Wilderness

Tick Removal

Belinda Lao, MD^* and Xiao Chi Zhang, MD^*

DOI: https://doi.org/10.21980/J8HK9H Issue 4:1 No ratings yet.

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).

Wilderness Visual EM

Lightning Ground Current Injury: A Subtle Shocker

Gregory S Podolej, MD^* and Naomi Nardi, MD^*

DOI: https://doi.org/10.21980/J8KD1C Issue 4:1 No ratings yet.

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.

Wilderness Dermatology Visual EM

Evaluation of Snake Bites with Bedside Ultrasonography

Josef E Jolissaint^*, Alexis Salerno, MD^{^} and Daniel Sheets, MD^{^}

DOI: https://doi.org/10.21980/J84S7D Issue 3:2 No ratings yet.

History of present illness: While watering his lawn, a 36-year-old man felt two sharp bites to his bilateral ankles. He reports that he then saw a light brown, 2-foot snake slither away from him. He came to the emergency department because of pain and swelling in his ankles and inability to bear weight. Physical examination revealed bilateral ankle swelling and

Wilderness Ultrasound Visual EM

Stingray Envenomation

Tanya Dall, MD^*

DOI: http://doi.org/10.21980/J86C7W Issue 2:2 No ratings yet.

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).

Wilderness Visual EM