Ashley Blachford, Author at Journal of Urgent Care Medicine

Abstracts in Urgent Care – February 2022

Surgery—or Not—for Appendicitis? Oral Analgesics and Musculoskeletal Extremity Pain What Patient Don’t Know About Ionizing Radiation Risk with NSAIDs, Cox-2 Inhibitors, and Opioids in Fractures Inhaled Budesonide for COVID-19 Spread of COVID-19 within the Household Ivan Koay MBChB, FRNZCUC, MD Nonoperative Management of Acute Appendicitis Take-home point: This study adds to a growing body of literature suggesting that, in select patients, a nonsurgical approach to appendicitis management leads to similar outcomes. Citation: The CODA Collaborative …

An 81-Year-Old Female with a History of A-Fib and a Recent Syncope Event

The patient is an 81-year-old female with past medical history of atrial fibrillation on apixaban who presents to urgent care after a syncopal episode 30 minutes prior to arrival. The patient felt lightheaded while being pushed in her wheelchair and then lost consciousness. There was no trauma. She returned to baseline approximately 2 minutes after the event. There was no seizure activity. The patient denied associated chest pain, shortness of breath, headache, urinary or fecal …

A 13-Year-Old Girl with Fever, Chills, Dry Cough, and Myalgia

A mother brings her 13-year-old daughter to your urgent care center with a complaint of fever, chills, dry cough, and myalgia for 3 days. On exam, the patient is febrile (101°F). In addition, there is conjunctival injection and blanching erythematous patches on the face and neck. The mother mentions that the family returned from a trip to Brazil 10 days prior. While traveling they ate local food, drank local (unfiltered) water, sustained a few mosquito …

A 30-Year-Old with a Painful Neck ‘Bump’ and Difficulty Swallowing

The patient is a 30-year-old male who presents with 2 days of difficulty swallowing and what he calls a painful “bump” on the right side of his neck. View the images taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

When Walk-Ins Aren’t Welcome

Patient volume has always been a delicate topic between the clinical staff and administrators of urgent care centers. It’s no secret who stands where in this ongoing debate. Regardless of each side’s opinions, UC volume has been largely stochastic historically, fluctuating at its own whim without regard for who wishes it were higher or lower. Things are different now, though. Thanks to COVID, UC overcrowding has become the new ED overcrowding—ubiquitous. The large volumes of …

Refunds: How to Avoid Them

Refunds have always been a challenge in healthcare. Not only do they create an administrative burden but there is also the potential for compliance risk. Some common causes for refunds are: Not validating the patient’s insurance eligibility and collecting the wrong copay amount Choosing a blanket amount to collect from all patients up front regardless of whether they have insurance (ie, over collecting at the time of service) Sending statements too early, causing duplicate payments …

PAs Aren’t Just ‘Assisting’ in Providing Urgent Care

In this issue’s Health Law article, What’s the Best Policy for Unlocking an Urgent Care’s Doors when a Provider Isn’t Present? (page 19), author Alan Ayers, MBA, MAcc points to the capabilities of advanced practice providers as one rationale some urgent care operators use when opting to stay open for business when a physician isn’t present. You could even go a step further and make the argument that the degree of direct care provided by …

Posterior Shoulder Pain—Not Always a Muscle Spasm

Urgent message: Patients present to urgent care with a variety of complaints, many of which are common—even if they are the result of an uncommon condition. It is important that the provider develop a broad differential diagnosis as they approach these problems. Richard A Ginnetti, MD, MBA, CPE and Justin Holschbach, MD CASE PRESENTATION History A 52-year-old male presents to urgent care with the chief complaint of new lower posterior neck and right shoulder pain …

A 14-Year-Old Wrestler with Shoulder Pain After a Match

The patient is a 14-year-old boy who reports to urgent care with left shoulder pain after a junior high wrestling match. He is vague about the precise location and possible mechanism of injury but through the physical exam you notice a prominence of the sternoclavicular joint and pain radiating along the clavicle. View the x-ray taken and consider what your diagnosis and next steps would be.

Abstracts in Urgent Care – January 2022

Pediatric Burns and Cool, Clear Water Limit Screen Time After Concussion? Gastroenteritis in Children Diagnosing Giant Cell Arteritis POCUS and Ectopic Pregnancy Detecting C diff Vaccinating Adolescents Against COVID-19 Ivan Koay MBChB, FRNZCUC, MD First Aid for Pediatric Burn Patients Take-home point: Many children with burns receive inadequate cooling after burns when presenting for emergency care. Citation: Frear C, Griffin B and Kimble R. Adequacy of cool running water first aid by healthcare professionals in …