Wilderness

Creative Commons images
Wilderness, Visual EM

Brown Recluse Spider Bite

/

Examination of the skin revealed erythema and induration on the right lateral leg 12 cm in diameter with a 6 cm area of central necrosis and surrounding petechiae without fluctuance or crepitus. The patient was neurovascularly intact distal to the lesion. Laboratory values were within normal limits, except for an elevated C-reactive protein (5.31 mg/dL, normal range <0.70 mg/dL). The patient was diagnosed with ulceration secondary to envenomation from a brown recluse spider.

Wilderness, Curricula

Emergency Medicine Curriculum Utilizing the Flipped Classroom Method: Environmental Emergencies

/

Through a flipped classroom design, we aim to teach the presentation and management of environmental emergencies, specifically cold related illness, heat related illness, undersea medicine, high altitude medicine, submersion, electrocution, radiation injury, and envenomation. This unique, innovative curriculum utilizes resources chosen by education faculty and resident learners, study questions, real-life experiences, and small group discussions in place of traditional lectures. In doing so, a goal of the curriculum is to encourage self-directed learning, improve understanding and knowledge retention, and improve the educational experience of our residents.

Creative Commons images
Wilderness, Visual EM

Tick Removal

/

On physical exam, an engorged tick was found attached to the patient’s left upper back.  The underlying skin was nontender but mildly erythematous, without central clearing. The tick was gently removed with blunt angle forceps and sent for further analysis, which later revealed the specimen to be an American dog tick (Dermacentor variabilis).

Creative Commons images
Wilderness, Dermatology, Visual EM

Lightning Ground Current Injury: A Subtle Shocker

/

The first photograph demonstrates a dendritic blister (Lichtenburg figure) on the medial aspect of his right foot where the ground current injury entered the patient’s foot. Although no data exists regarding the sensitivity or specificity of Lichtenberg figures as skin findings, they are considered pathognomonic for lightning injuries and are not produced by alternating current or industrial electrical injuries. The second photograph demonstrates a 4 x 3 cm area of petechiae where the ground current injury exited the patient.

Creative Commons images
Wilderness, Visual EM

Stingray Envenomation

/

Physical exam revealed a 3cm laceration to the ulnar side of the dorsum of the left hand with minimal hand swelling. There was no exposed tendon or bone, the hand was neurovascularly intact and had full strength. A small barb was visualized and removed from the injury site. Radiograph of the left hand confirmed that there was no remaining barb (see normal x-ray).

Scroll to Top