Malaria Prophylaxis

Josh Mularella, DO20150 Comments


You leave next month for a 3 week trip around Southeast Asia with several friends. They are all looking to you for advice on what to take for malaria prophylaxis. Do you even remember malaria from medical school? Here is some help… Different Species Plasmodium falciparum– found throughout the tropics, responsible for most deaths Plasmodium vivax– half of infections outside of … Read More

Revisiting the GCS in 2015

Josh Mularella, DO20150 Comments


The Glasgow Coma Scale (GCS) was devised by Sir Graham Teasdale and Bryan Jennett in 1974 to assess the depth of impaired consciousness/coma following trauma (falling off bar stools and hitting your head). The scale has since been adopted internationally and is now even used in non-traumatic settings. But how exactly do YOU calculate the GCS? Sometimes it looks like a … Read More

Into the wild – again

Josh Mularella, DO20150 Comments


In June 1997 I left the confines of Boston behind and spent the summer working at Denali National Park in Alaska. My college friend Lara, whom I met in the university outing club (and the subject of my awesome photo above) came along as well. I worked in the employee dining room and she made beds. It was a great … Read More

The disappearing discriminatory zone

Josh Mularella, DO20150 Comments


  And of course my first real post is about something not at all related to wilderness medicine. Let me explain… I have been self-quarantined for the past three days with a constant cough, sore throat and runny nose. The Brits in my class refer to it as the “freshers”, the result of living with people from other countries for the … Read More