Ashley Blachford, Author at Journal of Urgent Care Medicine

39-year-old Male with Sharp, Nonradiating Chest Pain

History: A 39-year-old male with no known past medical history presents to urgent care for evaluation of several hours of sharp, non-radiating, left-sided chest pain. The pain is non-exertional, non-pleuritic, began after his last meal and resolved without intervention approximately 30 minutes prior to arrival. No history of similar pain in the past. No associated shortness of breath, nausea, vomiting, or diaphoresis. View the ECG taken and consider what your diagnosis and next steps would …

A 55-Year-Old with a Recent History of Rash

A 55-year-old female presents to urgent care with a few weeks of a mildly pruritic rash on her trunk and arms. On examination, there are scattered erythematous, fine, scaly plaques. The coin-like plaques are round or oval in configuration and affect her extremities symmetrically. The patient denies current medications or any personal or family history of dermatologic conditions. She reports no systemic symptoms. However, she shares that she has been taking longer and more frequent …

An 18-Year-Old with Diffuse Abdominal Pain

An 18-year-old male presents to urgent care with widespread abdominal “gas pain” for several days. He denies changes in diet or changes in bowel habits. However, he recalls having a hard collision with another player during a lacrosse game prior to onset of symptoms. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Spoiler Alert: 2020 Saw a New Trent in Urgent Care Data Claims

Spoiler Alert: 2020 Saw a NewTrend in Urgent Care Data Claims Spoiler Alert: 2020 Saw a NewTrend in Urgent Care Data Claims The effects of the COVID-19 pandemic on healthcare systems around the world has been unprecedented, at least in our lifetimes. The cost in lives and dollars, pounds, euros, yuan, is incalculable at this point, as the pandemic continues. What we can get our arms around, however, is how visits to urgent care centers …

Addressing Without Managing: Defusing the Ticking Time Bombs in Urgent Care

In the world of urgent care, it’s assumed that we exist to provide immediate, episodic care for discrete problems. The sore throat, sprained ankle, and laceration are our bread and butter. However, we do not practice in a vacuum. We share patients with other clinicians who longitudinally follow and manage their multiple comorbidities. Additionally, for the growing number of patients without a primary care provider, we commonly serve as the sole point of contact with …

A 31-Year-Old Male Complaining of Weakness

KEY QUESTIONS What Electrolyte disturbances cause the interval problem seen in this ECG? Which dysrhythmia is this patient at risk for?

No Troponin, No Problem: Reimagining Chest Pain Assessment in Urgent Care

Most urgent care providers loathe when a patient checks in with chest pain because, typically, they are presenting because they’re worried about a heart attack, and we’re worried we don’t have the tools to exclude this diagnosis. It’s no surprise that we’re met with consternation when we suggest they may have come to the wrong place for care. But is unavailability of troponin testing a worthy scapegoat? And is the practice of ED referral for …

Knee Immobilization for Acute Knee Injuries: A Review

Urgent message: Immobilization following acute knee injury occurs more commonly than the evidence might dictate in urgent care and other acute care settings. Evaluation of data in existing literature suggest that this common practice carries risk for adverse effects when not warranted. Matthew Bruce Baird, MD, CAQ-SM; Mallory Shasteen, MD, CAQ-SM; and Vicki Nelson, MD, CAQ-SM. Citation: Baird MB, Shasteen M, Nelson V. Knee immobilization for acute knee injuries: a review. J Urgent Care Med. …

Abstracts in Urgent Care – May 2022

Immobilizing Ankle Fractures Treating Septic Olecranon Bursitis EKG Interpretation: Human vs Machine preHEART Score and Prehospital Care Rethinking Otitis Media Management Boosters Limit Risk for COVID—but by How Much? Ivan Koay MBChB, FRNZCUC, MD Casting vs Bracing for Ankle Fractures Take-home point: Plaster casting was not superior to functional ankle bracing for certain ankle fractures. Citation: Kearney R, McKeown R, Parsons H, et al. Use of cast immobilisation versus removable brace in adults with an …

<strong>What Is the Acceptable Miss Rate for a Major Adverse Cardiac Event (MACE)? </strong><strong>A Follow-Up Survey After Release of the American College of Emergency Physicians (ACEP) Clinical Policy on Acute Coronary Syndromes</strong>

What Is the Acceptable Miss Rate for a Major Adverse Cardiac Event (MACE)? A Follow-Up Survey After Release of the American College of Emergency Physicians (ACEP) Clinical Policy on Acute Coronary Syndromes

Urgent message: Previously JUCM-published research revealed that even very low risk for a major adverse cardiac event left clinicians uncomfortable with discharging patients per 2018 ACEP guidelines. What can be learned from a follow-up study reflecting the updated version? Rebekah Samuels, OMS-III; Francesca Cocchiarale; Samidha Dutta, DO, PGY-3; Jarryd Rivera, MD; Amal Mattu, MD; Michael Pallaci, DO; Paul Jhun, MD, FAAEM; Jeff Riddell, MD; Cameron Berg, MD; and Michael Weinstock, MD. Citation: Samuels R, Cocchiarale …