical assessment and appropriate use of diagnostic resources for the dyspneic patient. Identifying patients requiring immediate emergency department referral is an important skill. Evan Price, DO; Eric Patten, MD; Shakil Hossain, DO; Michael Weinstock, MD Citation: Price E, Patten E, …

Abstracts in Urgent Care – June 2024

Using AI to Detect Myocardial Infarction Take Home Point: The use of an occlusive myocardial infarction (OMI) artificial intelligence (AI) electrocardiogram (ECG) model has the potential to improve identification of acute coronary syndrome (ACS) by enabling timely and accurate detection of OMI regardless of the presence ST-segment elevation. Citation: Herman R, Meyers H, Smith S, et. al. International evaluation of an artificial intelligence-powered electrocardiogram model detecting acute coronary occlusion myocardial infarction. Eur Heart J Digit …

Keeping an Eye on the H5N1 Virus

The H5N1 avian flu virus is spreading in dairy cows across the country, however, the risk of human-to-human transmission is rare. Because the virus is spreading so rapidly, scientists are considering wastewater sampling for surveillance, according to CIDRAP. Baylor College of Medicine and the University of Texas Health Sciences Center researchers reported 19 of 23 monitored wastewater sites had at least 1 result of H5N1 detected in wastewater from March 4 to April 25. It’s …

Influence of Clinical Setting on Antibiotic Prescribing Practices for Acute Otitis Media in Children at an Urban Academic Medical Center

Urgent Message: This retrospective chart review study found that the odds of children receiving an antibiotic prescription for acute otitis media in urgent care and the emergency department were significantly higher compared to a primary care setting. Further research is needed to better understand factors contributing to higher antibiotic prescribing rates in acute care settings. Angelica M. Mangahas, BS; Heather M. Weinreich, MD, MPH; Johanna Wickemeyer, MD; Margaret Schmit MD; Rakhi Thambi, MD, MBA Citation: …

Flu Season Winds Down With Lower Than Average Visits in Early April

Outpatient visits for flu like illness are on a steady decline in the United States, indicating reduced activity of respiratory viruses including flu, COVID, and respiratory syncytial virus. The Centers for Disease Control and Prevention (CDC) reports the first week of April showed that visits for respiratory illness with fever plus a cough or sore throat fell to 2.8%, just below the national baseline of 2.9%. Positive labs for flu were down 7.7% since the …

Rapid Viral Tests Best When They Inform Treatment Decisions

A recent review suggests that the routine application of rapid respiratory viral tests in emergency departments (EDs) offers limited benefits for antimicrobial stewardship. Presented in JAMA Internal Medicine, the review examined 11 randomized clinical trials involving patients with acute respiratory infections (ARIs) seeking care in EDs. It revealed that while rapid viral testing led to increased usage of influenza antivirals among positive cases (absolute risk difference 1%), it did not significantly impact overall antibiotic use, …

Abstracts in Urgent Care – March 2024

Omicron versus Flu & RSV – Which is Most Dangerous for Children? Take Home Point: In this study, hospitalization rates were highest for patients with RSV than Omicron (COVID-19) in all age groups of children. Citation: Hedberg P, Abdel-Halem L, Valik J, et. al. Outcomes of Pediatric SARS-CoV-2 Omicron Infection vs Influenza and Respiratory Syncytial Virus Infections. JAMA Pediatr. 2023 Dec 26: e235734. doi: 10.1001/jamapediatrics.2023.5734 Relevance: With increasing availability for respiratory pathogen testing, it is …

Nine Recurring Coding Pitfalls for Urgent Care Clinicians to Avoid

Brad Laymon, PA, CPC, CEMC Over my career as a physician assistant, I have delved extensively into the intricacies of medical coding guidelines. Through collaborative initiatives with healthcare systems and fellow clinicians, I have been able to identify 9 common, recurring coding pitfalls. This process came with significant time and experience, and I want to share what I’ve learned as my ultimate objective has always been advancing charting accuracy to instill confidence among providers in …

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