ISSN-1059-6518
Volume 26 Number 1
Critical Care Check List
By Frank Hubbell, DO
The Big Idea is that, occasionally, significant life-threatening injuries do occur, and when they do, we have to be able to quickly react to them. The last time that we did a review article on these life-saving skills was in 2007.
The life-saving, critical care skills are not used nearly as often as the more common non-critical care skills. The vast majority of the time our patients are conscious, coherent, and can tell us exactly what happened, when it happened, and where it hurts. They usually have only one primary injury, and it is rarely life-threatening.
Because of this, our critical care skills tend to get a little dusty. It is well worth it to every once and a while to take the time to blow off the dust and polished these skills.
What follows is a concise, step-by-step review list to help practice and remember these life-saving skills, so they will come to mind when they are needed. For life-saving skills to be effective, the life-threat has to be recognized quickly and dealt with effectively. Time is of the essence, but it is also equally important not to miss anything.
To make this task as efficient and accurate as possible, it is best to use a step-by-step list, trying to avoid any detours that will only result in confusion and the possibility of missing a critical step and diagnosis.
These are the Principles of Rapid Critical Care Evaluation for Detecting and Managing Life-Threats:
Change in Level Of Consciousness – CVA, diabetes
Shortness of Breath – asthma, chocking, anaphylaxis, pneumothorax
Chest Pain – acute coronary syndrome
Shock – hypovolemic, neurogenic, cardiogenic, obstructive
RAPID CRITICAL CARE EVALUATION:
(aka the primary survey)
This rapid action sequence proceeds once the SCENE IS SAFE.
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URUSHIOL and RASHES
/in Allergies, Poisons, Rash, Skin itching, Uncategorized/by WMN EditorsISSN-1059-6518
URUSHIOL and RASHES
By Frank Hubbell, DO
Illustrations By T.B.R. Walsh
What do cashews, mangos, and pistachios have in common with poison ivy? As unbelievable as it seems, they share one very unpleasant secret: urushiol.
Most everyone loves cashew nuts, considering them a tasty treat. Recently we were in Costa Rica, and as we were heading for a National Park, the driver of our tour bus stopped by the side of the road to pick a funny-looking, pear-shaped, bright red fruit from a tree. After he gave the fruit to us to exam, he explained that it was a cashew apple and attached to the bottom of it was a single cashew nut, referred to as drupe. He then related that the cashew was a member of the poison ivy family and was, which quite toxic.
What’s up with that?
As it turns out cashews, mangos, pistachios, ginko bilboa, poison ivy, poison oak, and poison sumac all belong to the same plant family Anacardiaceae. What these plants all have in common is that they contain the toxin urushiol.
Urushiol is an oily organic allergen that is well known for causing the classic red, itchy poison ivy rash.
Urushiol Facts: This is one amazing toxin!
– Only 1 nanogram (one billionth of a gram) of the urushiol will cause the rash.
– An average of 100 nanograms of the urushiol will cause a rash in 90% of people.
– ¼ ounce of urushiol is all that is needed to cause a rash on every person on earth.
– The amount of urushiol that would fit on the head of a pin will cause a rash on 500 people.
– Urushiol will remain active for 1 – 5 years on surfaces, in clothing, and on plants that have died. This explains why people can get poison ivy rashes in the middle of the winter when the plants are dormant or gone.
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THE WONDERFUL WORLD OF SPIDERS
/in Bites and Stings, Poisons, Travel Medicine/by WMN EditorsISSN 1059-6518
THE WONDERFUL WORLD OF SPIDERS
By Frank Hubbell, DO
Illustrations by T.B.R. Walsh
It is said that there are so many spiders in the world that you are never more that 10 feet away from one. With over 50,000 species of spiders this is probably true. However, there only a few that can harm humans. Even though there are only a few that are dangerous to humans, most people still have a disproportionate fear of itsy, bitsy, spiders.
Taxonomic rank of spiders:
Kingdom – Animalia
Phylum – Arthopoda
Subphylum – Chelicerata
Class – Arachnida
Order – Araneae
Family – there are 109 families of spiders
Species – there are 50,000 species of spiders
Note that spiders are members of the phylum Arthopoda, in the class Arachnida not Insecta. SPIDERS ARE NOT INSECTS.
There are 11 orders of the class Arachnida:
Listed below are the orders of spiders with examples of each order:
Acari – ticks and mites
Amblypygi – whip scorpions
Araneae – spiders
Opiliones – harvestmen or daddy longlegs
Palpigradi – tiny whip scorpions
Pseudoscorpions – tiny spiders with scorpion like with pincers
Ricinulei – hooded tickspiders
Schizomida – small spiders that live in the upper layers of soil
Scorpions – scorpions
Solifugae – camel, wind, or sun spiders
Thelyphonida – vinegarrons or large whip scorpions
This article will focus primarily on the order Araneae, spiders, and, in particular, the ones that are considered dangerous to humans.
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Activated Charcoal
/in Poisons/by WMN EditorsISSN-1059-6518
Volume 26 Number 1
Activated Charcoal
By Frank Hubbell, DO
What is activated charcoal for?
Activated charcoal is used to treat certain types of ingested poisonings as well as in water purification filters to remove toxins and unwanted tastes.
How does it work?
Activated charcoal works by having a large surface area and being highly absorptive. After absorbing and binding the poison in the stomach and small intestine, thus, preventing it from being absorbed into the system, it will then pass out of the digestive tract along with the feces.
How is it made?
Charcoal is finely ground and heated in the presence of oxygen. This causes the charcoal to become very porous, increasing the surface area of the charcoal and creating a large number of traps that will absorb and hold other compounds, especially poisons.
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Critical Care Checklist
/in Medical Response, Patient Assessment, Treatment/by WMN EditorsISSN-1059-6518
Volume 26 Number 1
Critical Care Check List
By Frank Hubbell, DO
The Big Idea is that, occasionally, significant life-threatening injuries do occur, and when they do, we have to be able to quickly react to them. The last time that we did a review article on these life-saving skills was in 2007.
The life-saving, critical care skills are not used nearly as often as the more common non-critical care skills. The vast majority of the time our patients are conscious, coherent, and can tell us exactly what happened, when it happened, and where it hurts. They usually have only one primary injury, and it is rarely life-threatening.
Because of this, our critical care skills tend to get a little dusty. It is well worth it to every once and a while to take the time to blow off the dust and polished these skills.
What follows is a concise, step-by-step review list to help practice and remember these life-saving skills, so they will come to mind when they are needed. For life-saving skills to be effective, the life-threat has to be recognized quickly and dealt with effectively. Time is of the essence, but it is also equally important not to miss anything.
To make this task as efficient and accurate as possible, it is best to use a step-by-step list, trying to avoid any detours that will only result in confusion and the possibility of missing a critical step and diagnosis.
These are the Principles of Rapid Critical Care Evaluation for Detecting and Managing Life-Threats:
Change in Level Of Consciousness – CVA, diabetes
Shortness of Breath – asthma, chocking, anaphylaxis, pneumothorax
Chest Pain – acute coronary syndrome
Shock – hypovolemic, neurogenic, cardiogenic, obstructive
RAPID CRITICAL CARE EVALUATION:
(aka the primary survey)
This rapid action sequence proceeds once the SCENE IS SAFE.
Read more