The Molting Man: Anasarca-Induced Full-Body Desquamation.

Blisters and subsequent desquamation of the skin in the presence of acute edema is a well-known clinical phenomenon. In this case report, we describe a new variant that we have termed anasarca-induced desquamation in a 50-year-old man with molting of the entire cutaneous surface after acute edema, in a setting of 40-lb weight gain over 5 days. Laboratory workup for infectious causes and punch biopsies of skin lesions ruled out Stevens-Johnson syndrome and staphylococcal scalded skin syndrome, which have a similar clinical presentation to anasarca-induced desquamation.

Steroid-Refractory Lichenoid Eruption Associated with Pembrolizumab in a Patient with Non-Small Cell Lung Cancer.

Programmed cell death receptor 1 (PD-1) inhibitors are promising and effective treatments for various cancers. Cutaneous adverse events, such as lichenoid drug eruptions, are well-known common side effects associated with PD-1 inhibitors. Lichenoid drug eruptions associated with PD-1 inhibitors show rapid improvement with high potency topical steroids and do not require cessation of the offending drug.

Nonuremic calciphylaxis triggered by rapid weight loss and hypotension.

Calciphylaxis is a potentially fatal disease caused by metastatic calcification of the small- and medium-sized blood vessels of the dermis and subcutis. It most commonly is seen in patients with renal disease requiring dialysis, but it also may be triggered by nonuremic causes in patients with known risk factors for calciphylaxis. We report a case of nonuremic calciphylaxis (NUC) occurring in the setting of multiple risk factors, including chronic corticosteroid use, obesity, rapid weight loss, and hypotension.

Determinants of Success and Failure in Prehospital Endotracheal Intubation.

Introduction: This study aimed to identify factors associated with successful endotracheal intubation (ETI) by a multisite emergency medical services (EMS) agency.

Methods: We collected data from the electronic prehospital record for all ETI attempts made from January through May 2010 by paramedics and other EMS crew members at a single multistate agency. If documentation was incomplete, the study team contacted the paramedic.

Prehospital peripheral intravenous vascular access success rates in children.

Objective: Achieving successful peripheral intravenous (PIV) vascular access in children can be difficult. In the prehospital setting, opportunities are rare. Obtaining access becomes vital in emergent and life-threating conditions, such as seizures, hypoglycemia, and cardiac arrest.

The Airtraq Optical Laryngoscope in helicopter emergency medical services: a pilot trial.

Objective: To determine the degree of success helicopter emergency medical services personnel have in placing an endotracheal tube using a relatively new device for endotracheal intubation (ETI) known as the Airtraq (AT) Optical Laryngoscope (King Systems Corp, Noblesville, IN), and to determine the frequency with which flight crews had to resort to other means for advanced airway management.

Methods: This prospective, observational pilot trial evaluated the critical care flight team's ability to perform ETI using the AT as a first-line device in the prehospital setting. Flight crews were instructed to use the AT for any patient needing ETI.

Prehospital diagnosis of ST-segment elevation myocardial infarction using an "all-posterior" 12-lead electrocardiogram.

A prehospital 12-lead electrocardiogram (ECG) is commonly used for patients with suspected ST-segment elevation myocardial infarction (STEMI). This case report describes how paramedics diagnosed inferior STEMI with all ECG leads positioned on a patient's back (i.e.