Journal of Urgent Care Medicine

Abstracts in Urgent Care – September 2023

How Long Should We Prescribe Antibiotics for Pediatric UTI? Take-Home Point: Children receiving 5 days of antibiotics for urinary tract infection (UTI) had a higher rate of treatment failure that children receiving 10-day courses. However, absolute treatment failure rates were low in both groups. Citation: Zaoutis T, Shaikh N, Fisher B, et. al. Short-Course Therapy for Urinary Tract Infections in Children: The SCOUT Randomized Clinical Trial. JAMA Pediatr. 2023 Jun 26; e231979. Relevance: There have …

Analogy: A Powerful and Underutilized Bedside Tool

Joshua Russell, MD, MSc, FCUCM, FACEP Sophie was back with another one of her kids in tow. This was the fifth time in a month. I could almost hear my staff roll their eyes when she walked through the door. Even though she was a denizen of the clinic, I was about to meet her for the first time because I usually covered other sites. Although I was out of the loop, my medical assistant …

In-Office Dispensing: The Good, the Bad, and the Unlikely

On paper (so to speak), in-office prescribing in the urgent care center would seem to be a no-brainer for all concerned: patients could avoid the time-consuming hassles of navigating the retail drugstore morass and head straight home with their medication, and providers could be assured that their patients got the right medication in a timely manner and could be the responsible parties to answer any questions they may have—all while collecting a modest profit. That’s …

HbA1c as Screening/Diagnoses for Early or Asymptomatic Diabetes in the Urgent Care Facility

Urgent message: The use of all-inclusive kits with compact, table-top analyzers provides a rapid quantification of HbA1c levels in patients. The use of these tests for in-house screening has the potential to increase the diagnoses of early or asymptomatic diabetes in young adults and under-served or overlooked populations. Jay H. Shubrook, DO; Jane M. Caldwell, PhD; and Lindsey E. Fish, MD Citation: Shubrook JH, Caldwell JM, Fish LE. HbA1c as screening/diagnosis for early or asymptomatic …

A 55-Year-Old Female with Sudden-Onset Wrist Pain

The patient is a 55-year-old woman who presents with sudden-onset wrist pain in her right wrist. She reports that she is right-handed and played pickleball the day before onset, and that she is an avid bicyclist, but denies falling or experiencing any pain in the course of those activities. She says she “just woke up with it hurting.” View the image taken and consider what your diagnosis and next steps would be. Resolution of the …

Differential Competitive Advantage

In the May issue of JUCM, Josh Russell wrote in his Letter from the Editor-in-Chief about thinking differently about follow-up. If you are not a physician, physician assistant or nurse practitioner and decided to skip his letter that month because it seemed too clinical, I urge you to go back and read it. One of the aspects of Urgent Care that separates us from other kinds of healthcare operations—or used to—is the tight collaboration between …

Changing an Employee from Full-Time to Part-Time Status

Urgent message: Whether due to reduced staffing needs or employee preference, some employees in urgent care are no longer scheduled for full-time hours. Changing from full-time to part-time status, however, may have consequences beyond simply working fewer hours. There are any number of reasons why an urgent care owner or operator might want to change the status of an employee from full-time to part-time. Generally speaking, an employer is permitted to do so for any …

A Novel Pediatric Resuscitation Course Designed for the Urgent Care Setting

Urgent message: Urgent care centers play a vital role as a gateway into the health system for many children with acute care needs. Some of these needs require identification by the urgent care team, who may then need to stabilize the patient and initiate transfer to optimize clinical outcomes. Nikhil B. Shah, MD INTRODUCTION Pediatric office emergencies can be challenging for urgent care staff to manage. These high-stakes events do not occur frequently enough to …

A 67-Year-Old Male with Chest Pain, Dyspnea, and a History of Lung Cancer

A 67-year-old male presents to urgent care complaining of pleuritic chest pain and dyspnea. He has a history of lung cancer, but denies known cardiac history. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is describe on the next page.

A 23-Year-Old with a Pruritic, Spreading Rash

A 23-year-old woman presents with a severely pruritic rash that developed on her leg and is spreading. The patient reports that 2 days prior to onset, she had gone hiking with her dog. She recalls going off-trail and brushing up against “woody vines and shrubs.” She denies sustaining insect bites and notes that the sun was particularly intense that day, so she wonders if this may be a sun reaction. She appears well and has …