In the spirit of roasts and fire-breathing dragons

You’re on a lovely amble through the backcountry when suddenly you see smoke rising nearby and catch a whiff of a familiar scent that throws you back to your med school OR days: burning flesh. You quickly find one obtunded, severely burned hiker who inadvertently set fire to his camp. After a quick airway assessmentRead more

In honor of a rosh review question that I got wrong, lets review Lyme disease!   Lyme disease is caused by the spirochete Boriella burgdorferi, transmitted to humans through tick bites from ixodes ticks. Location: US, endemic in NE coast, midatlantic region, and north central states. Transmission: transmission of the spirochete occurs during feeding whichRead more

It’s Freezing!

You are at elmhurst in the cardiac room. It is FREEZING outside. The triage nurse tells you there is a frequent flier in triage, EMS found him sleeping on the street with +AOB. He is confused and moaning to sternal rub. They cannot get an oral temp and they cannot find the rectal probe, butRead more

Ticked off

Today’s TR pearl is brought to you by Drs. Shearer, Hernandez, Sun and O’Halloran and summer in the Northeast. The weather is warm and people are flocking to the great outdoors. This means…ticks, as well as the tick borne diseases they may carry. For how to remove a tick, see Dr. Paulis’s excellent clinical pearlRead more

Burn Baby Burn

Happy 4th of July! I’m taking the day to review a commonly incurred injury on the holiday: burns. Whether it’s from operating a grill after a few too many libations or an unfortunate encounter with fireworks, the incidence of burns seems to go up dramatically on the 4th. While we mostly see minor burns inRead more

Bites Bites Bites

Animal Bites (Cat, Dog, Monkey, Lizard, Snake) Quick bullets to prep for in-training, let’s review Management for ALL animal bites X-ray if suspect foreign body Remove teeth Routine wound care/irrigation Update tetanus   Cats Pathogens: Pasteurella, Bartonella (cat scratch) Treatment Leave the wound open (don’t suture) Strongly consider antibiotics for ALL bites  Amoxicillin/clavulanate PCN allergic:Read more

The NYC Marathon and Heat Related Illnesses

The NYC Marathon is this Sunday! The city has been gifted with some unseasonably warm weather the past couple days, but this has the potential to cause problems for the thousands of runners. Today we will talk about heat exhaustion and stroke, which represents the most severe end of a spectrum of heat related illnesses.Read more

Jellyfish Sting Management: To Pee or not to Pee?

In preparation for July 4th weekend and upcoming beach season…let’s review a quick-to-read basic management of a jellyfish sting (not including those pesky Australian Irukandji jellyfish):   To inactivate nematocysts: Pour vinegar or acetic acid solutions for ~30 seconds (Grade 2C) Promptly remove tentacles to prevent continued venom release (avoid vigorous rubbing [Grade 1C]) Beware: detached live tentacles release venomRead more

Christmas Eve and it’s 70 degrees out…

The chef preparing your holiday meal is found in the kitchen unresponsive. He is taken to the ED and this is his EKG: What happened? As it turns out, the chef was so hot on this balmy Christmas Eve, that he decided to take a quick nap break in the freezer room.  The EKG aboveRead more

Name That Poisonous Beast!: the Final Episode

In my last day as TR, I will end with a final “Name that Poisonous Beast!”.  Farewell, to poisonous beasts everywhere!  In this case, back in the garden. Name this poisonous beast! A) And it’s amphibian colleague: B)Read more