Journal of Urgent Care Medicine

Urgent Care Assessment of Patients with Possible Diverticulitis

Urgent Message: Diverticulitis is a prevalent condition characterized by localized inflammation most commonly of the sigmoid colon. It is often diagnosed with a computed tomography scan with intravenous contrast. Uncomplicated cases are most common and require only monitoring, however complicated cases can require hospitalization and emergent surgical intervention. Urgent care clinicians should be comfortable assessing patients with possible diverticulitis and recognizing features that suggest the possibility of more complicated disease. Naushair Hussain DO; Shahmeer Hussain …

MIS-C Could Be Caused By Molecular Mistaken Identity

New research in Nature suggests that an autoimmune over-reaction could be what’s driving a pattern of multisystem inflammatory syndrome in children (MIS-C) after COVID-19 illness. Researchers looked at 199 blood samples from children with MIS-C and 45 control samples from children with COVID-19 but without MIS-C. About one-third of the MIS-C patients had autoantibodies for part of the human protein SNX8, which is found in the heart, lungs, kidneys, brain, skin, eyes, and gastrointestinal tract. …

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, …

Urgent Care Evaluation and Management of Boxer’s Fractures

Urgent Message: Boxer’s fractures are among the most common hand fractures and should be suspected in cases of closed fist injury. Additionally, a laceration that accompanies a boxer’s fracture may represent a fight bite, which should be treated to reduce the risk of infection. Jennifer Hicks, DO; Bradley Strauch, MD Citation: Hicks J, Strauch WB. Urgent Care Evaluation and Management of Boxer’s Fractures. J Urgent Care Med. 2024; 18(8):32-36 Editor’s Note: While the images presented …

Charting with Purpose: Precision Strategies for Accurate Coding and Malpractice Defense

Jeff Willis, MD Urgent Message: A well-told story explaining your thought process during a patient encounter will contain all the elements required for accurate coding. Attorneys are less likely to question care when a logical and complete story is clearly documented. Citation: Willis J. Charting with Purpose: Precision Strategies for Accurate Coding and Malpractice Defense. J Urgent Care Med. 2024; 18(4) 13-16. As a medical legal consultant, I have learned medical malpractice claims are an …

Tympanic Membrane Conditions Beyond Otitis Media in Urgent Care Practice

Urgent Message: Better understanding of tympanic membrane/middle ear conditions can inform more accurate diagnoses at the point of care. Citation: LaCour J. Tympanic Membrane Conditions Beyond Otitis Media in Urgent Care Practice. J Urgent Care Med. 2023;18(3):15-19 Author Affiliation: Jeff LaCour, MD, Compassio Medical Education. Video: Watch a video featuring Jeff LaCour, MD, that further explains tympanic membrane conditions with supplemental images. WATCH VIDEO Urgent care providers are often tasked to determine the source of …

Systemic Steroid Stewardship in Urgent Care: Recognizing Indication Creep to Limit Avoidable Harms

Urgent Message: Steroid overprescribing is a universal urgent care issue. While systemic steroids have several indications in which the preponderance of evidence supports their use in the urgent care setting, indication creep has led to their use outside of these scenarios resulting in significant risk for avoidable and unjustifiable adverse reactions. Citation: Hansen P. Systemic Steroid Stewardship in Urgent Care: Recognizing Indication Creep to Limit Avoidable Harms. J Urgent Care Med. 2023;18(3);29-32 Author Affiliation: Paul …

Differentiating Acute Conjunctivitis Presentations in Children

Urgent message: Make the distinction between viral and bacterial conjunctivitis to ensure children receive appropriate treatment and to avoid the negative consequences of antibiotic overuse. Julian P. Ponsetto MD, Momoko K. Ponsetto MD Download the article PDF Here Citation: Ponsetto JP, Ponsetto MK. Differentiating acute conjunctivitis presentations in children. J Urgent Care Med. 2023;17(11):15-20. Infectious conjunctivitis or “pink eye” is common in the pediatric population, accounting for 2.7% of diagnoses in pediatric urgent care.1 However, …

HbA1c as Screening/Diagnoses for Early or Asymptomatic Diabetes in the Urgent Care Facility

Urgent message: The use of all-inclusive kits with compact, table-top analyzers provides a rapid quantification of HbA1c levels in patients. The use of these tests for in-house screening has the potential to increase the diagnoses of early or asymptomatic diabetes in young adults and under-served or overlooked populations. Jay H. Shubrook, DO; Jane M. Caldwell, PhD; and Lindsey E. Fish, MD Citation: Shubrook JH, Caldwell JM, Fish LE. HbA1c as screening/diagnosis for early or asymptomatic …

A Novel Pediatric Resuscitation Course Designed for the Urgent Care Setting

Urgent message: Urgent care centers play a vital role as a gateway into the health system for many children with acute care needs. Some of these needs require identification by the urgent care team, who may then need to stabilize the patient and initiate transfer to optimize clinical outcomes. Nikhil B. Shah, MD INTRODUCTION Pediatric office emergencies can be challenging for urgent care staff to manage. These high-stakes events do not occur frequently enough to …

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