Journal of Urgent Care Medicine

Knee Immobilization for Acute Knee Injuries: A Review

Urgent message: Immobilization following acute knee injury occurs more commonly than the evidence might dictate in urgent care and other acute care settings. Evaluation of data in existing literature suggest that this common practice carries risk for adverse effects when not warranted. Matthew Bruce Baird, MD, CAQ-SM; Mallory Shasteen, MD, CAQ-SM; and Vicki Nelson, MD, CAQ-SM. Citation: Baird MB, Shasteen M, Nelson V. Knee immobilization for acute knee injuries: a review. J Urgent Care Med. …

When X-Rays Lie: Important Orthopedic Diagnoses to Consider with Normal Imaging

Urgent message: Musculoskeletal pain is a common urgent care complaint, with x-rays very commonly ordered. However, a “normal” image does not necessarily support eliminating what could be a serious injury from the differential diagnosis. Arun Sayal, MD, CCFP(EM) Citation: Sayal A. When X-Rays Lie: Important Orthopedic Diagnoses to Consider with Normal Imaging. J Urgent Care Med. 2022;16(7):13-16. Medical tests lie. Not intentionally, of course, but their result may not align with reality. A test may …

Evaluating Decreased Libido: The Lowdown on Low T

Urgent message: Hypogonadism not only impedes biological development, but also negatively impacts a patient’s sense of identity and well-being. Prompt diagnosis is achievable through strategic utilization of hormone level testing in conjunction with a patient’s stated symptoms and medical history. Lisa O. Iyeke, BS and Mark J. Richman, MD, MPH Citation: Iyeke LO, Richman MJ. Evaluating decreased libido: the lowdown on low T. J Urgent Care Med. 2021;16(6):33-34. CASE PRESENTATION A 46-year-old male with benign …

A Legal Quandary: Poor Care…or Malpractice?

Urgent message: Failure to consider subtleties and the context in which a patient presents can lead to insufficient differential diagnoses and, therefore, mis- or missed diagnoses that leave the patient at risk for poor outcomes and the provider at risk for litigation. Michael Weinstock, MD and Charles Pilcher, MD Back pain is usually back pain, whether it’s from a muscular strain or another self-limiting, non-serious cause. But there is potential danger lurking below the surface, …

Urgent Care Diagnosis and Management of Deep Vein Thrombosis

John DesMarais, MD and Samidha Dutta, DO Urgent message: Screening patients with suspected DVT using the Well’s criteria is an efficient tool that would be even more impactful with access to point-of-care, high-sensitivity D-dimer testing in the urgent care setting. Citation: DesMarais J, Dutta S. Urgent care diagnosis and management of deep vein thrombosis. J Urgent Care Med. 2021;15(2):13-17. Case Presentation A 37-year-old woman presents to urgent care with 3-day history of right leg swelling …

Evaluation of Nonfatal Drowning in Urgent Care

Urgent message: Lingering warm weather and postpandemic euphoria continue to have patients eager to pursue outdoor activities, including swimming in pools, freshwater lakes, and oceans. Those who have suffered a drowning episode and whose symptoms have resolved may seek care or reassurance at the local urgent care center. Citation: Davidoff TQ. Evaluation of nonfatal drowning in urgent care. J Urgent Care Med. 2021;15(11):11-14. Case Presentation A 4-year-old Hispanic male without significant past medical history is …

Best Practices for LGBTQ-Friendly Urgent Care

Urgent message: LGBTQ individuals are subject to implicit and explicit bias in our society, ranging from microaggressions and antagonistic legislation to overt discrimination and harassment. This can inhibit willingness to seek medical care—and, subsequently, lead to worse health outcomes. Given the more accessible, episodic nature of urgent care, understanding how word choice and other subtle cues communicate our competency in working with LGBTQ patients can help us engender trust more quickly. INTRODUCTION The goals for …

Outpatient Management of COVID-19 in the Urgent Care Clinic: Administering Monoclonal Antibodies

Urgent message: The approved use of monoclonal antibodies to treat patients who have COVID-19 may signal a shift from inpatient to outpatient care of infected individuals who do not require hospitalization. Urgent care facilities may be ideally suited to serve as treatment centers and to become destinations of choice for such patients. Lindsey Fish, MD Now that COVID-19 has been with us for over a year, we are in a much different position regarding the …

Pretravel Consultations in the Urgent Care Setting

Urgent message: A pretravel consultation assesses the patient’s fitness for travel in the context of anticipated risks associated with their journey. This individualized counseling takes into account not just age or destination, but also general health and other factors such as past travel experience. Given the proliferation of single-specialty travel medicine clinics, with appropriate training and preparation, these assessments can easily be performed in the urgent care setting. Benjamin Silverberg, MD, MSc, FAAFP, FCUCM Citation: …

Managing Concussions in Acute Care

Jordan Wackett MD, MPH, Joshua Kornegay, MD, Craig Rudy, MD The most recent recommendation from the Concussion in Sport Group calls for 24-48 hours of rest and a graded return to activity (unrestricted once asymptomatic)2. Unfortunately, asymptomatic from a concussion standpoint is not always obvious, which can make the new recommendation difficult to implement as patients may remain symptomatic while adhering to rest. Symptomatology is often multifactorial and they may be instructed to rest despite …