Ashley Blachford, Author at Journal of Urgent Care Medicine

Abstracts in Urgent Care – April 2021

Acetaminophen vs Ibuprofen in Children Optimizing Podcasts for Learning Dosing Ketorolac IV in Renal Colic Torus Distal Radius Fractures Avulsion Fractures of the Fifth Metatarsal Base COVID-19 and ECGs Long-Term Sequelae of COVID-19 COVID-19, Zinc, and Vitamin C Use of Acetaminophen and Ibuprofen for Fever and Pain in Young Children Take-home point: Acetaminophen and ibuprofen are both safe for short-term treatment of pain and fever in children under 2 years of age. Ibuprofen produces more …

A 35-Year-Old Male with Shoulder Pain After a Fall

The patient is a 35-year-old male who presents to urgent care with acute pain in his left shoulder after falling during a bicycle ride. Pain is worse with movements, but he is able to range the shoulder somewhat. You observe bruising and swelling at the impact site. View the images taken and consider what your diagnosis and next steps would be.

Credentialing and Contracting: What to Expect When Expanding

For those trying to grow their urgent care business, conversations around payer contracting and credentialing (CC) can often be overwhelming and seem contradictory to the mission of On-Demand Care. Tammy Mallow, our resident Experity advisor on all things CC says she often finds herself being the perceived as a “dream killer” when educating owners to the inner workings of this process. Established groups often expect the payer rules to be the same as they were …

Pitfalls of Point of Care Ultrasound (POCUS)—A Perspective

Urgent message: Point-of-care ultrasound (POCUS) is well established as an imaging tool in the urgent care center. Although it is generally considered safe and easy to use, safety and hygiene considerations are frequently ignored—possibly leaving patients at risk for infection and excessive radiation exposure. Avijit Barai MBBS, MRCS, MSc, PgCertCPU, FRNZCUC; Martin Necas, MMedSonography, AMS, RDMS, MRT, RVT; and Bruce Lambie, MBBS, FACEM INTRODUCTION Point-of-care ultrasound (POCUS) is well established as an imaging tool in …

Chin Lacerations in Children—A Call for Caution

Urgent message: Adhesive repair for skin lacerations in pediatric patients is a viable (sometimes preferable) option—under the right circumstances. Careful consideration is warranted when the wound is to the chin. Joshua Sherman, MD and David Mathison, MD, MBA INTRODUCTION The use of adhesive repair in lieu of sutures for the management of minor lacerations has become increasingly commonplace.1 When used correctly, cosmetic outcomes are similar and may be superior to suture repair in certain situations. …

Implementing Clinical Practice Guidelines in Adults with Hypertension: An Effective Practice Change in Urgent Care

Urgent message: Too often, patients first learn that they have hypertension secondary to an unrelated presenting complaint—often, in the urgent care setting. Improving adherence to treatment guidelines may improve management and, ultimately, outcomes. Jennifer Iacovo, DNP, APRN, FNP-C; Bonni Cohen, PhDc, DNP, APRN, ANP-C, FNP-C, CHFN, CNE, FAANP; and Judith Butler, DNP, CNM, WHNP, CNE Abstract Background: There are approximately 100 million adults in the U. S. with hypertension (HTN); almost half go undiagnosed. The …

A 96-Year-Old Male with Palpitations and a History of CAD

The patient is a 96-year-old man who is brought to your urgent care center by his daughter, with whom he lives. She reports that he has been feeling light-headed for “a few days.” The patient confirms this, adding that he has felt his heart “fluttering,” as well. He denies chest pain and shortness of breath, but acknowledges a history of coronary artery disease. View the ECG and consider what your diagnosis and next steps would …

A 13-Year-Old Girl with Scaling and Fissures on Her Lips

The patients is a 13-year-old girl who presents to a pediatric urgent care clinic with 1 month of scaling and fissures on her lips which began after she started using a retinoid cream prescribed for acne. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 71-Year-Old Woman with Femur Pain After a Fall

The patient is a 71-year-old female who presents with proximal femur pain after losing her balance and sustaining a “soft” fall onto a carpeted surface. She has a past history of hypertension, hypercholesterolemia, and osteoporosis. She takes a statin, an ACE inhibitor, and a bisphosphonate. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Why Don’t You Take A Break?

I took up smoking for about 6 months in college, but not for the reasons you’d guess. This was during my freshman year shortly after I got a job waiting tables. It was a hard job. There was always work to be done—refill a drink, check how the food was cooked, and, most importantly, bring the check post-haste when the customers wanted to leave. The shifts always seemed like a blur. I’d run around non-stop …