This week we talk with Dr Lindsey Fish, Medical Director of the Peña Southwest Urgent Care Clinic at the Denver Health and Hospital.  She is an Associate Professor of Medicine at the University of Colorado School of Medicine. She was one of the authors of a paper published in the Journal of Urgent Care Medicine that showed patients discharged from urgent care with tachycardia had significantly higher odds of having a return visit to urgent care and higher odds of being admitted to hospital...

While occurring in adolescents, Osgood-Schlatter Disease can persist into adulthood and is an important differential for anterior knee pain.     Check out the OrthoBullets page by Dr Woon   Check out the Radiopaedia page by Hererra   Check out the Case Report Mentioned Murphy CE, Kenny CM. Not just for boys: a rare case of symptomatic Osgood-Schlatter disease in a skeletally mature woman. BMJ Case Rep. 2019 Mar 26;12(3):e228963. doi: 10.1136/bcr-2018-228963. PMID: 30914412; PMCID:...

Dr Joshua Russell, Editor in Chief of the Journal of Urgent Care Medicine came to New Zealand from the USA for our Bootcamp in Wellington.  Here we discuss his thoughts on NZ, UC down under, the future of Urgent Care and why UC research is so important.   Details on the JUCM Fellowship in Medical Writing can be found here.   Check out the Bootcamp report    www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed...

What is the Koebner Phenomenon?   Check out the Dermnet pages mentioned. Tattoo-associated skin reactions by Ngan and Elghblawi Koebner Phenomenon by Luo   www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice...

What should you look for in quadriceps tendon and patella tendon ruptures?   Check out the Orthobullets pages Patella Tendon by Ben Sharareh MD - https://www.orthobullets.com/knee-and-sports/3024/patellar-tendon-rupture Quadriceps Tenson by Jason McKean MD - https://www.orthobullets.com/knee-and-sports/3023/quadriceps-tendon-rupture    Check out the video by Loz and Liz discussing the injury which is mentioned in the podcast -...

What is a Felon and what should we do about it?   Check out the papers and pages mentioned. Nardi NM, McDonald EJ, Syed HA, et al. Felon. [Updated 2024 Apr 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430933/  Orthobullets page by Leah Ahn MD Koshy JC, Bell B. Hand Infections. J Hand Surg Am. 2019 Jan;44(1):46-54. doi: 10.1016/j.jhsa.2018.05.027. Epub 2018 Jul 14. PMID: 30017648. Clark DC. Common...

Some important considerations when working up chest pain that will make us think of a thoracic aneurysm.     Check out the paper mentioned Habib M, Lindström D, Lilly JB, D'Oria M, Wanhainen A, Khashram M, Dean A, Mani K. Descending thoracic aortic emergencies: Past, present, and future. Semin Vasc Surg. 2023 Jun;36(2):139-149. doi: 10.1053/j.semvascsurg.2023.04.009. Epub 2023 Apr 30. PMID: 37330228.   Check out the MDCalc page for...

What is Kehr's sign?     Check out the paper mentioned Rastogi V, Singh D, Tekiner H, Ye F, Mazza JJ, Yale SH. Abdominal Physical Signs of Inspection and Medical Eponyms. Clin Med Res. 2019 Dec;17(3-4):115-126. doi: 10.3121/cmr.2019.1420. Epub 2019 Jul 15. PMID: 31308022; PMCID: PMC6886890.     www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to...

Drug-induced tendinopathy can occur early, and late in a person's usage.  So we must consider a patient's medication history closely whenever they have symptoms of tendinopathy or rupture.      Check out the September 2024 Prescriber update, Vol 5, No 3.   www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer...

Dry socket might present to urgent care.  What is it and what should we do about it?   Check out the papers mentioned Chemaly D. How do I manage a patient with dry socket? J Can Dent Assoc. 2013;79:d54. PMID: 23763736.  https://pubmed.ncbi.nlm.nih.gov/23763736/  Mamoun J. Dry Socket Etiology, Diagnosis, and Clinical Treatment Techniques. J Korean Assoc Oral Maxillofac Surg. 2018 Apr;44(2):52-58. doi: 10.5125/jkaoms.2018.44.2.52. Epub 2018 Apr 25. PMID: 29732309; PMCID:...

A caddy offers words of wisdom to their golfer.  Some of their advice is relevant to urgent care.     Check out the paper mentioned Gotlieb R, Praska C, Hendrickson MA, Marmet J, Charpentier V, Hause E, Allen KA, Lunos S, Pitt MB. Accuracy in Patient Understanding of Common Medical Phrases. JAMA Netw Open. 2022 Nov 1;5(11):e2242972. doi: 10.1001/jamanetworkopen.2022.42972. PMID: 36449293; PMCID: PMC9713608.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9713608/    Check out the LITFL article,...

We always look for the sail sign when reviewing radiographs of the elbow, but how often are they associated with occult fractures?   Check out the papers mentioned Skaggs DL, Mirzayan R. The posterior fat pad sign in association with occult fracture of the elbow in children. J Bone Joint Surg Am. 1999 Oct;81(10):1429-33. doi: 10.2106/00004623-199910000-00007. PMID: 10535592. https://pubmed.ncbi.nlm.nih.gov/10535592/ Al-Aubaidi Z, Torfing T. The role of fat pad sign in diagnosing occult elbow...

Cluster headaches present through urgent care and it is important to differentiate them correctly.   Check out the paper on which Lisa Kudrow has a credit Messinger HB, Messinger MI, Kudrow L, Kudrow LV. Handedness and headache. Cephalalgia. 1994 Feb;14(1):64-7. doi: 10.1046/j.1468-2982.1994.1401064.x. PMID: 8200028.   Check out the paper mentioned Weaver-Agostoni J. Cluster headache. Am Fam Physician. 2013 Jul 15;88(2):122-8. PMID: 23939643.   This links to the ICHD-3 Cluster Headache...

Don't confuse the Popeye Sign with the reverse Popeye Sign.     Check out the Stat Pearls Page -  Hsu D, Anand P, Mabrouk A, et al. Biceps Tendon Rupture. [Updated 2023 Jul 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.   Check out the OrthoBullets Page on distal ruptures.   Get Bootcamp tickets here -...

When do you perform a chest X-ray for chest trauma presenting through urgent care? This week we chat about this, and the STUMBL score, with Director of Clinical Training Dr David Sorrell.     Check out the STUMBL score on MD Calc - https://www.mdcalc.com/calc/10468/stumbl-battle-score Check out the paper mentioned by Dave Galvez, Carlos, Arenas-Jimenez, Juan, Del Campo, Jone, Maroto, Sergio, Sirera, Marina, Lirio, Francisco, 2020.  Diagnostic imaging pathways in the setting of acute chest...

We need to be aware of medications with anticholinergic effects, especially in the elderly.     Check out the BPAC article mentioned - https://bpac.org.nz/2024/anticholinergic.aspx#tab1 Check out the ACB calculator by Dr Rebecca King and Steve Rabino - https://www.acbcalc.com/    www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing...

Weight-bearing at the time of the injury and assessment forms part of the Ottawa ankle rules.     Check out the paper mentioned Chien B, Hofmann K, Ghorbanhoseini M, Zurakowski D, Rodriguez EK, Appleton P, Ellington JK, Kwon JY. Relationship of Self-Reported Ability to Weight-Bear Immediately After Injury as Predictor of Stability for Ankle Fractures. Foot Ankle Int. 2016 Sep;37(9):983-8. doi: 10.1177/1071100716648009. Epub 2016 May 9. PMID: 27162225.   Check out the original Ottawa ankle...

Smell can be used to diagnose.   Check out the paper mentioned Trivedi DK, Sinclair E, Xu Y, Sarkar D, Walton-Doyle C, Liscio C, Banks P, Milne J, Silverdale M, Kunath T, Goodacre R, Barran P. Discovery of Volatile Biomarkers of Parkinson's Disease from Sebum. ACS Cent Sci. 2019 Apr 24;5(4):599-606. doi: 10.1021/acscentsci.8b00879. Epub 2019 Mar 20.  https://pubmed.ncbi.nlm.nih.gov/31041379/  Check out the BBC interview with Joy...

Do antihistamines help with the itch of dermatitis?   Check out the paper mentioned Nankervis H, Thomas KS, Delamere FM, Barbarot S, Rogers NK, Williams HC. Scoping systematic review of treatments for eczema. Southampton (UK): NIHR Journals Library; 2016 May. PMID: 27280278. Check out the Dermnet NZ page. Authors: Dr Amy Stanway, Department of Dermatology, Waikato Hospital, Hamilton, New Zealand, February 2004; Updated: Honorary Associate Professor Paul Jarrett, Dermatologist, Middlemore...

When you need help with identifying medications from overseas visitors, you can always call your local pharmacist, or you could try this website.   Check out the webpage mentioned - https://www.resourcepharm.com/pharmacist/identification-of-foreign-medicines.html      www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical...

As medical professionals, we must know our legal and moral obligations to help in case of emergency. Check out the MCNZ page on helping in an emergency.   www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice...

Certain music can help improve your concentration, help you relax and improve your sleep.   Check out https://www.brain.fm/ Check out their white paper.   www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice...

Cold and flu remedies containing pseudoephedrine are now a class C drug in New Zealand and available from pharmacies.     Check out the prescriber update from June 2024. Check out the Ministry of Health page.   www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health...

Dr Tony Smith, Deputy Clinical Director at Hato Hone St John, tells us about Double Sequential and Vector Change Defibrillation for resistant VF/VT.  These new techniques, not currently covered in our NZRC resus algorithms, are being utilised by all ambulance services in New Zealand for patients who do not get ROSC after three shocks.   Tony can be contacted for questions at - [email protected]    Check out the paper mentioned Cheskes S, Verbeek PR, Drennan IR, McLeod SL, Turner L,...