Images and case presented by ECG Stampede. KEY QUESTIONS With this condition, what three ECG features predict adverse outcomes and what is the expected progression of ECG changes? What is the treatment?
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Decreasing Denials and Rejections Through Your Urgent Care Operating Model
A wise person once said, “If a claim is rejected or denied, the energy to get it paid is five times the energy if it went through as a clean claim.” Maybe it is only four times or three times the work, but the point is that we should all do everything we can to avoid rejections and denials! Unlike more complicated specialties subject to complicated coding, authorization, and other factors, in an urgent care …
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Why Private Equity and Other ‘Smart Money’ Is Bullish on Brick-and-Mortar Urgent Care
Urgent message: Despite the current seasonal, postpandemic lull in volume, sophisticated investors are focused on the long-term growth prospects of urgent care in terms of new rooftops, new patient populations, new services, and new payers…among others. Alan A. Ayers, MBA, MAcc Even for those who are “tenured” in the urgent care industry—the last 24 months of the COVID-19 pandemic have been a rough ride. If 100% were baseline volume, the average urgent care saw volume …
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How Useful Is Ultrasound in Diagnosing Ovarian Torsion?
Urgent message: Ultrasound can provide essential data in the urgent care evaluation of abdominal pain, aiding in the diagnosis of intestinal abnormalities, urinary tract infection, and obstetrical and gynecological problems such as suspected ovarian torsion. Andrew Alaya, MD, MSc Introduction Abdominal pain is one of the most common complaints among women of childbearing age who visit urgent centers. Urinary tract infection, diarrhea, constipation, acute viral gastroenteritis (AGE), pelvic inflammatory disease (PID), and dysmenorrhea are the …
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Pediatric Elbow Fractures: A Clinical Review
Urgent message: Though the most common fracture seen in pediatric trauma patients, elbow fractures can be difficult to identify in younger patients. Familiarity with elbow anatomy, ossification centers, and fracture patterns is essential for optimal outcomes. Amy Grover, MD CASE VIGNETTE A 7-year-old previously healthy female presents to urgent care with a chief complaint of left elbow pain after a fall on outstretched arm. She had immediate pain, swelling and difficulty moving her arm. Her …
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A 31-Year-Old Male Complaining of Weakness
KEY QUESTIONS What Electrolyte disturbances cause the interval problem seen in this ECG? Which dysrhythmia is this patient at risk for?
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No Troponin, No Problem: Reimagining Chest Pain Assessment in Urgent Care
Most urgent care providers loathe when a patient checks in with chest pain because, typically, they are presenting because they’re worried about a heart attack, and we’re worried we don’t have the tools to exclude this diagnosis. It’s no surprise that we’re met with consternation when we suggest they may have come to the wrong place for care. But is unavailability of troponin testing a worthy scapegoat? And is the practice of ED referral for …
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Knee Immobilization for Acute Knee Injuries: A Review
Urgent message: Immobilization following acute knee injury occurs more commonly than the evidence might dictate in urgent care and other acute care settings. Evaluation of data in existing literature suggest that this common practice carries risk for adverse effects when not warranted. Matthew Bruce Baird, MD, CAQ-SM; Mallory Shasteen, MD, CAQ-SM; and Vicki Nelson, MD, CAQ-SM. Citation: Baird MB, Shasteen M, Nelson V. Knee immobilization for acute knee injuries: a review. J Urgent Care Med. …
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Abstracts in Urgent Care – May 2022
Immobilizing Ankle Fractures Treating Septic Olecranon Bursitis EKG Interpretation: Human vs Machine preHEART Score and Prehospital Care Rethinking Otitis Media Management Boosters Limit Risk for COVID—but by How Much? Ivan Koay MBChB, FRNZCUC, MD Casting vs Bracing for Ankle Fractures Take-home point: Plaster casting was not superior to functional ankle bracing for certain ankle fractures. Citation: Kearney R, McKeown R, Parsons H, et al. Use of cast immobilisation versus removable brace in adults with an …
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What Is the Acceptable Miss Rate for a Major Adverse Cardiac Event (MACE)? A Follow-Up Survey After Release of the American College of Emergency Physicians (ACEP) Clinical Policy on Acute Coronary Syndromes
Urgent message: Previously JUCM-published research revealed that even very low risk for a major adverse cardiac event left clinicians uncomfortable with discharging patients per 2018 ACEP guidelines. What can be learned from a follow-up study reflecting the updated version? Rebekah Samuels, OMS-III; Francesca Cocchiarale; Samidha Dutta, DO, PGY-3; Jarryd Rivera, MD; Amal Mattu, MD; Michael Pallaci, DO; Paul Jhun, MD, FAAEM; Jeff Riddell, MD; Cameron Berg, MD; and Michael Weinstock, MD. Citation: Samuels R, Cocchiarale …
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