Journal of Urgent Care Medicine

Managing Cough Without Codeine in the Urgent Care Setting

Urgent message: Opioid prescribing and opioid-related deaths have risen during the COVID-19 pandemic. Although supported by the CHEST Diagnosis and Management of Cough and NICE COVID-19 guidelines, it is time to reevaluate the appropriateness of using codeine in suppressing cough. Megan Penner, PharmD and Hojung Jang, PharmD Candidate CLINICAL SCENARIO A 54-year-old female with a past medical history of diabetes, hypertension, and depression presents to the urgent care center with congestion, nasal discharge, fatigue, and …

A 31-Year-Old with Cough and Decreased Breath Sounds

The patient is a 31-year-old woman who presents with new-onset cough and decreased breath sounds to the lower lobes. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 5-Month-Old with Symptoms Beyond the Presenting Complaint

Urgent message: Treating preverbal children can be challenging under every-day circumstances for pediatricians who know the child and the family. Urgent care providers who may not have the benefit of that history must be especially vigilant for all available signs and symptoms to make diagnoses based on the full scope of the presentation. Michael Weinstock, MD Case Presentation (Please note: The Case Presentation is drawn directly from the treating physician’s notes, without editing or correction, …

An 18 Month-Old-Boy with Vomiting

In Bouncebacks, we provide the documentation of an actual patient encounter, discuss patient safety and risk-management principles, and then reveal the patient’s bounceback diagnosis. This case is from the book Bouncebacks!, available at www.anadem.com and www.amazon.com. History of Present Illness John is a healthy 18-month-old boy. One morning shortly after Christmas, he awoke with cough and congestion. After breakfast, he had an episode of vomiting. Though his symptoms remained mild over the next 3 days, …

Eighteen-Year-Old with Cough and Yellow Sputum

An 18-year-old young woman without a significant past medical history presents after 4 days of a cough productive of yellow sputum. Her mother states that her daughter has felt warm to the touch, but she has not checked her temperature with a thermometer. View the radiograph obtained (Figure 1) and consider what your diagnosis would be.

27-year-old man with a cough and fever

This x-ray was taken on a 27-year-old man with a cough and fever. View the image taken (Figure 1) and consider what your diagnosis would be

3-year-old boy with a cough and fever

This x-ray was taken on a 3-year-old boy with a cough and fever. View the image taken (Figure 1) and consider what your diagnosis would be.

90-year-old woman with a cough but no chest pain

This x-ray was taken on a 90-year-old woman with a cough but no chest pain. View the image taken (Figure 1) and consider what your diagnosis would be.

Clinical Challenge: December, 2012

In each issue, JUCM will challenge your diagnostic acumen with a glimpse of x-rays, electrocardiograms, and photographs of dermatologic conditions that real urgent care patients have presented with. If you would like to submit a case for consideration, please email the relevant materials and presenting information to [email protected]. The patient, an 8-year-old male, presented with a cough and fever. Resolution of the case is described on the next page.

32-year-old female presents with cough and fever

The patient, a 32-year-old female, presented with a cough and fever. View the image taken and consider what your diagnosis would be.

« Previous