Journal of Urgent Care Medicine

Pneumonia Diagnoses in EDs, Hospitals Demonstrate Wide Uncertainty

According to a study in the Annals of Internal Medicine, pneumonia diagnoses made in emergency departments (EDs) and hospitals show particular swings in diagnostic uncertainty. Researchers found that in 57% of patients hospitalized for pneumonia in 118 Veterans Affairs hospitals, the diagnosis of pneumonia changed one way or the other between initial presentation and discharge. Of the patients who were initially diagnosed with pneumonia, 36% did not have a pneumonia diagnosis when discharged. Clinical notes, …

Abstracts in Urgent Care – April 2024

Rehabilitation in Post-Acute Anterior Shoulder Dislocation Take Home Point: This study suggests that routinely referring patients to a program of physical therapy is not superior to a single session of advice, supporting materials, and option to self-refer to physical therapy. Citation: Kearney R, Ellard D, Parsons H, et. al. Acute rehabilitation following traumatic anterior shoulder dislocation (ARTISAN): pragmatic, multicentre, randomised controlled trial. BMJ. 2024 Jan 17:384: e076925. doi: 10.1136/bmj-2023-076925. Relevance: Shoulder dislocations commonly present to …

Comparing Urgent Care and Hospital Pneumonia Diagnoses

A retrospective study conducted across 28 urgent care clinics in Utah found an estimated rate of pneumonia overdiagnosis in urgent care clinics of 30%. The authors arrived at the estimate by examining a group of 7,214 patients’ pneumonia diagnoses recorded from January 2019 through December 2020 in the urgent care centers and comparing them with subsequent diagnoses in an emergency department (ED) or hospital. Of the urgent care patients who were later seen in an …

Abstracts in Urgent Care – July/August 2022

Colchicine in Acute Gout POCUS and Necrotizing Fasciitis Assessing Patient Satisfaction Misinterpreting Pediatric Radiographs Lung Ultrasound and Pediatric Pneumonia Diagnosing Pneumothorax A Review of the Evidence for Colchicine in Acute Gout Take-home point: Colchicine appears to be no more effective than NSAIDs for acute gout flares and evidence does not indicate greater efficacy at higher doses. Citation: Gottlieb M, Rabah W, Long B. Colchicine for acute gout. Acad Emerg Med. 2022;29(3):387-388. Epub ahead of print …

Abstracts in Urgent Care – March 2022

When Handlebar Meets Abdomen Corticosteroids and Asthma Antibiotics in Pediatric PAC Surfactant Use in AOM COVID Pneumonia and Disease Progression Neutralizing Antibodies in COVID Pediatric Abdominal Injuries from Handlebars Take-home point: Handlebar impact is a high-risk mechanism for serious intraabdominal injury in children and necessity of operative intervention is common. Citation: Vanderwalle R, Barker S, Raymond J, et. al. Pediatric handlebar injuries: more than meets the abdomen. Pediatr Emerg Care. 2021;37(9):e517-e523. Relevance: It is important …

Use of a Quality Improvement Tool for the Evaluation of Healthcare Disparities in Urgent Care: A Case Example for Bacterial Pneumonia

Urgent message: While healthcare disparities have been studied in several healthcare settings, it is unclear whether they persist in urgent care. This study may serve as a quality improvement tool to assess whether these disparities persist in an urgent care clinic. Derrick Murcia and Lindsey Fish, MD Citation: Murcia D, Fish L. Evaluation of healthcare disparities in urgent care: a case example for bacterial pneumonia. J Urgent Care Med. 2022;16(4):23-27. Epub ahead of print September …

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.

An 18-Year-Old Female with Sudden-Onset Chest Pain

An 18-year-old female presents to your urgent care center complaining of sudden-onset, sharp chest pain. She denies any trauma. View the image taken and consider your next steps, along with possible diagnoses.

Urgent Care Evaluation of Pneumonia

Urgent message: The incidence of community-acquired pneumonia (CAP) is seasonal in nature, with a peak during the winter months and a trough in the summer months. In the urgent care setting, primary concerns are risk factors for CAP, as well as current treatment and testing guidelines. Overview Pneumonia is an acute alveolar lung infection that presents with infiltrates upon chest imaging and is often accompanied by fever, cough, sputum production, shortness of breath, and physical …

Probe Deeper if Symptoms Just Don’t Add Up

It was a case that easily could have presented in any urgent care center, and one that shows the importance of probing beyond social and medical history, including a patient’s profession and hobbies if necessary. The patient presented with a 7-year history of breathing difficulty that had recently worsened. The only related detail seemed to be that he had been diagnosed with hypersensitivity pneumonitis (HP, also known as farmer’s lung and hot tub lung) 5 …

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