Ashley Blachford, Author at Journal of Urgent Care Medicine

Urgent Care Assessment of Patients with Possible Diverticulitis

Urgent Message: Diverticulitis is a prevalent condition characterized by localized inflammation most commonly of the sigmoid colon. It is often diagnosed with a computed tomography scan with intravenous contrast. Uncomplicated cases are most common and require only monitoring, however complicated cases can require hospitalization and emergent surgical intervention. Urgent care clinicians should be comfortable assessing patients with possible diverticulitis and recognizing features that suggest the possibility of more complicated disease. Naushair Hussain DO; Shahmeer Hussain …

Systematic Rapid Review: Efficacy of Hematoma Blocks for Pediatric Forearm Fractures

Shomel Gauznabi, MBChB, FRNZCGP, FRACGP, FRNZCUC, MD; Ivan Koay, MBChB, MRCS, FRNZCUC, MD Urgent Message: There is literature supporting that regional anesthesia, specifically hematoma blocks, is a safe, effective, and well tolerated alternative to procedural sedation for the management of pediatric forearm fractures. Citation: Gauznabi S, Koay I. Systematic Rapid Review: Efficacy of Hematoma Blocks for Pediatric Forearm Fractures. J Urgent Care Med. 2024; 19(x):42-50 Key Words: pediatric forearm fractures, anesthesia, hematoma blocks, urgent care …

Abstracts in Urgent Care – December 2024

ECG Interpretation: Humans Vs Machines Take Home Point: In this study, cardiologists and emergency physicians (EP) had greater accuracy for electrocardiogram (ECG) interpretation than current versions of ChatGPT and Gemini. Citation: Günay S, Öztürk A, Yiğit Y. The accuracy of Gemini, GPT-4, and GPT-4o in ECG analysis: A comparison with cardiologists and emergency medicine specialists. Am J Emerg Med. 2024 Oct:84:68-73. doi: 10.1016/j.ajem.2024.07.043. Relevance: Artificial Intelligence (AI) is rapidly evolving and becoming an integral part …

‘Health Data Obsessive Disorder’—A Modern Epidemic

“Low blood sugar” was his chief complaint, but Thomas was in my urgent care (UC) mostly because he was feeling anxious. It wasn’t hypoglycemia that was making him nervous either. Thomas didn’t have diabetes or take any medication for high blood sugar. Regardless, he was wearing a continuous glucose monitor (CGM), which he lifted his shirt to show me when I entered the room. Thomas explained his primary care physician (PCP) had prescribed the device …

Rural Urgent Care Growth Continues, But Challenges Remain

Urgent Message: Rural urgent care is the industry’s fastest growing segment, influenced by rural primary care shortages, hospital closures and extended ED wait times, but operational staffing and reimbursement complexities must be navigated. Alan A. Ayers, MBA, MAcc Citation: Ayers A. Rural Urgent Care Grows, But Challenges Remain. J Urgent Care Med. 2024; 19(3): 17-21 As access to care in rural areas continues to decline, urgent care (UC) can play a pivotal role in the …

Urgent Care Diagnosis and Management of Midshaft Ulnar (Nightstick) Fractures

Urgent Message: Fractures of the midshaft ulna, commonly referred to as “nightstick fractures,” typically occur after direct injury to a forearm outstretched above the head as a protective mechanism. Evaluation includes inquiry into the circumstances of the assault, assessment for any other areas of trauma, examination of the skin, wrist and elbow joints, and radiography of the forearm. Management of closed, nondisplaced midshaft ulnar fractures centers around splint immobilization and arrangement of appropriate follow-up. Chandrika …

Laceration Repairs Decline in Urgent Care

The percentage of urgent care visits involving a laceration procedure increased slightly from 0.75% in 2023 to 0.76% year-to-date in 2024, which is on-par with 2018 levels, according to Experity EMR analysis of more than 93.8 million urgent care visits, as of October 6, 2024. Over the past 15 years, the percentage of patients presenting with a laceration has gradually declined, attributed to a number of factors—chief among them being “case rate” reimbursement. Case rate …

55-Year-Old With Wrist Pain

A 55-year-old woman presents to urgent care complaining of pain when she moves her right wrist. She reports the pain began suddenly when she woke up that morning without any known trauma. An x-ray is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

35-Year-Old With ESRD

A 35-year-old male with a history of end-stage-renal-disease (ESRD) presents to urgent care complaining of back pain. The patient missed his dialysis session today because of the pain. An ECG is obtained. View the ECG captured below and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

15-Year-Old With Fever

A 15-year-old girl presents to urgent care with complaints of fever, arthralgia, abdominal pain, and a widespread rash that developed over the last 2 days. The patient says that the pain in her knees is severe and debilitating. On examination, the patient has a temperature of 100.3°F (37.9°C) as well as maroon and violaceous, purpuric papules and plaques on the legs, buttocks, and face. Laboratory examination shows elevated erythrocyte sedimentation rate and C-reactive protein, proteinuria, …