Urgent message: In the absence of controlled outpatient trials, the author proposes urgent-care specific guidelines for treatment of community-acquired MRSA, informed by clinical experience and local and regional case reports. Michael Dickey, MD The goal of any treatment is to maximize the chance of a positive outcome for a patient. The purpose of a treatment guideline is to maximize the chance of positive outcomes in groups of patients that present with a similar disease states. …
Read MoreDecember 2007
The Limping Child in the Urgent Care Center
Urgent message: The ability to evaluate children presenting with a limp—and to recognize red flags that help distinguish those to treat from those requiring immediate referral—should be within the purview of the urgent care clinician. Raymond W. Liu, MD, Hadeel Abaza, MD, and Allison Gilmore, MD A limping child without a clear traumatic history or diagnosis is a common presentation to an urgent care center. The broad differential diagnosis can be daunting, with causes that …
Read MoreNovember 2007
Assessment and Management of Common Hand Infections
Urgent message: Common superficial hand infections may be managed easily by the urgent care physician. Left untreated or undertreated, however, simple hand infections may progress to disabling conditions requiring urgent sub-specialty management. Arthur R. Smolensky, MD, Samuel M. Keim, MD, MS, and Peter Rosen, MD The hand is an intricate and crucial feature of the human body. Yet, with the exception of superficial cellulitis, common hand infections require relatively simple surgical procedures—many of which can …
Read MoreEvaluation, Identification, and Treatment of Urinary Tract Infections
Urgent message: Urinary tract infections are a common cause of abdominal pain and a common presenting complaint in urgent care. Proper diagnosis, treatment, and patient education on preventive measures are key to optimal outcomes. William Gluckman, DO, MBA, FACEP, Karen Keaney Gluckman, MSN, APN, C, CWCN, CCCN The global term urinary tract infection (UTI) incorporates cystitis and infection involving the bladder (a lower tract source), as well as pyelonephritis, an infection involving the kidneys (an …
Read MoreOctober 2007
Managing Heat Illness in Urgent Care
Urgent message: The urgent care provider’s most critical role in heat illness is to identify risk factors and the cause, to cool and hydrate the patient, assess for complications, and educate the patient in the hope of preventing a more serious exposure. Bridget Dyer, MD, Samuel Keim, MD, and Peter Rosen, MD Heat illness occurs when external heat conditions and internal heat production overwhelm the ability of the body to dissipate heat. Evaporation of sweat …
Read MoreSeptember 2007
Challenges in Assessing and Treating Insect Bites and Stings
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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