Practice Management
Urgent message: A variety of objects find their way into the ears, noses, and throats of children. Some can be lethal and require ED or specialist referral. Others can be safely removed in an urgent care setting. ANN MARY BACEVICE, MD In children who are brought to an urgent care for treatment, foreign bodies are common. Especially if they are between the ages of 18 months and four years, children will insert objects into their …
Read More
Identifying Risk Factors in Preparticipation Physicals for Young Athletes Urgent message: Doctors in the US and Europe are divided over what the cardiovascular component of a proper sports physical should include. Here is a reasonable approach. NATHAN P. NEWMAN, MD, FAAFP Sudden death in young athletes is not new. In 490 BC, when the Greeks improbably defeated the invading Persians at Marathon, a young herald, Phidippides, ran 25 miles back to Athens to announce the …
Read More
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 More
Urgent message: Most burn injuries can be handled in an outpatient setting—if they are classified accurately, treated appropriately, and referred to a regional burn center when indicated. TRACEY QUAIL DAVIDOFF, MD A “burn” is defined as a traumatic, thermal injury to the skin and deeper structures. Some or all of the cells of the skin can be destroyed not only by heat but also by cold, chemicals, electricity, or radiation. Burns are the third-leading cause …
Read MoreUrgent message: Even with the utmost attention to proper protocols, current data, and vast clinical experience, patient emotions are the unforeseeable x factor in a positive encounter (and, sometimes, even positive outcomes). Author: Bob Stuart, MD and Bob Bichler, RN As providers, we have been trying to understand how we can be more helpful and effective with the patients to which we provide care. How can I best provide care which will feel most satisfying …
Read More
Urgent message: Giant cell arteritis is an under-recognized and easily missed vasculitis of older adults, a challenging but “can’t miss” diagnosis. The urgent care clinician must be able to recognize this entity sometimes referred to as the “great masquerader” and be comfortable initiating timely emergency treatment. Ryan C. Jacobsen MD, EMT-P Giant cell arteritis (GCA), more commonly known as temporal arteritis, is an under-recognized vasculitis of older adults that can have potentially devastating consequences, most …
Read More
Urgent message: Fractures, in general, are relatively common among pediatric patients. Those most likely to be seen in the urgent care setting include injuries to the radius, ulna, humerus, lateral condyle, clavicle, tibia, and fibula. The second of two parts. Justin Kunes, MD, Shane R. Hanzlik, MD, Allison Gilmore, MD As noted in part 1 of this article (published in the February 2011 issue of JUCM and available at www.jucm.com), fractures are common injuries in …
Read More
Urgent message: Fractures are common among pediatric patients. Familiarity with the growth process and the unique properties of the immature skeleton—as well as immediate identification of conditions requiring emergent referral—are necessary for appropriate care and avoidance of long-term sequelae. The first of two parts. Justin Kunes, MD, Shane R. Hanzlik, MD, Allison Gilmore, MD Injuries that ultimately prove to be fractures are a common cause of visits to the emergency room and urgent care among …
Read More
Urgent message: Data show that urgent care centers are becoming a more common destination for patients experiencing chest pain. Immediate recognition of emergent vs. urgent causes may be the make-or-break moment for the patient’s outcome. Jasmeet Singh Bhogal, MD Introduction Evaluation of chest pain always presents as a diagnostic challenge, be it in the outpatient family medicine setting or the hospital emergency department. In fact, urgent care centers occupy a unique position in the equation; …
Read More