Emergency medicine clinics of North America
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Cold injury has been documented for centuries and remains a concern for military personnel, winter recreationalists, and urban homeless populations. Treatment advances in the last decades have included thrombolytic and prostaglandin therapies however the mainstay remains early recognition and rapid rewarming. This chapter focuses on frostbite, with a brief overview of other cold related conditions.
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Altitude-related illness occurs as a result of inadequate acclimatization. The mainstay of prevention is a slow, graded ascent profile which gives the body time to respond to a low-oxygen environment. The diagnosis of these conditions is often difficult in resource-limited environments, so history and a physical exam are key in identifying patients who will require descent and evacuation. Treatment modalities such as supplemental oxygen, portable hyperbaric chambers, and medications, are all temporizing measures until the patient can be safely evacuated to a lower elevation.
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Emerg. Med. Clin. North Am. · Aug 2024
ReviewTick-Borne Illnesses in Emergency and Wilderness Medicine.
This review highlights the causative organisms, clinical features, diagnosis, and treatment of the most common tick-borne illnesses in the United States, including Lyme disease, Rocky Mountain spotted fever, anaplasmosis, ehrlichiosis, tularemia, Powassan virus, and alpha-gal syndrome. Tick bite prevention strategies and some basic tick removal recommendations are also provided.
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This text serves to familiarize readers with animal bites and attacks. Topics include appropriate management of animal bite wounds, postexposure prophylaxis for possible rabies exposures, and unique infectious diseases transmitted through animal vectors. Large mammal attacks are discussed, in addition to the management of smaller animal attacks and exposures.
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Emerg. Med. Clin. North Am. · Aug 2024
ReviewClinical Management of North American Snake and Marine Envenomations.
Envenomations are the 23rd most common reason for calls to US poison control centers, with over 35,000 incidents reported annually. Snake bites account for over 20% of those calls, while marine envenomations are likely underreported at 3% to 4%.1 While these types of envenomations may not be encountered on a daily basis for many physicians, the different types of envenomations warrant unique management strategies based on the offending creature and symptom presentation. This text serves as a review of the epidemiology, clinical presentations, and management of endemic North American species of snakes and marine vertebrate and invertebrate envenomations.