Ashley Blachford, Author at Journal of Urgent Care Medicine

Abstracts in Urgent Care – March 2021

‘Seat Belt’ Signs Post MVA Pain Control in Corneal Abrasions Analgesia with Reduction of Shoulder Dislocation Can Early PT Help with Sciatica? How Vaping Compromises Breathing COVID-19 in the Country Pandemic Depression—A Real Thing? Avijit Barai, MBBS, MRCS, MSc (Critical Care), PgCertCPU, FRNZCUC Workup for “Seat Belt” Sign in Trauma Patients Take-home point: The presence of a “seat belt” sign has a high association with intraabdominal organ injury. Citation: Shreffler J, Smiley A, Schultz M, et …

Are There Any Restrictions on an Urgent Care Provider Charging a No-Show or Cancellation Fee?

Urgent message: When holding a time slot that could go to another paying customer, it’s common for service businesses to charge no-show or cancellation fees. With many urgent care centers moving to online registration and queuing systems, could this be a solution for maximizing throughput in urgent care as well? Alan A. Ayers, MBA, MAcc is President of Experity Networks and is Practice Management Editor of The Journal of Urgent Care Medicine. Please provide at …

Is Specialization the Future of Urgent Care?

Urgent care has historically been viewed as a setting where patients could present with anything short of life- or limb-threatening complaints (though even those parameters have been stretched in dire situations.) And that identity has served the industry well, as evidenced by nearly constant growth over several decades. As time wore on, though, it became evident that there are business opportunities to be had by addressing niches with special needs. Occupational medicine is a prime …

Practice Review: Patients Presenting with Symptoms of Odontogenic Infection

Urgent message: Odontogenic infections can pose life-threatening risk when swelling occurs in close proximity to the airway. It is essential that the urgent care provider is able to differentiate cases of relatively straightforward infection that can be managed in the urgent care setting vs true airway emergencies. Amandeep Kaur Bains, BDS(Hons) MFDS RCPS (Glasg); Awais Safdar Ali, BDS MJDF RCSEng; and Pavan Padaki, BDS, MFDS RCPS (Glasg), MBChB, MRCS, FRCS (OMFS) INTRODUCTION While odontogenic or …

A Hand Wound Caused by a Pressure Washer

Urgent message: Injuries caused by pressure washers often require debridement or, in severe cases, amputation. Immediate assessment and appropriate management, where feasible, can preclude the need for surgical intervention while effecting a positive outcome. Ellen Hancock, MD; Julie Park; MD, FACS; and Kendall Wermine INTRODUCTION Pressure washer injuries tend to involve the lower extremities and abdomen and usually require a form of surgical intervention such as debridement of tissue and, in severe cases, amputation.1-4 The …

A 43-Year-Old Man with a Cough, Body Aches, and Fever

The patient is a 43-year-old man who presents with a cough and a general complaint of “body aches” that began “a few weeks ago.” He denies sick contacts or symptoms associated with COVID-19, other than a temperature of 100.4⁰F that precipitated his visit your urgent care center. View the x-ray taken and consider what your diagnosis and next steps would be.

A 3-Year-Old Boy with Trouble Walking Due to Right Foot Pain

The patient is a 3-year-old boy whose mother brings him to your urgent care center, reporting that her son has to be coaxed to stand and to walk because he says his foot hurts. She is not aware of any injury, or possible mechanism of injury. You observe that the boy is limping. Review the x-ray taken and consider what your diagnosis and next steps would be.

A Novel Method for Blinding Reviewers to Gender of Proceduralists for the Purposes of Gender Bias Research

Urgent message Gender bias, whether overt or subconscious, may be to blame for disparities in hiring practices, salary, and advancement in medical schools, the urgent care setting, and any healthcare workplace. Recognizing the value of gender-neutral assessment may not only “even the playing field,” but increase the likelihood of identifying the best candidates for clinical positions. Michael Pallaci, DO; Jennifer Beck-Esmay, MD; Adam R. Aluisio, MD, MSc; Michael Weinstock, MD; Allen Frye, NP; Ashley See, …

A 7-Year-Old Girl with White Patches on Her Toenails

Case A mother brought her 7-year-old daughter to the pediatric urgent care center after noticing that several of the girl’s toenails on each foot had white patches and appeared short and broken. They seemed to be lifting off the nail beds and looked thinner than usual. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Last Minute Coding Changes for 2021

December brought us some last-minute coding changes. In some cases, this caused a small claim delay as clearinghouses and payers scrambled to update their systems. New ICD-10 Codes for COVID-19 Effective January 1, 2021, there are new ICD-10 codes for reporting COVID-19 related diagnoses. These codes replace the existing codes we are using that are not as specific. There are two other new codes: 81 (Multisystem inflammatory syndrome (MIS)); and 89 (Other specified systemic involvement …