Ashley Blachford, Author at Journal of Urgent Care Medicine

Urgent Care Management of Lacerations in the Elderly Patient

Urgent message: Fragile skin lacerations in geriatric patients require a different repair strategy from those in younger patients. Despite the increased complexity of their wounds, most elderly patients with lacerations can be appropriately managed in the urgent care center. Oscar D. Almeida, Jr., MD, FACOG, FACS and Amy Hunter, DNP, FNP-BC, MSN-RN INTRODUCTION Skin tears form a subcategory of traumatic lacerations frequently affecting older adults. A study that searched Medline and Cochrane Reviews found that …

Abstracts in Urgent Care – December 2021

The Importance (or Not) of High BP Readings Learning While Driving—Does It Work? Considering Sucralfate in Pediatric Oral Ulcers Osteopathic Manipulation for Low Back Pain Safety of Oral Corticosteroid Bursts in Children Nathan M Finnerty, MD FACEP and Brett C Ebeling, MD Do High Blood Pressure Readings Matter? Take-home Point: Elevated blood pressure readings in the emergency room were not associated with an increased risk of poor cardiovascular outcomes in 2 years. Citation: McAlister F, …

Stepping Outside Yourself

Joshua Russell, MD, MSc, FACEP Until recently, I’ve had the rare luxury of working in busy urgent care centers where I was virtually always working side-by-side with another provider. However, with changes in my career and UC staffing models in the wake of the pandemic, I find myself working in single coverage situations the majority of the time nowadays. While I do miss the camaraderie of multi-coverage practice, I miss the unfettered access to a …

A 60-Year-Old Woman with Dark, Painful Plaques on Her Legs

The patient is a 60-year-old woman who presents to urgent care after developing dark areas over both legs over the course of the past few days. They are extremely painful. On examination, there were violaceous and dark brown, retiform plaques, some depressed and some crusted, over the legs. The patient has a history of diabetes, hypertension, and chronic renal insufficiency for which she required hemodialysis. View the image and consider what your diagnosis and next …

A 49-Year-Old Male with Abdominal Pain

The patient is a 49-year-old male who presents with a primary complaint of what he describes as “gas pain” for the past 3 days. He denies any other symptoms or suspected etiologies. View the images taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Who in a Company Can Bind the Company in a Contract?

Urgent message: While legal documents may define who in an urgent care is able to legally obligate the company, such as when ordering a service or signing a contract, there are cases where “unauthorized” individuals can still bind the company—meaning the organization must have clear internal policies on signing authority. Alan A. Ayers, MBA, MAcc Let’s say that a physician employed at an urgent care facility is working on a Saturday when a toilet backs …

Abstracts in Urgent Care November 2021

POCUS in Ocular Presentations Experiencing—and Handling—Patient Biases Self-Swabbing for STIs CAM Boots for Toddler’s Fracture? Treating Children with Bronchiolitis Azithromycin in COVID-19 Point-of-Care Ultrasound for Eye Examination Take-home point: Ocular ultrasound (OUS) can be a quick, safe, and effective way to assess eye complaints and complements the clinical exam. Citation: Manton J, Henry C. Benefits to utilising ultrasound in examining the eye. Emerg Med Australas. 2021;33:745–747. Relevance: As availability of point-of-care ultrasound (POCUS) becomes more …

Urgent Care Diagnosis and Management of Deep Vein Thrombosis

John DesMarais, MD and Samidha Dutta, DO Urgent message: Screening patients with suspected DVT using the Well’s criteria is an efficient tool that would be even more impactful with access to point-of-care, high-sensitivity D-dimer testing in the urgent care setting. Citation: DesMarais J, Dutta S. Urgent care diagnosis and management of deep vein thrombosis. J Urgent Care Med. 2021;15(2):13-17. Case Presentation A 37-year-old woman presents to urgent care with 3-day history of right leg swelling …

Billing for Midlevels: Your Questions Answered

One of the biggest challenges for urgent care practices is staffing. Midlevels are a great solution. As states pass laws giving midlevels more autonomy to compensate for physician shortages, however, there is some confusion on how to bill for these providers’ services. I will attempt to answer some of your billing questions. Do I need to credential my midlevels? Yes and no. This is dependent on your contract. For some group contracts, any new provider …

Investigation and Assessment of Urine Culture Importance in the Evaluation of Uncomplicated Urinary Tract Infections in an Urgent Care Setting

Dianne Treacy Lore DNP, FNP-BC, CPNP-PC and Marlena Seibert Primeau DNP, FNP-BC, NHDP-BC, BSHEC Citation: Lore DT, Primeau MS. Investigation and assessment of urine culture importance in the evaluation of uncomplicated urinary tract infections in an urgent care setting. J Urgent Care Med. 2021;16(2):37-41. ABSTRACT Purpose Urinary tract infections negatively affect over 150 million individuals globally each year. Traditional management encompasses evaluating a urine culture and sensitivity (C&S). Although the guidelines set forth by the …