Practice Management
Urgent message: High degree of suspicion combined with thorough history and proper use of available tests can help the clinician identify patients in need of emergent referral. John Shufeldt, MD, JD, MBA, FACEP and Kelli Hickle Introduction A 47-year-old woman with a diagnosis of ovarian cancer developed an acute onset of mild shortness of breath two days after being discharged for a work-up of symptomatic ascites. Her medical history was significant for obesity and recent …
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Urgent message: Unusual as the diagnosis may be in 2009, patients with symptoms of what is later confirmed to be tetanus may be more likely to present to urgent care than to other practice settings. Curtis G. Kommer, MD, Latha Shankar, MD, and Mario Kapetsonis, MD Tetanus, a toxin-mediated infection of gram-positive bacteria Clostridium tetani, is a rare presentation in the 21st century. Since 2000, there have been fewer than 50 cases per year reported …
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Urgent message: Injuries sustained in playground falls are common presentations to emergency departments and urgent care centers alike. The urgent care physician should be alert to the keys to evaluation and management of traumatic neck pain. Muhammad Waseem, MD, Lalithambal Venugopalan, MD, and Gerard Devas, MD Cervical spine (C-spine) injuries occur infrequently in children. This is especially true for fractures of atlas vertebra, which is a rare injury in children. Its diagnosis may easily be …
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Urgent message: Atypical chest pain in a young male offers a challenge solved by ordering—and assessment—of the appropriate imaging. Shannon Dowler, MD The patient is a 20-year-old white male who presented to urgent care with a two-week history of mild dyspnea, with the onset of chest pain in the prior 24 hours. He denied wheezing, vomiting, and recent trauma, and reported that he has tried no medications for his symptoms. Further discussion with the patient …
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