Urgent Caring – Sept 2022

FROM THE EDITORS

The World Health Organization (WHO) announced the monkeypox outbreak as a global health emergency on July 23, 2022. Wow. The WHO has declared a global emergency for the second time in two years! Monkeypox and SARS-Cov-2 are now on the Urgent Care radar in addition to the pre-pandemic common infections. We wonder how these new emerging infections might impact Urgent Care

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ANTIBIOTIC STEWARDSHIP—FOCUS ON OTITIS MEDIA

Joseph Toscano, MD, FCUCM Section Editor, Antibiotic Stewardship Otitis media (OM) is one of the most common reasons that antibiotics are prescribed for children in Urgent Care. Over time, expert guidelines have informed and reinformed us about the appropriate antibiotics to use, how to dose them, and the duration of therapy. The most recent comprehensive expert guidelines1 for children 6

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URGENT CARE CASE STUDY

URGENT CARE CASE STUDY MEDIAL KNEE PAIN IN A RUNNERTRACEY QUAIL DAVIDOFF, MD, FCUCM A 55-year-old female presents with left medial knee pain for 2 weeks. She has no history of previous knee pain or injury. She is an avid

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OCCUPATIONAL MEDICINE

DOT EXAMS:  DETERMINATION PENDING VERSUS SHORT TERM CERTIFICATION Max Lebow, MD, MPH, FACEP, FACPMSection Editor, Occupational Medicine A common decision for the Medical Examiner during a DOT FMCSA Commercial Driver exam is in what circumstances to use Determination Pending (DP)

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WOUND MANAGEMENT

WOUND MANAGEMENT TAKING THE MYSTERY OUT OF MATTRESS SUTURESPatrick O’Malley, MDSection Editor, Wound Management  If you are new to suturing, you may have heard the term “mattress suture” before and wonder what this is and when to utilize them. I have looked high and low for the origin of this without much luck, but for some reason have a recollection

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CHEMICAL BURNS

EYE IRRIGATION SETUP Cesar Mora Jaramillo, MD, FAAFP, FCUCM Chemical burns (acids or alkalis) involving the eyes require immediate treatment to prevent damage and permanent vision loss. Regardless of the chemical involved, essential steps include removing the offending agent, promoting

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EXPERT INSIGHTS

EXPERT INSIGHTS PATIENT LABELING IN THE MEDICAL RECORD:  THE IMPACT OF STIGMATIZING LANGUAGE ON PATIENT CARE Victoria Pittman, MPAP, PA-C Brought to you by: Imagine that you’ve just arrived at work, and the first patient of the day checks in with “nasal congestion.” You review their medical record and click on a note from 6 months ago with the following:

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MANAGEMENT OF ACUTE TRAUMATIC WOUNDS AND THERMAL BURNS IN URGENT CARE

Click to View Larger Version KidBits: Non-accidental Burn Injuries in Pediatric Patients Intentional injury must be considered in the evaluation of all pediatric burns, as well as in burned adults who are at risk for abuse due to functional limitations or disabilities. Assessing for abuse can be challenging, as scald burns are the most common type of both accidental and

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BEST PRACTICE SUMMARY FROM THE COLLEGE OF URGENT CARE MEDICINE

DIAGNOSIS AND TREATMENT OF COMMUNITY ACQUIRED PNEUMONIA IN ADULTS Date Reviewed:  August 23, 2022 Evidence based guideline with strength of evidence:Diagnosis and Treatment of Adults with Community-acquired Pneumonia.An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of AmericaAm J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67 Patient Population:  Adult patients > 18 years who do

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CUCM POSITION STATEMENTS

POSITION STATEMENT #1: CORTICOSTEROID STEWARDSHIP IN URGENT CARE MEDICINE Subject:  Corticosteroid (CS) Stewardship Best Practices Patient Population:  Adults and children Rationale:  Steroid stewardship is needed in all clinical settings, including Urgent Care. It is acknowledged that corticosteroids can be a critical tool in the management of both acute and chronic conditions. The focus of this stewardship statement is to create

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URGENT UPDATES:  SEPTEMBER 2022

URGENT UPDATES: SEPTEMBER 2022 NIRMATRELVIR USE AND SEVERE COVID-19 OUTCOMES DURING THE OMICRON SURGEAccording to this study published in NJEM, the antiviral drug Paxlovid appears to reduce the risk of dying from COVID-19 by 79% and decrease hospitalizations by 73% in at-risk patients who are ages 65 and older. Among patients 65 years of age or older, the rates of

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URGENT CARE Q&A

NEW SECTION! URGENT CARE CLINICAL ANSWERS Are wound cultures needed after incision and drainage of abscesses? Avoid wound cultures in patients with uncomplicated skin and soft tissue abscesses after successful incision and drainage and with adequate medical follow-up. Skin and soft tissue infections are a frequent reason for visiting an Urgent Care center. Opening and draining an abscess is the

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CAUSE FOR APPLAUSE

In this issue of Cause for Applause we wish to recognize the rapidly growing number of Fellows of the College of Urgent Care Medicine. These fellows represent the best of us who work every day to provide the highest quality of medicine and advance the specialty of Urgent Care Medicine. They should be honored for their dedication and contributions. Do

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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

  1. Provide updates on the diagnosis and treatment of clinical conditions commonly managed by on-demand providers
  2. Alert on-demand providers to potential unusual cases that may present to them
  3. 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

EKG Section
Jerry W. Jones, MD FACEP FAAEM, Section Editor, EKG

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