Practice Management
A new epinephrine nasal spray has been approved by the Food and Drug Administration (FDA) for the treatment of allergic reactions, including anaphylaxis, in adult and pediatric patients who weight at least 66 pounds, according to an FDA press release. Until now, epinephrine has only been available for patients as an injection or auto-injection device. The agency says the new delivery mechanism addresses an unmet need in that some people who need urgent epinephrine treatment …
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Barely more than a third of children brought to an urgent care center or emergency room with anaphylaxis have received epinephrine before arriving, according to a new study published in the Annals of Allergy, Asthma, and Immunology. According to the report, which reflects the cases of 408 children with an average age of 7.25 years, just 36% of the patients had received epinephrine before reporting to an urgent care center or ED. The odds were …
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Urgent message: Acute stridor in pediatric patients is alarming to children, parents, and healthcare providers alike. Differential diagnosis is the key to initial evaluation and management of this worrisome symptom. Here is how to think it through. JERRI A. ROSE, MD, FAAP Stridor is an externally audible sound caused by abnormal air passage during breathing.1 It results from turbulent airflow through large airways. When a normal respiratory volume of air passes through narrowed airways, the …
Read MoreUrgent message: Anaphylaxis is a true medical emergency that requires rapid and aggressive treatment. When a patient with a Type 1 hyper – sensitivity reaction is brought to your urgent care, here is how to proceed. DAVID WEIN, MD, MBA, FACEP, and DENNIS DIXON, MD Introduction Anaphylaxis is a severe, whole-body, allergic reaction to a chemical that has become an allergen. Anaphylaxis is a true medical emergency, often with a rapid and unpredictable onset. It …
Read MoreEmergency treatment of Anaphylactic Reactions Key point: Early treatment with intramuscular adrenaline is the treatment of choice for patients having an anaphylactic reaction. Citation: Pumphrey R, Cant A, Clarke S, et al. Emergency treatment of anaphylactic reactions – Guidelines for healthcare providers. Resuscitation. 2008; 77(2): 157-169. Patients experiencing an anaphylactic reaction have life-threatening airway and/or breathing and/or circulation problems usually associated with skin or mucosal changes. Such patients should be treated using the ABCDE …
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Urgent message: The accessibility of urgent care makes it a prime venue for patients preparing for international travel and patients who may have become ill due to exposure to infectious agents while traveling overseas. Francine Olmstead, MD, FACP Whether a patient visits an urgent care center for an infection or a primary care physician for follow-up, every healthcare provider should inquire about anticipated overseas travel. In addition, if a patient is being evaluated for a …
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Urgent message: When presented with a patient who has experienced an insect bite or sting, the most crucial role for the urgent care clinician is to triage for anaphylaxis, venom toxicity, and local tissue damage. Kent A. Knauer, MD Now that summer is here, it is likely that urgent care practitioners—especially those practicing in suburban and rural areas—will see an increasing number of patients who have experienced an insect bite or sting. Though data are …
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