Ashley Blachford, Author at Journal of Urgent Care Medicine

Few Misused Rx Drugs Prescribed in Urgent Care

According to the United States Department of Justice, the most common prescription drugs that are misused fall into 1 of 3 categories: opioid pain relievers/narcotics; depressants; and stimulants. Experity EMR data encapsulating 17,526,083 prescriptions written at 3,037 urgent care centers from January 1 to August 20, 2024, shows the vast majority of urgent care centers do not prescribe these medications at all, and of those that do, these medications represent a very small percentage of …

Could This Young Patient Really Have a STEMI? A Case Report of a Spontaneous Coronary Artery Dissection

Urgent Message: It is important to quickly obtain an electrocardiogram in patients presenting with chest pain or other symptoms suggestive of acute coronary syndrome, even for those who are young and without traditional coronary risk factors. Citation: Krauss WC. Could This Young Patient Really Have a STEMI? A Case Report of a Spontaneous Coronary Artery Dissection. J Urgent Care Med. 2024; 19 (1):21-23 Key Words: chest pain, spontaneous coronary artery dissection, acute coronary syndrome Abstract …

30-Year-Old With Foot Inversion Injury

A 30-year-old man presents to urgent care with lateral ankle pain and swelling after a foot inversion injury he sustained while hiking. A mortise view x-ray of the ankle is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

16-Year-Old With History Of Orchiopexy

A 16-year-old male with a history of orchiopexy presents with syncope. He denies chest pain or shortness of breath. An ECG is obtained. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

38-Year-Old With Foot Rash

A 38-year-old man presents to urgent care for a pruritic rash that developed on his feet over the last week. The rash is worse on his left foot than the right. He frequently works out and showers at the gym before going to work. On examination, fine, powdery, scaly plaques are seen on his soles and insteps. He otherwise appears well and has no systemic symptoms. View the image below and consider what your diagnosis …

Development and Implementation of a Headache and Migraine Pathway in Pediatric Urgent Care: A Quality Improvement Initiative

Urgent Message: There are an estimated 250,000 visits annually associated with pediatric headaches in the United States, 84% of which are not treated according to best evidence-based practice (EBP). The development of an EBP headache and migraine pathway in a pediatric urgent care improved access to evidence-based guidelines and increased clinician confidence and knowledge regarding the diagnosis and management of headaches in children. Sarah J. Nembu, DNP, APRN, FNP-C, CPNP-AC; Melissa R. Penkalski, DNP, APRN, …

Recognition and Management of Achenbach Syndrome (Paroxysmal Finger Hematoma)

Urgent Message: By understanding the symptoms of paroxysmal finger hematoma, clinicians can reduce patient anxiety and decrease unnecessary testing, as the condition is generally mild and has a favorable prognosis. Citation: Sanz Martinez E, Kranichfeld WH, Ceballos Y. Achenbach Syndrome: Diagnosis of Paroxysmal Finger Hematoma. J Urgent Care Med. 2024; 19(1): 25-29 Introduction Paroxysmal finger hematoma (PFH), also known as Achenbach syndrome, is a vascular disorder of unknown etiology characterized by subcutaneous bleeding in the …

Mistaken Identity

For as long as I can remember, Urgent Care has defined itself in the context of something else. We’re “more than primary care but less than emergency,” and “we’re like those drugstore clinics but we can do a lot more.” Or “we fill a gap in on-demand access.” I guess that is necessary when you are new and small and unknown. The problem with this kind of definition is that it’s so other-dependent. The way …

Severe Obesity Rises By 2% Despite Overall Downward Trend

The prevalence of severe obesity among Americans, particularly among women, has risen over the past decade, as reported by the Centers for Disease Control and Prevention (CDC). According to a 2021-2023 survey involving 6,000 individuals, about 40% of U.S. adults are obese. Of those surveyed, nearly 10% had severe obesity, defined by a body mass index (BMI) of 40 or more. The rate of severe obesity increased from approximately 8% in the 2013-2014 survey to …