User:XCAC111/sandbox

Welcome to your sandbox!
This is place to practice clicking the "edit" button and practice adding references (via the citation button). Please see Help:My_sandbox or contact User_talk:JenOttawa with any questions.

Link: Project Homepage and Resources


 * Note: Please use your sandbox to submit assignment # 3 by pasting it below. When uploading your improvements to the article talk page please share your exact proposed edit (not the full assignment 3).


 * Talk Page Template: CARL Medical Editing Initiative/Fall 2019/Talk Page Template

Assignment 2
'''Davis, C., Engeln, A., Johnson, E. L., McIntosh, S. E., Zafren, K., Islas, A. A., ... & Cushing, T. (2014). Wilderness Medical Society practice guidelines for the prevention and treatment of lightning injuries: 2014 update. Wilderness & environmental medicine, 25(4), S86-S95.''' Amy Chen

1. I searched for a source in the pubmed. I wanted to find a practice guideline because those contain information in a well-organized manner and will serve as a good review to capture the main points when considering a disease.


 * 1) My search terms were lightning injury AND practice guidelines AND treatment AND prevention
 * 2) This was the first one that came up

2. I also searched within the trip database for similar terms.


 * 1) https://emedicine.medscape.com/article/770642-treatment

3. I chose this one because it was a more comprehensive source than the other two. This practice guideline was also succinct and contained relevant facts that would be appropriate for a wiki page. The third source that I considered was also the previous version, so I chose this more recent version with the 2014 update.

4. This sources meets the Wikipedia MEDRS criteria for the following reasons:


 * 1) Secondary resource: this is a clinical practice guideline for wilderness medicine. This is not a primary source such as an RCT or cohort study.
 * 2) Reputable source: this source is published by a professional society; this is published by the Wilderness Medical Society. This document was also published by a reputable journal by the Wilderness Medical Society called Wilderness & Environmental Medicine.
 * 3) Up-to-date: This document was published within the last 5 years and still contains relevant information.

5. I plan to use this document to improve the description of the current lightning injury page which lack more succinct and relevant information for health effects. This document also has the clinical practice guidelines surrounding treatment which is also inadequate on the page we are editing.

= Assignment 3 - Lightning Injury =

Proposed Changes
1) I plan to add a few more symptoms to the Signs and Symptoms section, specifically adding "burns", "functional and behavioral changes", and "vision loss". I will also be adding another small description on keraunoparalysis, another common sign/symptom of lightning injury. This information will be paraphrased from the source used for assignment 2.


 * I think I might clarify "vision loss" as "ocular cataracts" - I think vision loss suggests something more acute but classically its delayed onset of cataracts that are associated with lightning strikes. - HW

Lightning injury can also induce a transient paralysis known as keraunoparalysis. Signs and symptoms of keraunoparalysis include lack of pulse, pallor or cyanosis, and motor and sensory loss in the extremities. However, keraunoparalysis usually resolves within a few hours.


 * Good addition - can I suggest we change it to "Lightning strikes can also induce..." as opposed to lightning injury? I think that makes a bit more sense. Otherwise I'm excited to this get added since it is commonly talked about/reference in relation to lightning injuries and seemed like a big gap in the page - HW

Rationale for proposed changes
2) For the first change, I wanted to include some more signs and symptoms associated with lightning injuries to give a more comprehensive overview of signs and symptoms. The original text was a bit limited in terms of symptoms experienced after lightning injuries. The second change with the addition of keraunoparalysis outlines another common symptom that lightning injury may cause. I chose to use the Wilderness and Environmental Medicine Journal Practice Guidelines for the Prevention and Treatment of Lightning Injuries because of the practicality of the information included. The practice guideline is concise and contains useful information for the diagnosis and treatment of lightning injuries.

3) Some varied opinions around these changes may be around the fact that keraunoparalysis will be added to the signs and symptoms section. Although keraunoparalysis is a symptom caused by lightning injury, it is also an important consideration within treatment of lightning injury. This is due to the lack of pulse that the person undergoes and the precautions around treating someone with keraunoparalysis. Therefore, some may feel that it may belong in the treatment section. However, I moved forward with my decision because I thought that treatment should strictly fall under the treatment section of the page.

Critique of Source
4) This source is lower on the hierarchy of evidence and may contain bias. Practice guidelines are made by experts in the field are are therefore influenced by subjectivity. However, there did not seem to be financial conflict of interest or conflict of interest due to other factors at stake and the content was written in an objective sense. The methods section of the guideline was also comprehensive. The evidence used and the content were reviewed by a panel of diverse experts and assessed using a classification scheme for grading evidence and recommendations. Although Wilderness Medicine physicians may have their own perspective on lightning injury diagnosis and treatment and may have included information only relevant to their work. However, the guide was comprehensive because it included a range of signs and symptoms and treatments of various body systems so I decided it was still appropriate and objective enough to use to update the signs and symptoms section of the Wiki.