Nothing says “emergency” like a bite from a venomous reptile. If you work in an area populated by snakes, which covers most of the United States and the world, then chances are good that you will see a patient with a snake bite in the Emergency Department (ED). The severity of the symptoms and the treatment vary greatly with different snakes. In this post, we will outline the ED approach to and management of common U.S. snake envenomation.
The genus Centruroides, also known as the Bark Scorpion, is found throughout the southwestern United States and northern Mexico. Many emergency medicine practitioners in the Southwest are exceptionally familiar with the treatment of envenomation from Centruroides as a quarter million are reported annually1,2. Although typically mild envenomations occur in adults, children and the elderly are at increased risk for severe complications3. The toxic syndrome consists of a sympathetic and parasympathetic storm that can result in myocardial damage, involuntary jerking, wandering eye movements, and most threatening – loss of airway.
Unlike the previous cardiology modules, the environmental module was comparatively under-represented in the top 50 sites of the Social Media Index. Below we have listed our selection of the 4 highest quality blog posts within the past 12 months (as of October 2015) related to environmental emergencies, curated and approved for residency training by the AIR Series Board. More specifically in this module, we identified 2 AIRs and 2 Honorable Mentions.
Unlike the previous cardiology modules, the environmental module was comparatively under-represented in the top 50 sites of the Social Media Index. Below we have listed our selection of the 3 highest quality blog posts within the past 12 months (as of September 2015) related to environmental emergencies, curated and approved for residency training by the AIR Series Board. More specifically in this module, we identified 0 AIRs and 3 Honorable Mentions.
Heat-related illnesses comprise a continuum of disorders ranging from the minor heat edema, heat rash, heat cramps, and heat exhaustion to the more life-threatening condition known as heat stroke. As a general rule, it is involves a process whereby heat gain overwhelms the body’s mechanisms of heat loss. Often it is caused by an impairment of the body’s cooling and adaptive mechanism to effectively transfer heat to the environment, thus leading to a rise in core temperature. 1
A 26-year-old woman presented to an urban Detroit emergency department complaining of bilateral foot pain after walking outside in the snow for 30 minutes without shoes or socks. She was unable to ambulate secondary to the pain and swelling. Physical examination revealed bilateral pallor, doughy texture, and coolness to the touch. There was generalized tenderness to palpation throughout the digits. The overlying skin was edematous, although without signs of breakdown.
To provide a resource for evidence-based Emergency Medical education, this list of must-read landmark articles was created to supplement the Emergency Medicine (EM) internship year of training. There are 52 articles so that one article can be read at leisure each week of the year. I searched national databases and polled faculty at the University of Washington to identify articles that faculty would expect any EM resident to be familiar with or that they felt were practice-changing in EM. Articles were selected for the final list based on the quality of study design, sample size, and relevance for EM residents.