Ashley Blachford, Author at Journal of Urgent Care Medicine

Pandemic Fluctuations: A Historic Drop, Then a Meteoric Rise in Patients Visits Per Day

Just to confirm, the COVID-19 pandemic has generally not been kind to the urgent care industry. Locations that could get their hands on testing supplies at the outset were inundated with patients clamoring to know if they had the virus. The many facilities that got shut out of test distribution chains suffered greatly, though—as did the industry as a whole. Now, even as case loads continue to climb again in many states, the public’s panic …

A 60-year old Male with Dyspnea and Hypoxemia at the Start of a Global Pandemic

Urgent message: The identification and global impact of the novel coronavirus has significantly challenged medical decision-making. Urgent care providers now consider the inclusion of the SARS-CoV-2-causing illness in their differential diagnosis when evaluating patients with signs and symptoms of an acute respiratory infection. Louis Costanzo, MD, MBA Introduction As of March 2021, there have been more than 28.6 million documented cases of COVID-19 in the United States, with the majority of cases those ages 18 …

Focus on Pediatrics

Neuro Effects of COVID-19 Melatonin and Children with Postconcussive Symptoms Pediatric, Sports-Related Concussion Acute Migraine in Children and Adolescents Emily Montgomery, MD and Kelsey Riggs, MS3 Neurologic Manifestations of COVID-19 Take-home point: COVID-19 has a variety of presentations that include neurologic manifestations—most commonly, headaches. Citation: Niazkar HR, Zibaee B, Nasimi A, Bahri N. The neurological manifestations of COVID-19: a review article. Neurol Sci. 2020 Jul;41(7):1667-1671. Relevance: More than 1/3 of patients with COVID-19 experience neurologic …

The Implementation of Nurse-Intiated Ankle and Foot X-rays in an Urgent Care Setting

Urgent message: Nurse-initiated protocols (NIPs) have been found to be beneficial in emergency department settings. Nurse-initiated x-rays for ankle and foot injuries can reduce patients’ length of stay while improving staff satisfaction. Utilization of NIPs in an urgent care setting can bring positive benefits to patients, staff, and the organization. Allison Usset Gilles, DNP, FNP-C, RN; Der Xiong, DNP, FNP-C, RN; and Jenny A. Prochnow, DNP, MBA, RN INTRODUCTION Background Overcrowding and long wait times …

Outpatient Management of COVID-19 in the Urgent Care Clinic: Administering Monoclonal Antibodies

Urgent message: The approved use of monoclonal antibodies to treat patients who have COVID-19 may signal a shift from inpatient to outpatient care of infected individuals who do not require hospitalization. Urgent care facilities may be ideally suited to serve as treatment centers and to become destinations of choice for such patients. Lindsey Fish, MD Now that COVID-19 has been with us for over a year, we are in a much different position regarding the …

Why is the Waiting Room Still Empty? Perspectives from a Pediatric Urgent Care Physician

In February 2020, the first U.S. case of community spread COVID-19 was identified at a pediatric urgent care center in Seattle, reinforcing the fact that UC is on the frontlines of healthcare. Between March and May 2020, the majority of healthcare services saw a significant downturn in volumes as patients quarantined and businesses shutdown. But as the number of domestic COVID-19 cases increased, many general urgent care centers saw unprecedented volume surges that continued throughout …

Pretravel Consultations in the Urgent Care Setting

Urgent message: A pretravel consultation assesses the patient’s fitness for travel in the context of anticipated risks associated with their journey. This individualized counseling takes into account not just age or destination, but also general health and other factors such as past travel experience. Given the proliferation of single-specialty travel medicine clinics, with appropriate training and preparation, these assessments can easily be performed in the urgent care setting. Benjamin Silverberg, MD, MSc, FAAFP, FCUCM Citation: …

A 28-Year-Old Boxer with Wrist Pain After a Bout

The patient is a 28-year-old male with right wrist pain after a boxing match. He reports that he felt “a pop” and immediate pain along the ulnar aspect of his wrist after throwing a punch. He has no past medical history and takes no medications. 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.

Managing Concussions in Acute Care

Jordan Wackett MD, MPH, Joshua Kornegay, MD, Craig Rudy, MD The most recent recommendation from the Concussion in Sport Group calls for 24-48 hours of rest and a graded return to activity (unrestricted once asymptomatic)2. Unfortunately, asymptomatic from a concussion standpoint is not always obvious, which can make the new recommendation difficult to implement as patients may remain symptomatic while adhering to rest. Symptomatology is often multifactorial and they may be instructed to rest despite …

A 46-Year-Old Woman with a Painful, Erythematous Plaque on Her Leg

The patient is a 46-year-old female who presents with a painful, erythematous, indurated plaque on her lower leg. She reports that it developed over the past month. At first she attributed the pain to “a bump” of unknown origin, but as the area of red skin expanded she became concerned that she became concerned, as she reports a history of deep-vein thrombosis. View the image taken and consider what your diagnosis and next steps …