Angela Dugan is an orthopedic physician’s assistant in Grand Forks, North Dakota, who sees the local walk-in clinic helping people every day.

Often, patients who visit Dugan at Sanford Health Orthopedics and Sports Medicine Grand Forks have acute Injuries – that is, the injury is fresh and occurred suddenly.

Injured people may have to travel 15 miles or more to receive medical attention and may have to care for their injuries themselves until they reach the hospital.

In this difficult scenario, the first step is to find someone who can take you to a clinic.

The next step when dealing with a strain, sprain, or possible fracture is generally referred to as RICE, which stands for rest, ice, compression, and elevation.

“The best thing you can do is immobilize and protect the injured area,” Dugan said. “Let’s say it’s a knee, a wrist or an ankle – you want to try to limit the weight-bearing. If it’s a lower or upper extremity, you might want to wrap a towel over the injury. Something to protect it. It’s also always a good idea to apply ice immediately, especially if you have to drive to the clinic.”

Review of RICE

RICE relieves pain, limits swelling and speeds healing. It is often the best treatment for soft tissue injuries such as sprains and strains. Here’s how to do it:

• Move the injured area as little as possible to allow healing to begin.
• Apply ice immediately to reduce the inflammation, which causes more pain and slows healing. Cover the injured area with an ice pack wrapped in a thin towel for about 15 to 20 minutes three to four times a day.
• Using a pressure bandage will help prevent or reduce swelling. Use an elastic bandage and wrap the injured area without making it so tight that the blood supply is cut off.
• Elevate the injured area above the level of the heart. Prop one leg or arm up while you rest it. You may need to lie down to get your leg above the level of your heart.

Find someone to help you

Dugan stressed that not driving after an acute injury is a crucial part of a first aid plan.

“You shouldn’t drive for several reasons,” Dugan said. “First, if it’s a lower extremity, it may be a factor that prevents you from driving at all. But even if it’s something else, you’re probably in pain and your reaction time and ability to concentrate will be impaired.”

Dugan’s patients are not always dealing with an injury that just happened; often it is an injury that occurred days or weeks ago. In these cases, knowing yourself and knowing how to treat yourself can be very helpful.

You have to ask yourself: Do I really need to go to the doctor? Can I put ice on the injured area? Can I take anti-inflammatories like ibuprofen or Aleve to reduce the inflammation and ease the pain?

“If you get injured and it doesn’t really get better, you can’t keep playing,” Dugan said. “You have to rest and let the injury heal. If the injury doesn’t fit RICE, it’s time to go to the clinic and see if there’s anything you can do to treat the problem.”

If an injury is visible, such as a sprain or open fracture, you should treat it as an emergency. If you are unsure, call your emergency department and speak to a nurse who can help you decide.

“It’s just important to know that getting timely care for an acute injury is beneficial not only to the patient but also to the physician,” Dugan said. “It can help them put you in a position where your care can be as productive as possible.”

Walk-in clinic complements outpatient care

The Grand Forks walk-in clinic, where Dugan works as a physician, opened in May. In a location that serves many surrounding rural communities, it can provide a level of convenience and safety, filling a gap in health care for those who don’t have suitable options where they live.

In Grand Forks, office hours are Monday through Friday from 8:00 a.m. to 4:30 p.m. The clinic primarily provides acute care for muscle, bone and joint injuries. If the orthopedic office deems physical therapy necessary, same-day referrals and appointments can be arranged.

Related: Do you need urgent care or need to go to the emergency room?

Dugan provided a real-life example of what the existence of a walk-in clinic can mean for a community:

“Two patients came to me with acute fractures,” she says. “We put splints on them and prepared them for follow-up examinations, which can also take place in the clinic. The rapid treatment is one of the clinic’s real strengths. We have received a lot of positive feedback from patients.”

Since there is no walk-in clinic, Dugan’s patients would have no choice but to make an appointment with a general practitioner or go to the emergency room.

“That would not have been the proper use of the emergency room, and they were not dealing with the type of injuries where you would have wanted to wait to see a primary care physician,” Dugan said. “Instead, they were able to see an orthopedic specialist immediately who could evaluate their injuries and schedule follow-up visits. That’s very efficient care.”

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Posted in Grand Forks, Orthopedics, Rural Health, Sports Medicine