Ashley Blachford, Author at Journal of Urgent Care Medicine

Abstracts in Urgent Care – December 2022

Ivan Koay MBChB, MRCS, FRNZCUC, MD Applying the Ottawa Ankle Rule to Pediatric Patients Take-home point: Application of the Ottawa Ankle Rule (OAR) limits unnecessary imaging in children without missing clinically relevant fractures. Citation: de Almeida S, Rios J, Lima S, et al. Applying the Ottawa Ankle Rule in a pediatric emergency department. Pediatr Emerg Care. 2022;38(3):e1123-e1126. Relevance: Ankles fractures in children are common.Use of the OAR, a simple clinical decision rule, by UC providers …

Benefits of Utilizing Limited-Scope X-Ray Techs in the Urgent Care Setting

Urgent message: X-ray is an essential component of urgent care operations. Amid rising costs and staffing shortages, limited-scope x-ray techs may be a viable alternative to licensed radiology techs to perform imaging in the clinic. Alan A. Ayers, MBA, MAcc One of the unexpected changes we’ve seen come out of the COVID-19 pandemic is the difficulty urgent care centers face in hiring licensed radiologic technologists (RTs). Even hospitals struggle to hire, offering sign-on bonuses of …

How Urgent Care Can Address Its Degrading Scope of Practice

Urgent message: Founded by emergency medicine doctors on a mission to keep nonemergent patients out of the ED, urgent care has been forced by changes in reimbursement policies to emphasize high productivity and labor cost savings—ultimately leading to overall fewer procedures and thus a lower acuity level for urgent care centers. Benjamin Barlow, MD; Monte Sandler; Alan Ayers, MBA, MAcc The urgent care community has faced many challenges over the past several years. The largest …

Antibiotic Duration for Skin and Soft Tissue Infections in Pediatric Urgent Care

Urgent message: Approximately one quarter of pediatric ambulatory visits result in antibiotic prescriptions, with over one third of those exceeding guideline-recommended durations. Factors that influence urgent care providers toward longer durations have not been studied previously. Megan Hamner, MD; Amanda Nedved, MD; Holly Austin, MD; Donna Wyly, RN, MSN, CPNP-AC, PPCNP-BC; Alaina Burns, PharmD, BCPPS; Brian Lee, PhD, MPH; and Rana E. El Feghaly MD, MSCI Citation: Hamner M, Nedved A, Austin H, Wyly D, …

The Rising Importance of Urgent Care in the Fight Against the STI Epidemic

Urgent message: After a brief hiatus during the peak of the COVID-19 pandemic, the rate of new sexually transmitted infections has resumed at epidemic rates in the United States. With many specialty STI clinics having closed, urgent care may be better positioned than ever to help curb their spread. Glenn Harnett, MD Citation: Harnett G. The rising importance of urgent care in the fight against the STI epidemic. J Urgent Care Med. 2022;16(3):15-20. Key words: …

A 79-Year-Old Male with Left Shoulder Pain and a History of Hypertension and CAD

A 79-year-old male with past medical history of hypertension and coronary artery disease presents to urgent care with left shoulder pain that is worse with movement. He reports intermittent nausea and vomiting, but denies dizziness, chest pain, shortness of breath, or history of trauma. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 32-Year-Old with Fever, Cough, Arthralgia, and Photophobia

A 32-year-old immunocompetent male presents with fever, cough, arthralgia, and photophobia for a few days. On examination, he had a temperature of 100°F (37.8°C) and conjunctival injection. There was a widespread erythematous macular rash on his wrist. When asked about travel, the patient mentioned that he recently visited his family in the Dominican Republic. During his travels, he drank local water and sustained a few mosquito bites. His symptoms began approximately 4 days after his …

A 42-Year-Old with Swelling After a Kick to the Face

The patient is a 42-year-old male who presents with nose and facial swelling after being kicked in the face while wrestling with his teenage son. View the images taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

STIs Are Epidemic in the U.S.—but How Many of Those Patients Are Going to Urgent Care?

If you read this issue’s cover article on how important urgent care is in fighting the current surge of sexually transmitted infections in the United States, you know that we are in the midst of an STI epidemic. (And if you didn’t read it, you should turn to page X to do so after you’re done here.) Sure, there have been demographic shifts in healthcare preferences; more Americans than ever (especially in the younger …

Managing Cough Without Codeine in the Urgent Care Setting

Urgent message: Opioid prescribing and opioid-related deaths have risen during the COVID-19 pandemic. Although supported by the CHEST Diagnosis and Management of Cough and NICE COVID-19 guidelines, it is time to reevaluate the appropriateness of using codeine in suppressing cough. Megan Penner, PharmD and Hojung Jang, PharmD Candidate CLINICAL SCENARIO A 54-year-old female with a past medical history of diabetes, hypertension, and depression presents to the urgent care center with congestion, nasal discharge, fatigue, and …