Journal of Urgent Care Medicine

Abstracts in Urgent Care December 2023

Blood Pressure Monitoring—Cuff Size Matters Take Home Point: The use of an inaccurately sized automated blood pressure (BP) cuff resulted in significantly inaccurate BP readings. Citation: Ishigami J, Charleston J, Miller E, et. al. Effects of Cuff Size on the Accuracy of Blood Pressure Readings: The Cuff(SZ) Randomized Crossover Trial. JAMA Intern Med. 2023 Oct 1;183(10):1061-1068. doi: 10.1001/jamainternmed.2023.3264. Relevance: Chronic hypertension is a leading cause of cardiovascular and cerebrovascular morbidity and mortality, and accurate measurement …

Tympanic Membrane Conditions Beyond Otitis Media in Urgent Care Practice

Urgent Message: Better understanding of tympanic membrane/middle ear conditions can inform more accurate diagnoses at the point of care. Citation: LaCour J. Tympanic Membrane Conditions Beyond Otitis Media in Urgent Care Practice. J Urgent Care Med. 2023;18(3):15-19 Author Affiliation: Jeff LaCour, MD, Compassio Medical Education. Video: Watch a video featuring Jeff LaCour, MD, that further explains tympanic membrane conditions with supplemental images. WATCH VIDEO Urgent care providers are often tasked to determine the source of …

64-Year-Old With Dyspnea and History of COPD

Case presented by Jonathan Giordano, DO A 64-year-old female presents in the urgent care complaining of dyspnea for the past 3 days. After asking a few questions, you learn the woman has a history of chronic obstructive pulmonary disease (COPD). View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page

51-Year-Old With Asymptomatic Rash

A 51-year-old man presents to urgent care concerned about an asymptomatic rash that developed over his face within the last month. On examination, pink and violaceous, annular, scaly papules, and plaques were seen on his cheeks and within his beard area and nasolabial folds. The patient appeared well and reported no systemic symptoms. View the image above and consider what your diagnosis and next steps would be. Resolution of the case is described on the …

Urgent Care Scope of Services

Same-day ambulatory healthcare services are the hallmark of urgent care (UC). Because UC clinicians care for a wide range of conditions and injuries, they need to be proficient in a broad scope of immediate intervention services. In its latest white paper, the Urgent Care Association (UCA) noted that more organizations are moving to a staffing model with nurse practitioners (NPs) and physician assistants (PAs) serving as the primary providers on-site, rather than physicians. This model grew …

Master the Distinction Between Level 3 and Level 4 Visits with These Best Practices

A recurring issue for healthcare practitioners is the frequency with which they find themselves contemplating whether a patient encounter should be classified as a level 3 or level 4 office visit. With a staggering 79% of ambulatory patient visits falling within these categories, this query has become exceedingly common among providers. Complicating matters further, the coding guidelines from the American Medical Association (AMA) contain gray areas that can contribute to additional confusion.[1] This article aims …

Systemic Steroid Stewardship in Urgent Care: Recognizing Indication Creep to Limit Avoidable Harms

Urgent Message: Steroid overprescribing is a universal urgent care issue. While systemic steroids have several indications in which the preponderance of evidence supports their use in the urgent care setting, indication creep has led to their use outside of these scenarios resulting in significant risk for avoidable and unjustifiable adverse reactions. Citation: Hansen P. Systemic Steroid Stewardship in Urgent Care: Recognizing Indication Creep to Limit Avoidable Harms. J Urgent Care Med. 2023;18(3);29-32 Author Affiliation: Paul …

Pediatric Knowledge Needs Assessment: A Pilot Study

Urgent Message: Pediatric emergency medicine researchers have an opportunity to enhance collaboration with general emergency medicine and acute care clinicians to bridge the gap between research and dissemination of evidence-based care recommendations. Bashar S. Shihabuddin, MD, MS, FAAP, FACEP; Jessica Fritter, MACPR, ACRP-CP; Charmaine B. Lo, PhD MPH; Rachel Stanley MD, MHSA; Michael Weinstock, MD Citation: Shihabuddin B, Fritter J, Lo C, Stanley R, Weinstock M. Pediatric Knowledge Needs Assessment: A Pilot Study. J Urgent …

The Cost of Fear

I have a story I want to share with you, but I’m finding it hard to do without it reeking of privilege. This is a story about feeling 100% welcomed in one place when you don’t feel that way in many others. This is a rare for me, and perhaps it will feel like a poor example to you. Yet, it is part of my lived experience and brought something home for me that made …

Leadership Must Guide Behavior Change for the Next Phase in Urgent Care

Ben Barlow, MD, is Chief Medical Officer of Experity As I’ve discussed before, urgent care medicine is ready for its next phase, and exceptional leadership is needed to make urgent care a shining light within a struggling house of medicine. Engaging your team and setting one priority goal is the best approach for solidifying a behavior change that leads to exceptional results. Picking one goal is the easy part. Getting all team members to engage …