Contributor: Megan Hurley, MD Educational Pearls: Heat cramps Occur due to electrolyte disturbances Most common electrolyte abnormalities are hyponatremia and hypokalemia Heat edema Caused by vasodilation with pooling of interstitial fluid in the extremities Heat rash (miliaria) Common in newborns and elderly Due to accumulation of sweat beneath eccrine ducts Heat syncope Lightheadedness, hypotension, and/or…
Read MoreContributor: Megan Hurley, MD Educational Pearls: Initial assessment of patients with severe burn injuries begins with ABCs Airway: consider inhalation injury Breathing: circumferential burns of the trunk region can reduce respiratory muscle movement Circulation: circumferential burns compromise circulation Exposure: Important to assess the affected surface area Escharotomy: emergency procedure to release the tourniquet-ing effects of…
Read MoreContributor: Aaron Lessen, MD Educational Pearls: How fast does cellulitis recover? A recent prospective cohort study took a look at this question. The study included 300 adults with cellulitis (excluding those with peri-orbital cellulitis or abscesses) in two emergency departments in Queensland, Australia. They collected data from initial and follow-up surveys at 3, 7, and…
Read MoreContributor: Aaron Lessen, MD Educational Pearls: Monkeypox transmission is still occurring in the United States Transmitted by contact to exposed lesion MSM are a high-risk group for monkeypox infection Symptoms include rash and flu like symptoms Monkeypox lesions are often described as blister-like, firm, clear, and rubbery Most commonly develop on the face and/or anogenital…
Read MoreContributor: Peter Bakes, MD Educational Pearls: Mild frostbite injury usually only requires supportive care In severe frostbite injury, patients should receive an immediate angiogram, be admitted, and receive tPA if there is evidence of vascular occlusion Salvage rate is around 80% for appropriate patients who receive tPA in phalangeal frostbite injury References Paine RE, Turner…
Read MoreContributor: Chris Holmes, MD Educational Pearls: Parkland Formula: 4 mL x [Total Body Surface Area Burned (%)] x [body weight (kg)] given in 24 hours 50% given over 8 hours and 50% given over the next 16 hours Brooke Formula: 2 mL x [Total Body Surface Area Burned (%)] x [body weight (kg)] given in…
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mr. freeze Chief Complaint: Painful wounds on skin for months HPI: 32-year-old male with past medical history of alcohol use disorder and general anxiety disorder presents with painful skin wounds to the right thigh for approximately four months. He curbed his cravings for EtOH with inhalant use. He uses keyboard duster cans several times a…
Read MoreContributor: Jared Scott, MD Educational Pearls: Hand eczema is present in about 10% of the population and has a great prevalence in hairdressers, healthcare workers, and food service employees Using 1% oatmeal cream instead of a base cream showed statistically significant improvement in outcomes of HE in healthcare workers in a double-blind study References Sobhan…
Read MoreContributor: Ricky Dhaliwal, MD Educational Pearls: Primarily affects children <6 years old and adults with kidney disease Caused by staph aureus releasing exotoxins that result in erythema and sloughing of the skin Present with significant pain, dehydration and underlying staph infection Treatment typically oxacillin/nafcillin with admission for wound care with petroleum gel and xeroform Burn…
Read MoreContributor: 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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