Ashley Blachford, Author at Journal of Urgent Care Medicine

Is It Appendicitis? The Role of Clinical Scoring Systems, Labs, and Diagnostic Imaging

Urgent message: Ultrasound can provide essential data in the urgent care evaluation of suspicion of acute appendicitis. Facilitating a rapid diagnosis allows for immediate and appropriate decisions regarding management. Andrew Alaya, MD, MSc INTRODUCTION Appendicitis is thought to be the result of luminal obstruction due to various etiologies (such as lymph node hyperplasia, coprolites, or parasites) which lead to increased mucus production and bacterial overgrowth. This results in wall tension and eventually necrosis and potentially …

Where Do You Start When Starting Your Urgent Care?

Heather Real There are many reasons to start your own urgent care, whether it be feeding your entrepreneurial spirit, investing in an industry that has proven to be stable and growing (even amidst multiple economic crises in the last three decades), or responding to the needs of a community. For many, the reasons include at least some of these, and more. Realizing the desire to take on this project is the first step; however, there …

What Qualifies Someone to Take X-Rays in the Urgent Care Center? It All Depends on Where You’re Located

X-rays are high on the list of services patients expect urgent care centers to provide when needed. Currently, however, a dearth of qualified technicians can make guaranteeing that they can do so somewhat challenging. The November issue of JUCM will start an in-depth discussion of how the industry can best approach meeting that challenge for the benefit of the patient and the individual operator. One essential part of that discussion will be answering the question …

A 45-Year-Old Male with Palpitations

The patient is a 45-year-old male who presents with palpitations for the past 30 minutes. He denies chest pain, dizziness, or syncope. His vital signs are normal aside from tachycardia and he appears to be in no acute distress. View the ECG taken and consider what your diagnosis and next steps might be. Resolution of the case is described on the next page.

A 43-Year-Old with a New Rash on the Trunk

A 43-year-old man presents to urgent care with a rash that he noticed a couple of days ago on his trunk. On exam, there is skin atrophy and multiple smooth papules and hypopigmented oval macules. Upon palpation of the lesions, you find that the examining finger “sinks” into a pit with distinct edges, like the ring of a hernia. The patient is immunocompetent, and his medical history is unremarkable except for lichen planus. He patient …

A 16-Year-Old Boy with Arm Pain After a Baseball Game

The patient is a 16-year-old male who presents to urgent care with pain in the humerus area hours after finishing a baseball game. View the x-ray taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

New ICD-10-CM Codes in Effect as of October 1

It’s time for the major release of ICD-10-CM that occurs on October 1 every year. For 2023, this update reflects 1,468 new codes, 251 deleted codes, 35 revised codes, and 36 codes converted to parent. Like the last few updates, Social Determinants of Health (SDOH) are front and center. SDOH are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, …

DOT Physicals and Urine Drug Testing Represent a Growth Opportunity for Urgent Care Centers

Urgent message: Demand for DOT-related services for truck drivers is soaring. Urgent care centers can augment traditional insurance-paid visits with B2B relationships while serving a historically unhealthy population. Alan A. Ayers is President of Experity Consulting and Senior Editor of The Journal of Urgent Care Medicine. The commercial trucking industry in the United States is massive (Table 1). The U.S. Department of Transportation (DOT) requires that all commercial motor vehicle drivers receive a physical every …

A Legal Quandary: A Diagnosis of Cellulitis…That Isn’t

Michael Weinstock, MD; Gabby Gostigian, MD; and Matthew Delaney, MD Urgent message: Failure to consider subtleties and the context in which a patient presents can lead to insufficient differential diagnoses and missed diagnoses that leave the patient at risk for poor outcomes and the provider at risk for litigation. INTRODUCTION Cellulitis from a wound infection in the urgent care is common, and so is our management: wound care and antibiotics. But consider a scenario in …

The Value of Vitals – Part I

Joshua Russell, MD, MSc, FCUCM, FACEP Recently, a PA I supervise called me about a young woman who came in for hematemesis and melena at home. The provider, let’s call him Tom, told me that the patient had normal vital signs, but he thought she should still go to the ED. I could sense some reluctance in his voice though. It was probably because the patient was just 32 years old and looked well. Understandably, …