ISSN 1059-6518



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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Critical Care Checklist


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


(aka the primary survey)

This rapid action sequence proceeds once the SCENE IS SAFE.

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What is a SOAP Note?

November/December 2011 ISSN-1059-6518 Volume 24 Number 6


What is a SOAP Note?

By Frank Hubbell, DO

Illustrations by T.B.R. Walsh


When providing patient care you have a lot of information to gather about the patient including; their past medical history, the chief complaint, vital signs, injuries, and treatment plan. As this information is gathered, it has to be organized, recorded, and able to be mobile. (Mobile in that it has to be able to travel with the patient as they move from the location of the crisis, into an ambulance, and delivered to a definitive care setting.)


The SOAP Note was developed years ago, and today it is a standardized method for organizing all of the patient’s medical information. For many years the SOAP Note has been recognized as the standard for collecting and recording patient data. As a result, it is universally recognized by pre-hospital as well as hospital-based personnel.


Use of the SOAP Note also makes it much easier to communicate, as everyone is using the same template, knows how the information will flow, and where data will be located within the structure of the document.


The SOAP note is organized into Subjective, Objective, Assessment, and Plan.

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July/August 2011  ISSN-1059-6518  Volume 24 Number 4

Disclaimer: The content of the Wilderness Medicine Newsletter is not a substitute for Read more