Comments for Receiving. http://drhem.com the place for EM Tue, 07 Feb 2012 13:29:54 +0000 hourly 1 http://wordpress.com/ Comment on Senior Report 5.12 by John Wilburn http://drhem.com/2012/02/06/senior-report-5-12/#comment-2985 Tue, 07 Feb 2012 13:29:54 +0000 http://drhem.com/?p=2294#comment-2985 1.
2.
3.

I’m coming for the # 1 Spot

John

]]> Comment on Intern Report 5.11 by Adam R http://drhem.com/2012/01/30/intern-report-5-11/#comment-2942 Thu, 02 Feb 2012 02:50:33 +0000 http://drhem.com/?p=2282#comment-2942 (secret answers)

]]> Comment on Intern Report 5.10 by matt http://drhem.com/2012/01/23/intern-report-5-10/#comment-2931 Mon, 30 Jan 2012 23:46:31 +0000 http://drhem.com/?p=2273#comment-2931 CDC recc for inhalational bioweapon exposures are for a poly drug regime:
ciprofloxicin or doxycycline, plus 1 or 2 other drugs(rifampin, vancomycin, penicillin, ampicillin, chloramphenicol, imipenim, clindamycin, clarithromycin) with caution that naturally occuring beta-lactamase in native B. anthracis is relativly high, so the ‘cillins are not good initial choices.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5042a1.htm#tab1

I’m not sure if the previous terroism events around 2001 were single strain or not. With a natural infection a single strain is thought to predominate. Sverdlovsk PCR has revealed at least 4 separate strains from autopsy samples. I have been unable to chase down the complete epidemiology but with a bioweappn unusual things can crop up like the published autopsy data, 42 cases, 9 female and no kids, out of 70 fatalities, interesting for a weapon. The other articles frequently list the fatalities as “70 people” without demografic identifiers.

Pathology of inhalational anthrax in 42 cases from the Sverdlovsk outbreak of 1979.
Abramova FA, Grinberg LM, Yampolskaya OV, Walker DH.
Proc Natl Acad Sci U S A. 1993 Mar 15;90(6):2291-4.

Proc. Natl. Acad. Sci. USA
Vol. 95, pp. 1224–1229, February 1998
Microbiology

As a bioweapon you will like see multiple strains with likely variations in antibiotic resistence across the various strains choosen for dispersal. Generally what is published seems to support the “Go Big or Go Home” or “Kill it all and let the ID Docs sort it out” philosophy

]]> Comment on Case 5.6 by Frankie http://drhem.com/2011/12/12/case-5-6/#comment-2770 Thu, 15 Dec 2011 22:27:19 +0000 http://drhem.com/?p=2209#comment-2770 :) snakes on a plane.

]]> Comment on Case 5.6 by Tim Scott http://drhem.com/2011/12/12/case-5-6/#comment-2768 Thu, 15 Dec 2011 19:52:35 +0000 http://drhem.com/?p=2209#comment-2768 1.
2.
3.
4.

I love snakes. I’m going to put one in Kristi’s stocking as a special gift for her on xmas morning.

]]> Comment on Case 5.6 by Kristi Maso http://drhem.com/2011/12/12/case-5-6/#comment-2754 Tue, 13 Dec 2011 02:35:26 +0000 http://drhem.com/?p=2209#comment-2754 1)
2)
3)
4)

5) I hate snakes…by the way.

]]> Comment on Case 5.4 by Tim Scott http://drhem.com/2011/11/28/case-5-4/#comment-2692 Fri, 02 Dec 2011 16:39:51 +0000 http://drhem.com/?p=2165#comment-2692 I want to change my answer to #3 from A to C. Thank you.

Tim

]]> Comment on Case 5.4 by John Wilburn http://drhem.com/2011/11/28/case-5-4/#comment-2679 Thu, 01 Dec 2011 20:57:53 +0000 http://drhem.com/?p=2165#comment-2679 1. Greater Trochanters of the femurs
2. Windswept pelvis fractures (lateral Compression fx’s
3. Loss of voluntary rectal tone, however pubic symphysis >1cm widening has been shown to result in Bladder injuries/Urethra injuries more so than other types of pelvic fractures

]]> Comment on Case 5.3 by Craig Sharkey http://drhem.com/2011/11/21/case-5-3/#comment-2667 Sat, 26 Nov 2011 05:49:45 +0000 http://drhem.com/?p=2144#comment-2667 1 a, 2 a, 3 a

]]> Comment on Case 5.3 by Jeff http://drhem.com/2011/11/21/case-5-3/#comment-2666 Sat, 26 Nov 2011 04:16:29 +0000 http://drhem.com/?p=2144#comment-2666 A………A………A!

]]>