Burns are low-volume, high-acuity injuries that require special attention and care from the pre-hospital team to the Emergency Department and finally to a dedicated burn unit and ICU. As a first responder in the pre-hospital setting, there are a couple things that need to remain at the forefront of your mind when dealing with burn…
Read MoreAuthor: Don Stader, MD Educational Pearls: Three options for a blister in partial thickness burns: do nothing, unroof it, or poke a hole in it Recent study suggest that aspirating the blister may be more effective in regards to wound healing The overlying skin acts as a bio-band-aid and patients recover slightly faster References:…
Read MoreAuthor: Sue Chilton, MD Educational Pearls: Triad of fat emboli syndrome is a petechial rash, AMS, and respiratory distress. Petechiae usually start in the axilla. 90% of patients with long bone fractures will shed fat. May see ground-glass opacities on imaging, but perfusion defects will not be seen on CTA or V/Q scan Patients with…
Read MoreAuthor: Nick Hatch, M.D. Educational Pearls Honey can be used to treat burns because it has antibacterial properties. In one study, honey outperformed silver sulfadiazine for burn treatment, but more research is needed in this area. In practice, honey is likely more useful outside the ER than inside the ER. References: Gupta SS, Singh O,…
Read MoreRun Time: 7 minutes Author: Greg Burcham M.D. Educational Pearls: Case presentation: A 48 year-old male cyclist travels to new england for a race. Afterwards he is sore, tired and fatigued, but 1 week later back in Colorado he is still sore, tired, and fatigued, and he also noticed a rash that started after a…
Read MoreRun Time: 2 minutes Author: Michael Hunt M.D. Educational Pearls: The first case of skin botulism from the use of black tar heroin in Colorado was documented in July of 2016. Botulism is most deadly toxin known to man and originates from the genus of tetanus and difficile – Clostridium botulinum. Characteristics of botulinum, bulbar…
Read MoreRun Time: 2 minutes Author: Ian Gillman PA-C Educational Pearls: While cellulitis is a very common condition seen in the ER, there are other conditions that can mimic cellulitis. Some of these conditions are gout, pseudogout, erythema migrans, gas gangrene, osteomyelitis, and necrotizing fasciitis. An ultrasound can be performed to confirm cellulitis, which would be…
Read MoreRun Time: 7 minutes Author: Dr. Samuel Killian Educational Pearls: Presentation: A fever and nasal congestion that began in an infant one week ago but has resolved. A rash that was predominantly over the cheeks but has spread to the rest of the body. No pain with the rash, just blistering. Diagnosis: Fifth disease or…
Read MoreRun Time: 14 minutes Author: Dr. Donald Stader Educational Pearls: When a patient comes in with purpura the way to think is outside in, because there is a long list of things that can cause purpura. The most common cause of purpura is trauma. The next level is a blood vessel problem; Ehler’s-Danlos Syndrome, Vitamin…
Read MoreRun Time: 4 minutes Author: Dr. Samuel Killian Educational Pearls: Pityriasis rosea is a papulosquamous rash believed to be caused by a virus (although no one has identified the agent) presenting with a salmon-colored patch followed by the presentation of lesions that follow the cleavage lines forming a “christmas tree” pattern. Treatment is supportive with antihistamines…
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