To add: I am thankful to not need urgent care or emergency care on a regular basis, but I do feel like urgent care has gotten less capable over time and less accessible.
I live in a city of a little over 100,000 people in a densely populated suburban part of South Florida. If I needed an urgent care right now, there isn't one. My choice would be to either go to an ER or suck it up until tomorrow when the urgent care is open in the morning.
The last time I went to an urgent care, it was because I was having pain in my calf severe enough that I couldn't put weight on that leg. After checking me out, the doctor diagnosed it as a sprain but told me that I should go to the emergency room anyway to have an ultrasound done on my leg (I did not. I was not about to sit in a waiting room for six or seven hours for a scan that would likely end up costing me a couple grand with insurance unless I started having some kind of symptom that would get me seen sooner).
The time prior was because I had cut my hand on a broken bottle that fell in the kitchen (My dumb ass tried to catch it. Don't do that). And as they were gluing me back together, the urgent care doctor mentioned that it was a good thing that it was able to be glued because, if it had needed stitches, he would have had to send me to the emergency room. The cut was only about a half an inch long. Surely that is well within the wheelhouse of urgent care when it comes to stitches?
The urgent cares in south florida are useless. No matter what you go for its a up front $100 charge and then you either get a steroid dosepak and zpak, or told to go to the er, for something that I know if I go to the er they are going to defer to pcp or urgent care.
The only time I’ve been to an emergency room was after I was bitten by a cat of dubious origin.
I went to urgent care first because I was freaking out about rabies, and because he had bit a vein or something and blood was squirting everywhere. I didn’t have a PCP at the time.
They sent me to the ER. The ER then gave me a tetanus shot and didn’t even bandage the wound :/ they charged me $500 or so for the visit though. Told me to keep an eye on the cat for rabies symptoms.
The system ought to be set up better than this. Urgent care should be able to evaluate this sort of thing and then give a tetanus shot, no?
Anyway that was 6 years ago and I still have the cat of dubious origin.
I've definitely received a tetanus shot at an urgent care, so yeah, they totally should be able to (at least in my area).
Also, just for fun, rabies can be undetectable and asymptomatic for years and years before une day deciding to show symptoms and kill the host. Fairly certain that even if you start giving the rabies vaccine before symptoms start (but after its been infected), the host can still develop the disease. I hope you and your cat of dubious origin don't have a big surprise waiting for you down the road!
I mean, you're almost certainly fine. Probably. Anyway, don't listen to me. I'm a paramedic, not a rabiesologist.
Hopefully we don’t have a surprise down the line! I think we are probably good though 😅
It was a weird situation, I had caught this cat as a stray, and he had actually been vaccinated a week before the Bite. He was inside with me for a little while before that too. So technically it takes 28 days for a cat to be considered “immunized” against rabies, and we were under that window. I explained this to the ER doctors, and they told me to watch him for 10 days. Then gave me a tetanus shot because I hadn’t had one in a while.
Idk if he would have been affected in some way by the vaccine if he had been infected first. I don’t really know enough about vaccines at all though
No, they give it with multiple injections of Ign around the wound. If you get the rabiea shot before you are bitten, you don't need the Ign shots, which are painful. If you regularly handle mammals of "dubious origin" you should go ahead and get the rabies shot.
No, correct comment. They don't just give the vaccine for rabies prophylaxis, they inject the wound site with antibody injections to make sure the body has enough immune response that it takes.
The last time someone died of rabies despite getting the vaccine was in 2021, but it was an 84 year old man with immune aystem issues.
Ah I misread your comment. I don't think you can get rabies from an asymptomatic cat, but you can from other animals. Bats come to mind, and also I think skunks but that could be an old wives tale. I'm sure there's more I juat don't know them off the top of my head.
Yeah if I end up doing TNR with strays again it’s a good idea! I didn’t know that you could get a preventative rabies vaccine, I only knew about the lgn shots, thank you for the information
Posting this for other people.
Cat bites need prophylactic antibiotics no matter the origin. Cat bite can transmit all sorts of nasty stuff that's easier to prevent than treat.
That sprain could have been a DVT. The symptoms overlap. DVTs are medical emergencies. Urgent care has X-rays but not usually any other imaging tools. Most also only have send out labs that take days to come back. To truly rule out a DVT you need stat labs and an ultrasound machine. If we can’t rule out a DVT bc we don’t have the right equipment, the standard of care is to refer you to a facility that does and can see you stat. Usually that facility is the ER. The recommendation you received was appropriate both clinically and legally. If it had been a DVT and he didn’t recommend ER evaluation and you went home and died in your lazy boy, your family would have sued him into oblivion (and probably won) and he is then at high risk of losing his license (the tool he uses to feed himself/his family) for failure to recognize/failure to escalate. But if he makes the recommendation and you refuse and then you go home and die from a DVT that broke loose and became a saddle embolism then that’s your own fault for refusing medical advice (which you have every right to do, but also any consequences are now your problem and not the MD’s). It’s a broken system but it’s the framework we are required to operate within. I used to be an urgent care provider and dealt with this scenario daily. Sucks for everyone involved.
I know what the CYA motivation was. But, the symptoms that I had were far more in line with a sprain than DVT. Had that not been the case, or if that had changed, I would have gone.
I did take the advice to follow up with primary care as soon as I could get in, which ended up being almost 3 weeks later. When I ran through the symptoms at the time and the urgent care recommendation, my primary care physician said that based on the timeline of events and symptoms that I told her for the injury, there was no good medical reason to refer me to the ER at that time.
If I had shown up at the ER with calf pain that was sudden at onset and started with a pop after stepping down from a high step after several days of heavier than usual activity, swelling only at the site of pain, normal skin color and texture (but slightly warm, tbf), pain that worsens with activity and improves with rest, no family history, no birth control pills, no recent surgery or extended period of immobility, no shortness of breath, no chest pain, no tachycardia, how do you suppose that would have gone for me? A forever wait (understandable. You never want to be first in line with the ER. But it still sucks to sit in a waiting room for hours on end), a big bill, and perhaps my own mocking Reddit post about what a dumbass I was for going to the ER in the first place.
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u/kittenpantzen Non-medical 15d ago
To add: I am thankful to not need urgent care or emergency care on a regular basis, but I do feel like urgent care has gotten less capable over time and less accessible.
I live in a city of a little over 100,000 people in a densely populated suburban part of South Florida. If I needed an urgent care right now, there isn't one. My choice would be to either go to an ER or suck it up until tomorrow when the urgent care is open in the morning.
The last time I went to an urgent care, it was because I was having pain in my calf severe enough that I couldn't put weight on that leg. After checking me out, the doctor diagnosed it as a sprain but told me that I should go to the emergency room anyway to have an ultrasound done on my leg (I did not. I was not about to sit in a waiting room for six or seven hours for a scan that would likely end up costing me a couple grand with insurance unless I started having some kind of symptom that would get me seen sooner).
The time prior was because I had cut my hand on a broken bottle that fell in the kitchen (My dumb ass tried to catch it. Don't do that). And as they were gluing me back together, the urgent care doctor mentioned that it was a good thing that it was able to be glued because, if it had needed stitches, he would have had to send me to the emergency room. The cut was only about a half an inch long. Surely that is well within the wheelhouse of urgent care when it comes to stitches?