GEMC:Environmental Disorders

This the main page for the Global Emergency Medicine Curriculum Project's Environmental Disorders section. For point of care treatment information see the respective category page and non-GEMC notes.

Bites and Envenomations: Arthropods, Insects, Spiders, Mammals, Marine Organisms, Reptiles

Journal Articles - Open Access

• Management of simple insect bites: where's the evidence? Drug and Therapeutics Bulletin 2012;50:45-48 doi:10.1136/dtb.2012.04.0099. http://dtb.bmj.com/content/50/4/45.full
• Bhattacharjee C, Bradley P, et al. Do animals bite more during a full moon? Retrospective observational analysis BMJ 2000; 321 doi: http://dx.doi.org/10.1136/bmj.321.7276.1559 http://www.bmj.com/content/321/7276/1559
• Garbutt, F, and Jenner, R. Wound closure in animal bites Emergency Medicine Journal 2004;21:589-590 doi:10.1136/emj.2004.017962. http://emj.bmj.com/content/21/5/589.2.full
• Lavonas EJ, Ruha AM, Banner W, et al. Unified treatment algorithm for the management of crotaline snakebite in the United States: results of an evidence-informed consensus workshop BMC Emergency Medicine 2011, 11:2 doi:10.1186/1471-227X-11-2. http://www.biomedcentral.com/1471-227X/11/2
• Lewin MR, Bickler P, Heier T, et al. Reversal of experimental paralysis in a human by intranasal neostigmine aerosol suggests a novel approach to the early treatment of neurotoxic envenomation Clinical Case Reports. 2013 July DOI: 10.1002/ccr3.3. http://onlinelibrary.wiley.com/doi/10.1002/ccr3.3/full
• Malhotra P, Sharma N, et al. Fatal acute disseminated encephalomyelitis following treated snake bite in India Emergency Medicine Journal 2005, 22:308-309 doi:10.1136/emj.2004.014431. http://emj.bmj.com/content/22/4/308.full
• Ozanne-Smith J, Ashby K, and Stathakis VZ. Dog bite and injury prevention—analysis, critical review, and research agenda Injury Prevention 2001, 7:321-326 doi:10.1136/ip.7.4.321. http://injuryprevention.bmj.com/content/7/4/321.full
• Sacks JJ, Kresnow M, Houston B. Dog bites: how big a problem? Injury Prevention 1996;2:52-54 doi:10.1136/ip.2.1.52. http://injuryprevention.bmj.com/content/2/1/52.full.pdf
• Smith MR, Walker A, Brenchley J. Barking up the wrong tree? A survey of dog bite wound management Emergency Medicine Journal 2003;20:253-255 doi:10.1136/emj.20.3.253. http://emj.bmj.com/content/20/3/253.full
• Thong, BY. Barkham, TMS. Suppurative polyarthritis following a rat bite Annals of the Rheumatic Diseases 2003;62:805-806 doi:10.1136/ard.62.9.805. http://ard.bmj.com/content/62/9/805.full
• Warrell DA. Treatment of bites by adders and exotic venomous snakes BMJ 2005; 331 doi: http://dx.doi.org/10.1136/bmj.331.7527.1244. http://www.bmj.com/content/331/7527/1244

Blogs and Websites

• Mammal Bites:Answers EM Lyceum. July 2011. http://emlyceum.com/2011/07/27/mammal-bites-answers/
• Terry P. Antibiotics in non venomous snake bite. BestBETs. Alexander M. Last Modified: March 2002. http://bestbets.org/bets/bet.php?id=155
• Rosengren D. What is the dose of Australian snake antivenom? Adventure Medicine. Sep 2012. http://www.adventuremedicine.net/2012/09/dose-of-australian-snake-antivenom/
• Levine M. New snakebite recs from an unlikely source. Emergency Physicians Monthly. Oct 2011. http://www.epmonthly.com/subspecialties/toxicology/new-snakebite-recs-from-an-unlikely-source/
• Rosengren D. ACEM Winter Symposium-Irukandji Adventure Medicine. Aug 2012. http://www.adventuremedicine.net/2012/08/acem-winter-symposium-irukandji/
• Rosengren D. ACEM Winter Symposium-Box Jellyfish Adventure Medicine. Aug 2012. http://www.adventuremedicine.net/2012/08/acem-winter-symosium-box-jellyfish-update/
• Hensley J. Stop peeing on it! EBM Gone Wild. Aug 2013. http://ebmgonewild.blogspot.com/2013/08/stop-peeing-on-it.html
• Hensley J. Along came a spider. EBM Gone Wild. Aug 2013. http://ebmgonewild.blogspot.com/2013/08/along-came-spider.html
• Hensley J. And now for something completely different. EBM Gone Wild. Aug 2013. http://ebmgonewild.blogspot.com/2013/08/and-now-for-something-completely.html
• Hensley J. See you later, alligator. EBM Gone Wild. Aug 2013. http://ebmgonewild.blogspot.com/2013/08/see-you-later-alligator.html

Podcasts

• Wax P. Update on Antivenoms. 2012. From 2012 Toxicology World Congress. http://freeemergencytalks.net/2012/11/paul-wax-usa-update-on-antivenoms/ (40m43s)
• Epter M. I pulled off a tick. 2012. From AAEM Scientific Assembly 2012. http://freeemergencytalks.net/2013/01/mike-epter-i-pulled-off-a-tick/n-3-1040-i-pulled-off-a-tick-mike-epter/ (31m07s)

Videos

• Wright J, Smith L, and Castle L. Snakebite: What would Samuel do? 2013. Social Media and Critical Care. http://vimeo.com/57166701 (6m57s).
• Patwari R. Spider Bites. 2013. Academic Life in Emergency Medicine. http://youtu.be/9MhCYRFj6nI (8m31s)
• Patwari R. Hymenoptera Stings. 2013. Academic Life in Emergency Medicine. http://youtu.be/6HHxHS5_oAY (5m29s)
• Patwari R. Snakebites Intro. 2013. Academic Life in Emergency Medicine. http://youtu.be/Ew-ieJd26PU (4m10s)
• Patwari R. Rattlers. 2013. Academic Life in Emergency Medicine. http://youtu.be/DNPYHqhoGUU (5m20s)
• Patwari R. Elapid Bites. 2013. Academic Life in Emergency Medicine. http://youtu.be/5fAtkQtaKnM (5m12s)

Dysbarism: Air Embolism, Barotrauma, Decompression Syndrome

Journal Articles - Open Access

• Ahlen, C, Iverson J, et al. Diver’s hand: a skin disorder common in occupational saturation diving Occupational and Environmental Medicine 1998;55:141-143 doi:10.1136/oem.55.2.141. http://oem.bmj.com/content/55/2/141.abstract
• Hsu YL, Wang HC, and Yang PC. Desbaric air embolism during diving: an unusual complication of Osler-Weber-Rendu disease British Journal of Sports Medicine 2004;38:e6 doi:10.1136/bjsm.2002.004432. http://bjsm.bmj.com/content/38/4/e6.full
• Levett DZH, and Millar IL. Bubble trouble: a review of diving physiology and disease Postgraduate Medical Journal 2008;84:571-578 doi:10.1136/pgmj.2008.068320. http://pmj.bmj.com/content/84/997/571.full
• Raymond LW. Pulmonary barotrauma and related events in divers Chest 1995;107:1648-52. http://journal.publications.chestnet.org/data/Journals/CHEST/21715/1648.pdf
• Russi EW. Diving and the risk of barotrauma Thorax 1998;53:S20-S24 doi:10.1136/thx.53.2008.S20. http://thorax.bmj.com/content/53/suppl_2/S20.abstract
• Tetzlaff K, Reuter M, et al. Risk Factors for Pulmonary Barotrauma in Divers Chest 1197;112:654-59. http://journal.publications.chestnet.org/data/Journals/CHEST/21750/654.pdf
• Unsworth IP. Pulmonary barotrauma in a hyperbaric chamber Anaesthesia 1973;28:675-678. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2044.1973.tb00555.x/pdf
• Whelan TR. Facial nerve palsy associated with underwater barotrauma Postgraduate Medical Journal 1990;66:465-466 doi:10.1136/pgmj.66.776.465. http://pmj.bmj.com/content/66/776/465.abstract

Blogs and Websites

• Best Practice:Dysbarism BMJ Aug 2013. http://us.bestpractice.bmj.com/best-practice/monograph/1005.html
• Maini A. Dysbarism Made Easy... ED Trauma Critical Care Jan 2012. http://www.edtcc.com/blog/2012/1/21/dysbarism-made-easy.html

Slide Sets

• Arora, S. Dysbarism Jan 2013. http://www.intensivecarenetwork.com/index.php/icn-activities/icn-podcasts/455-59-sumesh-arora-on-dysbarism

Podcasts

• Arora, S. Dysbarism Jan 2013. http://www.intensivecarenetwork.com/index.php/icn-activities/icn-podcasts/455-59-sumesh-arora-on-dysbarism

Electrical Injury / Lightning

Journal Articles - Open Access

• Cohen MA. Clinical Pearls: Struck by Lightning. Academic Emergency Medicine 2001 Sep;8(9):893, 929-31. http://onlinelibrary.wiley.com/doi/10.1111/j.1553-2712.2001.tb01150.x/abstract Last accessed Sept 2013.
• Davis C, Engeln A, Johnson E, et al. Wilderness Medical Society Practice Guidelines for the Prevention and Treatment of Lightning Injuries. 'Wilderness & Environmental Medicine' 2012 Sep;23(3):260-9. doi: 10.1016/j.wem.2012.05.016. Epub 2012 Jul 31. http://www.wemjournal.org/article/S1080-6032(12)00180-9/fulltext Last accessed Sept 2013.

Blogs and Websites

• Nickson C. Lightning Injury. Life in the Fast Lane. http://lifeinthefastlane.com/education/ccc/lightning-injury/ Last accessed Sept 2013.
• Lightning Injuries. WikEM. Last modified 16 Oct 2011. http://www.wikem.org/wiki/Lightning_Injuries Last accessed Sept 2013.
• Rothwell S. Lightning Injuries Adventure Medicine. Sept 2012. http://www.adventuremedicine.net/2012/09/lightning-injuries/ Last accessed Sept 2013.
• Hensley J. What? I can't hear you! EBM Gone Wild. Sept 2013. http://ebmgonewild.blogspot.com/2013/09/what-i-cant-hear-you.html Last accessed Sept 2013.

Podcasts

• Lex J. Electrical Misadventures-Microwaves,Cords,Plugs,TASERs, and Lightning. 2010. From Giant Steps in Emergency Medicine. Accessed 8 Sept 2013. http://freeemergencytalks.net/2010/08/joe-lex-electrical-misadventures-microwaves-cords-plugs-tasers-and-lightning/ (54m20s)

High-Altitude Illness: Acute Mountain Sickness, Barotrauma of Ascent, High-Altitude Cerebral Edema, High-Altitude Pulmonary Edema

Blogs and Websites

• Hensley J. The brain wants oxygen. EBM Gone Wild. Aug 2012. http://ebmgonewild.blogspot.com/2013/08/the-brain-wants-oxygen.html Last accessed Sept 2013.
• Hensley J. Climbing? Trouble sleeping? EBM Gone Wild. Aug 2012. http://ebmgonewild.blogspot.com/2013/08/climbing-trouble-sleeping.html Last accessed Sept 2013.

Submersion Incidents: Cold Water Immersion, Near drowning

Videos

• • Schmidt A. Drowning: Critical Points for Care in the Field. 2013. Social Media and Critical Care. Accessed 19 Aug 2013. http://vimeo.com/57826732 (6m41s).

Temperature-Related Illness: Frostbite, Hypothermia

Journal Articles - Open Access

• Woo E, Lee JW, Hur G, et al. Proposed Treatment Protocol for Frostbite: A Retrospective Analysis of 17 Cases Based on a 3-Year Single-Institution Experience Arch Plast Surg 2013 Sep;40(5):510-516. Published online 2013 September 13. http://e-aps.org/DOIx.php?id=10.5999/aps.2013.40.5.510 Last accessed Oct 2013.

Videos

• • Oosterloo M. Dead cold, winter can be murder. 2013. Social Media and Critical Care. Accessed 19 Aug 2013. http://vimeo.com/57872537 (6m24s).