Contributor: Peter Bakes, MD Educational Pearls: Lyme disease gives a single expanding target lesion with central clearing called erythema chronicum migrans Erythema multiforme is another targetoid rash that presents with multiple target lesions Characterized into erythema minor and major based on severity but typically resolves More severe hypersensitivity reactions include Stevens-Johnson Syndrome (<10% skin involvement),…
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should have ordered in Chief Complaint: Hand Burn HPI: 23-year-old right hand dominant male presenting to the emergency department for a burn to the left hand which he sustained just prior to arrival. He reports that he was frying chicken when the oil started on fire. In a panic, he ran with the pan outside…
Read MoreContributor: John Winkler, MD Educational Pearls: Swimmers itch is due to a flatworm parasitic infection that causes an itchy rash after the worm burrows into the skin The flatworm is passed between bird and snail hosts The itch is due to the death of the parasite under the skin which leads to an extremely itchy…
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Calcium burns Chief Complaint: Calcium Burns HPI: 46 year old male with past medical history of ESRD on HD, hypertension, congestive heart failure and secondary hyperparathyroidism underwent a subtotal parathyroidectomy without complications 18 days ago. Pt had extravasation of IV calcium chloride infusion to his right forearm 17 days ago; hand surgery was consulted and…
Read MoreBurns 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…
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