An Age-Based Approach to Fever of Uncertain Origin in the Pediatric Patient

An Age-Based Approach to Fever of Uncertain Origin in the Pediatric Patient

Urgent message: Fever in pediatric patients, while frequent, is rarely the result of a serious illness. Urgent care practitioners must be able to consistently distinguish between serious and benign causes with a minimum of invasive testing. BRENDAN KILBANE, MD, FAAP Introduction Ever is one of the most common chief complaints in pediatric patients who present for urgent evaluation. A surprising number of families continue to suffer from “fever phobia,” with one study noting that 91% …

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Strategies for Avoiding Drug-Drug Interactions in Urgent Care

Strategies for Avoiding Drug-Drug Interactions in Urgent Care

Urgent message: With the increasing number of drugs on the market, patients are more and more likely to be taking multiple medications. Urgent care providers need to be alert for potential interactions when changing or adding to a patient’s drug therapy. MAYA HECK, MS1, and JOHN SHUFELDT, MD, JD, MBA, FACEP Consider This Patient Scenario:A 28-year-old woman who says she is a traveling nurse currently on an assignment at a nearby hospital presents to an …

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Acute Abdominal Pain in Children

Acute Abdominal Pain in Children

Urgent message: This article will guide you through the differential diagnosis, management and disposition of pediatric patients presenting with acute abdominal pain. KAYLEENE E. PAGÁN CORREA, MD, FAAP Introduction “My tummy hurts.” That is a simple statement that shows a common complaint from children who seek care in an urgent care or emergency department.1 But the diagnosis in such patients can be challenging for a clinician because of the diverse etiologies. Acute abdominal pain is …

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Management of Venous Thromboembolism in Urgent Care

Management of Venous Thromboembolism in Urgent Care

Urgent message: Clinical evaluation that includes pretest probability tools and judicious use of diagnostic tests is a requirement for patients who present in the urgent care setting with symptoms suggestive of VTE. MELVIN LEE, MD, CCFP, RMC   Early diagnosis of venous thromboembolism (VTE) is important to prevent the morbidity and mortality associated with it.Introduction VTE is subdivided into pulmonary embolism and deep venous thrombosis (DVT). DVT is most common in lower extremities. Those involving …

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Evaluation and Management of Pain (Part 1): Acute Pain

Evaluation and Management of Pain (Part 1): Acute Pain

Urgent message: Urgent care providers have a clinical, legal, and moral obligation to provide appropriate treatment for patients with pain. The first article in a two-part series addresses strategies for managing acute pain. TRACEY Q. DAVIDOFF, MD The interpretation of pain by patients is very subjective and not easily measured. That makes management of pain in the urgent care setting difficult. Current pain scales are often inaccurate or not truly reflective of a patient’s real …

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Evaluation and Management of Neck Pain in Urgent Care

Evaluation and Management of Neck Pain in Urgent Care

Urgent message: The differential diagnosis of neck pain is broad. A systematic and effective approach is required to rule out life-threatening conditions. RANIER NG, DO, and MICHAEL ROWANE, DO, MS, FAAFP, FAAO Neck pain is a frequently encountered complaint in urgent care. About two-thirds of the population will experience neck pain at some point in their lives.1 Many patients experience a sense of debilitation with every movement of their neck. Patients may perceive neck pain …

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An Urgent Care Approach to Excessively Crying Infants

An Urgent Care Approach to Excessively Crying Infants

Urgent message: Infants who cry excessively pose a challenge to physicians and parents. A systematic approach to the history and physical exam can guide the diagnostic approaches to determine if a benign – or serious – condition is responsible. Toni Clare Hogencamp, MD Crying is a primitive form of communication that infants rely on to communicate their distress. Because infants cannot verbalize their discomfort, they must rely on their cry to communicate with caregivers. Estimates …

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