by James Hubbard, M.D., M.P.H.

I still remember when a sweet, smiling little girl came into my office a few years back. She had injured her wrist. I did my usual exam which includes palpating areas of tenderness. Well I hit a sore spot; she let out a yelp and sobbed “why did you hurt me?” I felt so bad, but was tempted to tell her that’s what doctors do (not really). Instead I explained I needed to know what specific area was injured so I would know where to look on an x-ray. I don’t think she bought it.

At any rate, I thought of this when I read an Academy of Emergency Medicine study concluded the Ottawa Ankle Rules could be applied to as young as 6 years old and up. What are these rules? (more…)

by James Hubbard, M.D., M.P.H.

Continuing our skin-care series this week (see “Related Posts” at the end of this entry for more), I’ll now cover burns.

There a few general things to remember in treating burns caused by external heat.

1. They are not immediately life-threatening unless they pose a risk to your airway from damage or swelling of your face or neck, or involve 10 percent or more of your skin surface.
2. You can estimate skin surface by the rule of nines.  Each arm accounts for 9 percent total body surface, as does your face, including neck.  Each leg is 18 percent.  The front part of your trunk is 18 percent, as is the back part.  The last 1 percent goes for the genital area.  Another estimate is your palm is close to 1 percent.
3. The first thing to do is to try to limit the damage.  Remove any hot or restrictive items and run cold water over the affected area.  Don’t use ice because it may constrict needed blood flow to the area.  Never use grease, butter or ointments that may hold the heat in.
4. The first assessment on how to treat depends on surface area and depth of skin damage (degree). (more…)

by James Hubbard, M.D., M.P.H.

Many people I see with skin trauma tell me they didn’t know whether the wound is serious enough to warrant coming in.

Here are some tips on when to see a doctor for a cut—and what you can do at home. Remember, this if for information only. Everyone is unique and specific recommendations need to come from your personal doctor. (more…)

by James Hubbard, M.D., M.P.H.

Many times, it’s clear when someone is struck by lightning due the blinding flash and deafening boom.  However, as I wrote in a previous post, lightning can travel up to 10 miles, so a strike can happen on a sunny day.  Then the diagnosis may get difficult.

If someone who’s not been in your sight walks up confused with disheveled, even missing clothes, suspect it.  However, in this case, there’s not much you can do other than try to comfort and call 911 if available.

If you’re the one struck and are still awake, be thankful. You have good odds of surviving.  Seek shelter and get help.  Much of the following information can be applied to your situation.

HOW LIGHTNING HARMS YOU

Lightning can injure in several ways. (more…)

by James Hubbard, M.D., M.P.H.

I live in Colorado on the side of a mountain and can see miles and miles of sprawling plains from my back deck.  Lightening storms are better than the best fireworks display.  We see whole clouds light up, bolts across the sky and many that hit the ground.  I always wonder what it hit and hope it was not somebody.

There are only two safe places during a storm.  One is inside a sturdy building with grounding in place, like a house with plumbing and wiring in the walls.  Of course, stay away from plumbing, wiring and phone lines.  The other is inside an automobile with a metal roof, but not for the reason you think.  It’s not the rubber tires that keep you safe; it’s the metal surroundings that ground the lightening.  Be sure to not touch metal inside the vehicle.  Convertibles and cloth roofs don’t cut it, even with a rollover bar.

I’m sorry to say, but nowhere outside is safe, even for a storm 10 miles away.  The electrical current can strike you in at least five different ways. (more…)