Journal of Urgent Care Medicine

Abstracts in Urgent Care – October 2021

Duration of UTI Treatment in Men Acute Respiratory Illness in Children Isopropyl Alcohol for Acute Nausea in Adults Neurological Events and Metronidazole Prescribing Do the Modified Sgarbossa Criteria Offer Advantages Over the Original? Safety of a Second COVID-19 Vaccination Dose in Patients Who Had a Reaction to the First How Long Should We Treat UTI in Men? Take-Home Point: In afebrile men with UTI symptoms, a 7-day course of ciprofloxacin or trimethoprim/sulfamethoxazole was noninferior to …

The Unvaccinated Aren’t the Enemy

Taylor wore her embroidered sorority sweatshirt and a mask below her nose when she came to see me. She was 19 and had just finished her freshman year at the local university. Her story was cliché, as well: cough, runny nose, and sore throat “that wouldn’t go away.” She’d been sick for 8 days and she’d come in to get antibiotics. This isn’t a story about antibiotic stewardship, though. “Have you been tested or vaccinated …

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.

Abstracts in Urgent Care – September 2021

Cooling Pain from Digital Nerve Blocks Safety of Corticosteroids in Children Predicting the Course of Pediatric CAP Is Tranexamic Acid Helpful for Epistaxis? Drug Therapy for Sciatica Imaging May Not Correlate with Lumbar Pain COVID-19 Vaccination in Lactating Patients Applying Ice Reduces Pain from Digital Nerve Blocks Take-home point: Use of an ice pack applied prior to the administration of a digital nerve block reduces pain from local anesthetic injection Citation: Rasooli F, Sotoodehnia M, …

What the #$%^ is happening with EM Coding and Reimbursement?! – Part II

In the May issue of JUCM, we outlined what we were seeing with E/M coding levels utilizing the new AMA guidelines vs 2020 and 2019 levels. As COVID-19 visits steadily declined from January through June, we began to see a return to more “normal” urgent care visits. That was short-lived. July’s sharp increase in visit volumes was again driven by COVID-19! Here’s the update we promised. As a reminder, we saw E/M levels decline in …

Active COVID-19 Infection Is Indicated by WBC ≤7.0 and PLT ≤200 at Presentation

Yijung Russell, MD; Casey Collier, MD; Steve Christos, DO; and Shu B. Chan MD, MS Citation: Russell Y, Collier C, Christos S, Chan SB. Active COVID-19 infection is indicated by WBC 7.0 and PLT 200 at presentation. J Urgent Care Med. 2021;15(10):35-38. Introduction The impact coronavirus disease of 2019 (COVID-19) has had on individuals, businesses, and governments is unprecedented in many ways. Though widespread and frequent screening is recommended for better containment,1 limited availability of …

Breakthrough COVID Infection in a Vaccinated person from a Possible Vaccinated Exposure

Sergio Ramoa MD, MS Urgent Message: With variant COVID-19 mutations, incomplete herd immunity, and less restrictive government regulatory statues, it is important to remain vigilant with continued testing and prevention even with a full vaccinated history. Introduction In the United States, cases of COVID-19 have passed 32,000,000 and 570,000 for deaths. 141,000,000 cases and 3,000,000 deaths have afflicted the world. Approximately 9.6% of infected individuals are hospitalized and a majority have mild to moderate symptoms.1 …

Pandemic Fluctuations: A Historic Drop, Then a Meteoric Rise in Patients Visits Per Day

Just to confirm, the COVID-19 pandemic has generally not been kind to the urgent care industry. Locations that could get their hands on testing supplies at the outset were inundated with patients clamoring to know if they had the virus. The many facilities that got shut out of test distribution chains suffered greatly, though—as did the industry as a whole. Now, even as case loads continue to climb again in many states, the public’s panic …

A 60-year old Male with Dyspnea and Hypoxemia at the Start of a Global Pandemic

Urgent message: The identification and global impact of the novel coronavirus has significantly challenged medical decision-making. Urgent care providers now consider the inclusion of the SARS-CoV-2-causing illness in their differential diagnosis when evaluating patients with signs and symptoms of an acute respiratory infection. Louis Costanzo, MD, MBA Introduction As of March 2021, there have been more than 28.6 million documented cases of COVID-19 in the United States, with the majority of cases those ages 18 …

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 …