Ashley Blachford, Author at Journal of Urgent Care Medicine

COVID-19: New Zealand’s Urgent Care Story

Stephen L. Adams, MBChB, FRNZCUC Like the rest of the world, New Zealand (and more particularly its healthcare system) has been changed, perhaps irrevocably, by COVID-19. Despite a relatively small direct effect on the population (0.06% infected, half of which were identified and isolated at border) with 0.0004% deaths1 (including one physician), the effects on primary care have been substantial. THE BEGINNING New Zealand clinicians were first notified of the Wuhan cluster in January 2020. …

Learner Presence Does Not Negatively Impact Patient Experience in Pediatric Urgent Care

Urgent message: Shorter urgent care visits are correlated with higher experience scores. The presence of learners does not negatively impact patient experience scores. David Skoglund, MD, MS; Brian Lee, PhD, MPH; and Amanda Montalbano, MD, MPH Citation: Skoglund D, Lee B, Montalbano A. Learner presence does not negatively impact patient experience in pediatric urgent care. J Urgent Care Med. 2021;16(2):30-36. ABSTRACT Objective The number of trainees seeking pediatric educational opportunities in community outpatient settings is …

A 6-Year-Old Boy with a Lesion on His Ear

The patient, a 6-year-old boy, presented to a pediatric urgent care center for a well-child visit. In the exam room, the father pointed out a red lesion on the helical rim of the patient’s ear. The papule was smooth and well-defined and didn’t seem to bother the boy. The father reports that he and the boy’s mother have grown concerned as they’ve noticed it develop over several months. View the image and consider what your …

A 65-Year-Old Man with Shortness of Breath and a History of Heart Failure

A 65-year-old male with a history of heart failure presents to an urgent care center with shortness of breath of 2 days duration. He denies chest pain, nausea, or vomiting. He reports that he ran out of his medications about a week ago. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. (Case presented by Catherine Reynolds, MD, McGovern Medical School, …

A 75-Year-Old with Chest Pressure

The patient is a 75-year-old male who presents with a primary complaint of pressure in his chest. He denies chest pain, dizziness, or “anything like a heart attack.” 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.

The Last Hour Problem

It’s 8 pm and I’m 9 hours into a 10-hour shift when four new patients walk in. Even though I’m feeling drained, I smile warmly as each passes my workstation. I “eyeball” them each as they walk by; my grin persists because they all seem stable and my “TUR” for this shift in the emergency department is now only 45 minutes away. TUR (or “time until relief”) is a metric I continuously track with ruthless …

Will Urgent Care Visits return to ‘Normal’ as the Pandemic Turns Endemic?

In spite of the fact that urgent care was overlooked as an essential partner in the fight against COVID-19 in the early days of the pandemic, the virus had a major impact on the complaints that drove patients to visit an urgent care center. In fact, according to JUCM research, most of 2019’s top 5 chief complaints fell by at least half as a proportion of all urgent care visits. COVID-19, which was essentially a …

Weight Loss, Abdominal Pain, and Distension in a 74-Year-Old Woman

Urgent message: Not all GI complaints can be attributed to gastrointestinal pathology; symptoms of dyspepsia, vomiting, early satiety, weight loss, and abdominal pain may also be from a pelvic etiology. Fabrizia Faustinella, MD, PhD and L. Alexandre Frigini, MD INTRODUCTION Gastrointestinal complaints are common in ambulatory centers, urgent care, and in emergency departments. The symptoms of abdominal pain, nausea, and vomiting account for 12% to 15% of ED visits.1 Several non-GI intra-abdominal, endocrine, and pelvic …

A 23-Year-Old with Wrist Pain After a Mountain Bike Mishap

The patient is a 23-year-old male who presents with a primary complaint of pain in his left wrist after falling from his mountain bike on a rocky path. 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.

Author: Ashley Blachford