June 2022

FROM THE PRESIDENT OF THE COLLEGE OF URGENT CARE MEDICINE (CUCM®)

Welcome to my first message as your newly-elected CUCM President. It is an honor to represent the interests of MD’s, DO’s, PA’s, and NP’s in Urgent Care Medicine. It was a pleasure meeting many of you at the UCA/CUCM Annual Convention in Las Vegas.

FROM THE EDITORS

This edition of Urgent Caring lands right on the heels of the 2022 Annual Urgent Care Convention. If you were there you saw great educational content, a lot of new vendors, heard some great music –both classical violin and blues — did some networking and had an all-around good time. The Foundation Celebration and After Party did not disappoint. It was exhilarating to finally do something in person and not on a video screen or podcast!

RECOGNIZING SEAN MCNEELEY, MD, FCUCM

In this edition of Urgent Caring’s Cause for Applause, we would like to recognize a member who has gone above and beyond for years for both The College of Urgent Care Medicine (CUCM) and the Urgent Care Association.

OVERCOMING PRESCRIBING HESITANCY OF RITONAVIR-BOOSTED NIRMATRELVIR (PAXLOVID)

The management of COVID-19 is rapidly evolving, and guidelines change based on newly released evidence. It is highly important for clinicians to stay up to date on the latest recommendations and guidelines.

WELCOME NEW BOARD MEMBERS

The UCA/CUCM conference in Las Vegas meant it was time for a change in the Board of Directors of CUCM. Tracey Davidoff, MD, FCUCM, former Vice-President rotated off the board and Jasmeet Bhogal, MD, MBA is now Immediate Past-President.

URGENT CARE CASE STUDIES

CASE STUDY #1: JAUNDICE IN AN ADULT FEMALE

Cesar Mora Jaramillo MD, FAAFP, FCUCM

The patient is a 55-year-old female with past medical history of GERD and HTN, who presents to Urgent Care with 3 days of generalized pruritus without rash. She mentioned that her urine was dark for the past 1 week but denies any other urinary symptoms.

CASE STUDY #2: RASH IN A YOUNG FEMALE

TRACEY DAVIDOFF, MD, FCUCM

A 10-year-old female presents to the clinic with complaints of an itchy rash on her buttocks for 2 days. Hydrocortisone cream and oral diphenhydramine have been ineffective.

Expert Insights

ARE YOU USING PROFESSIONAL INTERPRETERS IN YOUR URGENT CARE? IF THE ANSWER IS NO, YOU SHOULD BE

When was the last time you had to visit an Urgent Care as a patient? Perhaps it was for a COVID test or wrist pain following a trip and fall. Most likely you were a little stressed. Scared about the potential outcome (“What if this COVID test is positive…

CLINICAL PATHWAY FOR EVALUATION THE ADULT AND PEDIATRIC PATIENT WITH CLOSED HEAD INJURY

Decisions related to neuroimaging for children with mild closed head injury (CHI) are complicated by the potential need for sedation and the inherent risk of radiation exposure. Depending on their age, children can be up to 10 times more radiosensitive than adults, and the risk of subsequent cancer deaths can be as high as 1:1000.

ANTIBIOTIC STEWARDSHIP

Date Reviewed: May 20, 2022
Subject: Antibiotic Stewardship Best Practices
Patient Population: Adults and children
Rationale: Antibiotic stewardship is necessary and important to reduce antimicrobial resistance rates, minimize potential side effects and improve patient outcomes.

IN THE NEWS

MONKEYPOX

CHRIS CHAO, MD

Monkeypox is an infectious disease in human beings that is caused by the monkeypox virus. The monkeypox virus is closely related to the smallpox and cowpox virus. It was first identified in 1958 during an outbreak among monkeys in research laboratories and recognized as a human pathogen in the 1970s.

WOUND CARE UPDATE

MYTHS ABOUT WOUND IRRIGATION & HOW TO IMPROVE YOUR PRACTICE

Patrick O’Malley, MD

Irrigation of wounds is probably the most important thing we can do to prevent infection, so we must have a good understanding of this often overlooked and under-appreciated component of laceration management. There are three components to consider – water type, volume, and pressure.

CONTINUING MEDICAL EDUCATION (CME)

Target Audience

This CME activity is intended for medical professionals who practice medicine in the on-demand space including Urgent Care, retail medicine and other similar venues. These providers may include physicians, nurse practitioners, and physician assistants.

Designation Statement

The Urgent Care Association (UCA) designates this enduring material activity for a maximum of 3 AMA PRA Category 1 Credit(s) ™. Physicians should claim credits only commensurate with the extent of their participation in the activity. Credits may be claimed for one year from the date of release of this issue.

CME Objectives

Provide updates on the diagnosis and treatment of clinical conditions commonly managed by on-demand providers

Alert on-demand providers to potential unusual cases that may present to them

Utilize tips and tricks to improve patient care in the on-demand space

Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirement and policies of the Accreditation Council for Continuing Medical Education (ACCME) though the joint providership of the Urgent Care Association and the College of Urgent Care Medicine. UCA is accredited by the ACCME to provide continuing medical education for physicians.

CME Credit Instructions

Once you have read the article, please log into your UCA profile. Once you are logged in go to Learn-> CME->Request CME. Complete the survey with the requested information for Urgent Caring. Your certificate will then be emailed to you within 3-5 business days. Please email learning@ucaoa.org with questions.

CUCM CME Planning Committee

Tracey Davidoff, MD, FCUCM
Reports no financial interest relevant to this newsletter

Chris Chao, MD
Reports no financial interest relevant to this newsletter

Cesar Mora Jaramillo, MD
Reports no financial interest relevant to this newsletter

Patrick O’Malley, MD
Reports no financial interest relevant to this newsletter

Keith Pochick, MD
Reports no financial interest relevant to this newsletter

Disclaimer

Medical practice and knowledge are constantly evolving and changing. This information is peer-reviewed but should not be your only source. Providers of care should use discretion when applying knowledge to any individual patient.

URGENT CARING STAFF MEMBERS

Urgent Caring Editors-in-Chief
Tracey Q. Davidoff, MD, FCUCM
Cesar Mora Jaramillo, MD, FAAFP, FCUCM
Occupational Medicine Section
Max Lebow, MD, MPH

Advancing the Specialty/Antibiotic Stewardship Section

Joseph Toscano, MD, FCUCM

Wound Management Section

Patrick O’Malley, MD

Administrator

Laurel Stoimenoff, PT, CHC

Publisher

Urgent Care Association

CUCM Board of Directors: Executive Committee

– Chris Chao, MD, President
– Chrysa Charno, PA-C, FCUCM, Vice-President
– Cesar Mora Jaramillo, MD, FAAFP, FCUCM, Treasurer
– Jasmeet Bhogal, MD, Immediate Past President