The Podcasts of the Royal New Zealand College of Urgent Care

How long do grommets take to fall out?   Check out the papers mentioned Song CM, Park MH, Kim YH, Lee JH. Factors affecting the extrusion rate of ventilation tubes. Clin Exp Otorhinolaryngol. 2010 Jun;3(2):70-5. doi: 10.3342/ceo.2010.3.2.70. Epub 2010 Jun 30. PMID: 20607075; PMCID: PMC2896736. Link to paper Lin YC, Kao YL, Chen YC, Chen LC, Dang LH, Hung SH. Factors Related to Ventilation Tube Ext...

You might think that neck pain after minor trauma is probably a musculoskeletal injury.  But do not forget to consider vertebral artery dissection.     Check out the Stat Pearls page. Britt TB, Agarwal S. Vertebral Artery Dissection. [Updated 2023 Mar 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441827...

Look out for the Holstein-Lewis Fracture which is associated with radial nerve injury.  Also, be aware of the torsional forces associated with arm wrestling.   Check out the paper mention Moloney DP, Feeley I, Hughes AJ, Merghani K, Sheehan E, Kennedy M. Injuries associated with arm wrestling: A narrative review. J Clin Orthop Trauma. 2021 Apr 20;18:30-37. doi: 10.1016/j.jcot.2021.04.010. Erratum...

It is important to check peripheral neurology after trauma.  Neurapraxia, with an o, is one cause of altered sensation.     Check out the Stat Pearls Page for more information. Carballo Cuello CM, De Jesus O. Neurapraxia. [Updated 2023 Aug 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560501/ And their...

Are your patients aware that a fracture is the same as a break?  Do they think that one is worse than the other?   Check out the papers mentioned Peckham TJ. 'Doctor, have I got a fracture or a break'? Injury. 1994 May;25(4):221-2. doi: 10.1016/0020-1383(94)90065-5. PMID: 8206651. Link to abstract Kampa RJ, Pang J, Gleeson R. Broken bones and fractures - an audit of patients' perceptions. Ann R Co...

Type 2 diabetics can present with a DKA associated with SGLT-2 inhibitors.  And it may be euglycaemic.  So be wary.     Check out the Prescriber Update, Vol 45, No 4, Dec 2024 Check out the Stat Pearls page on DKA Lizzo JM, Goyal A, Gupta V. Adult Diabetic Ketoacidosis. [Updated 2023 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https:/...

Pinworms are often asymptomatic, or cause mild pruritus ani, but do they cause abdominal pain?   Check out the pages mentioned.   Demnet page on pinworms by Daniel Wong   Enterobius vermicularis: a possible cause of symptoms resembling appendicitis Dahlstrom, J.Macarthur, E. et al. Pathology, Volume 25, 5 Link to paper   Panidis S, Paramythiotis D, Panagiotou D, Batsis G, Salonikidis S, Kaloutsi V...

If you are working in urgent care over the holiday period, thank you.     www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   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 at all times.  For personal medical advice always c...

While the Christmas period is supposed to be a happy holiday for all, there are many increased stressors at this time of year.  These papers give food for thought for the season.     Mohammad MA, Karlsson S, Haddad J, Cederberg B, Jernberg T, Lindahl B, Fröbert O, Koul S, Erlinge D. Christmas, national holidays, sport events, and time factors as triggers of acute myocardial infarction: SWEDEHEART...

We should be familiar with Reye Syndrome and its association with aspirin. Check out the Stat Pearls page Chapman J, Arnold JK. Reye Syndrome. [Updated 2023 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526101/     Check out the original Reye paper REYE RD, MORGAN G, BARAL J. ENCEPHALOPATHY AND FATTY...

Do you palpate for the epitrochlear lymph node?   Check out the papers mentioned Selby CD, Marcus HS, Toghill PJ. Enlarged epitrochlear lymph nodes: an old physical sign revisited. J R Coll Physicians Lond. 1992 Apr;26(2):159-61. PMID: 1588523; PMCID: PMC5375540. https://pmc.ncbi.nlm.nih.gov/articles/PMC5375540/     Catalano O, Nunziata A, Saturnino PP, Siani A. Epitrochlear lymph nodes: Anatomy,...

An interesting and thought-provoking TED talk that argues for the need for clinicians to continue to examine patients thoroughly.     Check out Dr Verghese's TED talk here.   www.rnzcuc.org.nz podcast@rnzcuc.org.nz 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 ed...

Do you have a way to quickly and succinctly indicate that there is a possible patient of clinical concern within your clinic?   Read about Pan-pan on Wikipedia.   www.rnzcuc.org.nz podcast@rnzcuc.org.nz 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...

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 hig...

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...

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 podcast@rnzcuc.org.nz...

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 podcast@rnzcuc.org.nz 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 di...

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 whic...

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...

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: 373302...

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 podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Mus...

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 podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from  www.premiumbeat.com F...

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....

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: P...

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.nl...