Journal of Urgent Care Medicine

An Urgent Care Approach to Joint and Soft-Tissue Injection/ Aspiration: Part 1

Urgent message: Injection/aspiration therapy for selected musculoskeletal complaints is becoming more common in urgent care practice. Providers need a thorough understanding of injection/aspiration procedures and associated risks to be equipped to deliver rescue therapy to patients. THOMAS V. GOCKE, III, MS, ATC, PA-C, DFAAPA Joint pain, joint effusion, and recurrent soft-tissue trigger point irritation are common presentations in urgent care. As more and more patients present seeking immediate relief of such symptoms, it’s important that …

September 2014

Evaluation of Headaches in Urgent Care Part 2: Non-Emergent Headaches

Urgent message: Headaches are challenging chief complaints and being able to identify and differentiate among the non-emergent types of headaches will help with medical decision making and patient care. JACQUALINE DANCY, PA-C, MPAS In the conclusion of a two-part series, this article focuses on non-emergent headaches. For the purpose of this article, non-emergent headaches are classified as those that are not life-threatening and pose little to no risk of permanent functional disability. Most non-emergent headaches …

July/August 2014

Outpatient Management of Deep Venous Thrombosis

Urgent message: Urgent care providers are on the frontline in diagnosis of DVT. Outpatient management is a consideration for carefully selected patients. SABRINA SOOD, MD Deep venous thrombosis (DVT) is formation of a clot in the deep venous system, usually in a lower extremity. Half of untreated patients with DVT will go on to develop the fatal complication pulmonary embolism (PE). Approximately 300,000 to 600,000 Americans die each year due to venous thromboembolism (VTE).1 Urgent …

Assessment and Management of Asthma Exacerbation in Urgent Care: Part 2

Urgent message: The second part in a two-part series offers expert guidance on short and long-term management of the disease in the urgent care setting through the use of pharmacotherapy, protocols for treatment, and a written asthma action plan at discharge. BRADLEY M. TURNER MD, MPH, MHA, FCAP, FASCP and JANET M. WILLIAMS, MD, FACEP Introduction Once the suspicion of an asthma exacerbation exists, short term management is focused on reducing the severity of the …

Assessment and Management of Asthma Exacerbation in Urgent Care: Part 1

Urgent message: Asthma is increasing in prevalence and so, too, presentations of asthma in ambulatory settings. Urgent care providers have an important role to play in identifying and treating acute asthma exacerbations, including providing a written asthma action plan at discharge to improve long-term outcome. BRADLEY M. TURNER MD, MPH, MHA, FCAP, FASCP and JANET M. WILLIAMS, MD, FACEP Patients often seek assistance in urgent care centers for acute presentations of asthma. This provides unique …

Management of Ocular Complaints in Urgent Care: Part 1

Urgent message: Triage of eye conditions in urgent care to ensure the best patient outcome requires knowing what equipment to use and understanding when to refer to an ophthalmologist. Always remember to document acuity of vision in all patients presenting with an eye complaint. SARVOTHAM KINI, MD Introduction Ocular complaints are extremely common in the urgent care setting. Yet the capacity of individual urgent care centers to provide high quality eye care is variable. The …

Urgent Care Management of Needlestick Injuries: Part 2

Urgent message: Response to a needlestick with potential for HIV exposure requires understanding of both state laws on HIV testing and the latest USPSTF guidelines for post-exposure management. MAYA HECK, MS-2 and JOHN SHUFELDT, MD, JD, MBA, FACEPTwo police officers arrive at your urgent care site with a handcuffed, bloodied prisoner. One officer tells you that the person in custody “spit on me” during the altercation. The officer goes on to tell you that the …

Urgent Care Management of Needlestick Injuries: Part 1

Urgent message: Needlestick injuries are common and require a prompt response based on an understanding of the latest USPHS guidelines and informed consent and counseling of the patient. MAYA HECK, MS-2 and JOHN SHUFELDT, MD, JD, MBA, FACEP Your center is fortunate to contract with a variety of different business to provide employee health services. A local homeless shelter is one of the clients to whom your center provides new hire physicals, drug screens and …