Ashley Blachford, Author at Journal of Urgent Care Medicine

ICD-10 Changes for 2022

Every year on October 1, the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics release an updated ICD-10-CM Official Guidelines, as well as changes to the code set. This year there are 159 new codes, 32 deleted codes, and 20 revised codes, with a total of 72,748 codes to choose from. (Visit ICD-10-CM Official Guidelines for Coding and Reporting FY 2022 at https://www.cms.gov/files/document/fy-2022-icd-10-cm-coding-guidelines.pdf to see the entire document.) Three …

Assessing the Rate at which Pacemaker and Defibrillator Patients Present to the Emergency Room with their Manufacturer ID Card: A Cross Sectional Study

Urgent message: Care can be delayed if an urgent care or emergency clinician attempts to interrogate the CIED of a patient who does not know their device manufacturer and does not carry their ID card. This scenario illustrates the importance of patient education in care centers, such as the emergency department and urgent care. Tinh M. Le; James F. Neuenschwander, MD, FACEP; Mary Jones, DNP; Ankur Parekh; Hana Le; Kaitlyn Cedoz; and Clark Daugherty ABSTRACT …

Counterpoint: Readers React to JUCM Original Research

Andrew Grock, MD; Manuel Celedon, MD; and Jonie Hsiao, MD It was with great interest that we read Most Clinicians Are Still Not Comfortable Sending Chest Pain Patients Home with a Very Low Risk of 30-day Major Adverse Cardiac Event (MACE) by Dr. Michael Weinstock, et al in the February 2021 issue of JUCM.1 In this study, the authors surveyed attendants at an emergency medicine conference in 2018 as to their comfort level discharging patients …

Return to Sports in the COVID-19 Era: A Clinical Review

Urgent message: The COVID-19 worldwide pandemic has changed sports as we know it. Returning athletes back to sport safely continues to be widely debated among physicians in cardiology, primary care, infectious disease, and sports medicine. The return-to-play process after a COVID-19 infection will depend on the severity of their infection, duration of symptoms in the context of any concerning past medical history, and/or family history. Brian Harvey, DO and Natalie Stork, MD CASE PRESENTATION A …

Addressing Fraternization in the Urgent Care Workplace

Urgent message: Whereas sexual harassment is defined as unwanted and one-sided, many times employees choose to become romantically involved, requiring that urgent care centers have a policy and a plan to address workplace fraternization. Alan A. Ayers, MBA, MAcc is President of Experity Networks and is Practice Management Editor of The Journal of Urgent Care Medicine. In 2019, McDonald’s fired its Chief Executive Steve Easterbrook for engaging in a relationship that violated company policy. The …

An Unresponsive Pupil in the Urgent Care: Can A Diagnosis Be Made from the Bedside History and Exam?

Urgent message: Ocular complaints for which there is no immediate, obvious explanation do not necessarily have to be referred to the emergency room or ophthalmology. Employing the process of elimination to narrow down a broad differential, using the available evidence, can expedite the correct diagnosis while allowing the patient to remain in the urgent care. Kayla Penny, BS; Joseph LaRochelle, PharmD, BCPPS, FCCP; Deirdre Hooper, MD; Haley Caire, BS; and Kelsey Rooney, BS CASE PRESENTATION …

Telehealth Use Is Down from Its Peak—But the New Plateau Is Far Higher Than Pre-Pandemic Levels

Patients were more willing to use telehealth than ever in the early days of the COVID-19 pandemic. According to data from a report published by McKinsey & Company, telehealth claims grew 7,800% between February 2020 and April 2020. They dropped precipitously just a couple of months later, but have since plateaued. What could be of interest to urgent care operators who are considering telehealth as a service option, especially as we’re in the midst of …

Getting Served: The Do’s and Don’ts of Litigation

Upon returning home from a busy urgent care shift, you notice a certified letter with a law firm’s return address. You open the letter and realize you are being sued in the case of a 26-year-old woman you saw almost a year ago. As your heart beats harder, you think about returning to the urgent care to pull up the chart. You wonder who you should call (the medical director, the insurance company…?) Should you …

Abstracts in Urgent Care – October 2021

Duration of UTI Treatment in Men Acute Respiratory Illness in Children Isopropyl Alcohol for Acute Nausea in Adults Neurological Events and Metronidazole Prescribing Do the Modified Sgarbossa Criteria Offer Advantages Over the Original? Safety of a Second COVID-19 Vaccination Dose in Patients Who Had a Reaction to the First How Long Should We Treat UTI in Men? Take-Home Point: In afebrile men with UTI symptoms, a 7-day course of ciprofloxacin or trimethoprim/sulfamethoxazole was noninferior to …

A 7-Year-Old Boy with Scaly Red-Brown Papules on His Trunk

A 7-year-old boy is brought to your urgent care center by his mother because she’s concerned about a rash of scaly papules on his trunk, some of which had crusted or healed. A few of the lesions are hemorrhagic. She notes that they appeared a few days ago, accompanied by a mild fever. She dismissed the possibility that the source could be chickenpox because her son had been vaccinated. The boy reports that the papules …