Ashley Blachford, Author at Journal of Urgent Care Medicine

Dyspnea in the Urgent Care: Differentiating Benign From ‘Can’t Miss’

Urgent Message: Patients commonly present with respiratory symptoms in the urgent care setting and not infrequently complain of some degree of shortness of breath—or dyspnea. It is critical for clinicians to have comfort with the clinical assessment and appropriate use of diagnostic resources for the dyspneic patient. Identifying patients requiring immediate emergency department referral is an important skill. Evan Price, DO; Eric Patten, MD; Shakil Hossain, DO; Michael Weinstock, MD Citation: Price E, Patten E, …

Abstracts in Urgent Care – June 2024

Using AI to Detect Myocardial Infarction Take Home Point: The use of an occlusive myocardial infarction (OMI) artificial intelligence (AI) electrocardiogram (ECG) model has the potential to improve identification of acute coronary syndrome (ACS) by enabling timely and accurate detection of OMI regardless of the presence ST-segment elevation. Citation: Herman R, Meyers H, Smith S, et. al. International evaluation of an artificial intelligence-powered electrocardiogram model detecting acute coronary occlusion myocardial infarction. Eur Heart J Digit …

60-Year-Old With Annoying Cough

A 60-year-old man presents to urgent care complaining of an annoying cough for several months. He states that he frequently has sputum production with his cough. He denies any fever, chills, or other symptoms. Review the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

Urgent Care Evaluation and Management Of Injury to the Ulnar Collateral Ligament of the Thumb (Gamekeeper’s Thumb)

Urgent Message: With hyperabduction and hyperextension of the thumb, the ulnar collateral ligament may be stretched or torn, or may avulse a segment of bone from its insertion point. Radiographic imaging of suspected “gamekeeper’s thumb” must be obtained to evaluate for an associated fracture, which may change the decision for conservative vs surgical management. Omar Jafry, MS-3; W. Bradley Strauch, MD Citation: Jafry O, Strauch WB. Urgent Care Evaluation and Management Of Injury to the …

15-Year-Old Gasping for Air

A 15-year-old male with no significant past medical history presents after he was noted to be gasping for air and difficult to arouse after taking a nap. At the urgent care, an ECG is obtained. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

29-Year-Old With Stinging Sensation

A 29-year-old woman presents to urgent care for a painful rash that developed on her arm. It started 1 day after working on a landscaping project that involved pulling weeds under intense sunlight. On examination, an edematous, pink, scaly plaque and nearby erosions are seen on her right arm. The patient appears well and has no systemic symptoms. View the image below and consider what your diagnosis and next steps would be. Resolution of the …

Intraoral Angioedema After Olanzapine Overdose: A Case Report

Urgent Message: Patients may present to an urgent care facility with intraoral angioedema, a life-threatening emergency that requires referral to an emergency department in any case with rapid progression or concerns for airway involvement. This case report describes angioedema from olanzapine, an antipsychotic prescription drug. Chantelle Petterson, BDS, Benjamin Fu, MD, BDSc (HONS), MPhil, FRACDS (OMS) Citation: Petterson C, Fu B. Intraoral Angioedema After Olanzapine Overdose: A Case Report. J Urgent Care Med. 2024; 18(9):34-36 …

Please Show Me That I’m Wrong

I like to think that I usually have a pretty good read on Urgent Care, but I am currently mystified by something and need your help. For as long as I can remember, everyone in Urgent Care has chanted a common refrain: “We need a seat at the table!” In the beginning, we were too small to make enough noise to be heard and way, way too tight on funds to even think about hiring …

Clinicians May Not Recognize Rare Measles Cases

The US Centers for Disease Control and Prevention (CDC) has reported a surge in measles cases, including 57 cases associated with a migrant shelter in Chicago, Illinois, according to a new CDC report. It previously recorded 97 confirmed cases in the first quarter of 2024. It’s a significant uptick when compared to the average of 5 cases during the first quarters of 2020-2023. Almost all recent cases were among the unvaccinated. Among the World Health …

County Questions CA Hospital’s Closure of UC Clinic

Sonoma Specialty Hospital in Sebastopol, California, just 5 years ago was facing bankruptcy, but a sale helped to keep the facility’s doors open while also adding inpatient beds. However, the hospital’s current owner, American Advanced Management, has not made good on its obligation to operate an urgent care (UC) center to serve patients after the closure of the original hospital’s emergency department. Sonoma County is now seeking $1.3 million in loan repayment from the owners …

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