Bio

Clinical Focus


  • Emergency Medicine

Academic Appointments


Administrative Appointments


  • Chief, Division of Emergency Medicine, Department of Surgery (1991 - 1995)

Honors & Awards


  • DAN/Rolex Diver of the Year, Divers Alert Network (2009)
  • Hero of Emergency Medicine, American College of Emergency Physicians (2008)
  • New Orleans Grand Isle (NOGI) Award for Science, The Academy of Underwater Arts and Sciences (2006)
  • Founders Award, Wilderness Medical Society (2000)
  • Outstanding Contribution in Education Award, American College of Emergency Physicians (1999)
  • DAN America Award, Divers Alert Network (1998)
  • Diver of the Year, Beneath the Sea (2008)

Boards, Advisory Committees, Professional Organizations


  • Member, Council on Foreign Relations (2010 - Present)

Professional Education


  • Board Certification: Emergency Medicine, American Board of Emergency Medicine (1981)
  • Residency:UCLA Medical Center (1980) CA
  • Internship:Dartmouth Hitchcock Medical Center (1978) NH
  • Medical Education:Duke University School of Medicine (1977) NC

Community and International Work


  • Volunteer physician, Haiti

    Topic

    Emergency medical response

    Partnering Organization(s)

    International Medical Corps

    Location

    International

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

  • Volunteer physician, Kathmandu, Nepal

    Topic

    Emergency medical care

    Partnering Organization(s)

    Health Care Foundation of Nepal

    Populations Served

    local residents

    Location

    International

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    Yes

  • Hospitalito Atitlan, Santiago, Atitlan, Guatemala

    Topic

    Clinical practice

    Partnering Organization(s)

    Pueblo a Pueblo

    Populations Served

    local citizens

    Location

    International

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    Yes

Research & Scholarship

Current Research and Scholarly Interests


wilderness medicine; frostbite; marine envenomation; emergency medical care

Teaching

2014-15 Courses


Publications

Journal Articles


  • Poly-L-Arginine Topical Lotion Tested in a Mouse Model for Frostbite Injury WILDERNESS & ENVIRONMENTAL MEDICINE Auerbach, L. J., DeClerk, B. K., Fathman, C. G., Gurtner, G. C., Auerbach, P. S. 2014; 25 (2): 160-165

    Abstract

    Frostbite injury occurs when exposure to cold results in frozen tissue. We recently reported a novel mouse model for frostbite injury to be used in screening potentially therapeutic drugs and other modalities.We used the mouse skin frostbite model to evaluate the effect of poly-l-arginine contained in lotion (PAL) applied topically to involved skin.Sixty mice were studied in a randomized, double-blind method. Standardized 2.9-cm-diameter circles were tattooed on the mouse dorsum. Magnets snap frozen in dry ice (-78.5°C) were used to create a frostbite injury on skin within the circle as a continuous 5-minute freeze. Mice were treated with prefreeze placebo, postthaw placebo, combined prefreeze and postthaw placebo, prefreeze with PAL, postthaw with PAL, or combined prefreeze and postthaw with PAL. Appearance, healing rate, tissue loss, and histology were recorded until the wounds were healed.Application of PAL before inducing frostbite injury resulted in decreased tissue loss as compared with other treatment conditions.Applying PAL topically to frostbitten mouse skin caused decreased tissue loss. Poly-l-arginine should be studied further to determine whether it is a beneficial therapeutic modality for frostbite injury.

    View details for Web of Science ID 000336946800005

    View details for PubMedID 24631228

  • A Novel Mouse Model for Frostbite Injury WILDERNESS & ENVIRONMENTAL MEDICINE Auerbach, L. J., Galvez, M. G., De Clerck, B. K., Glotzbach, J., Wehner, M. R., Chang, E. I., Gurtner, G. C., Auerbach, P. S. 2013; 24 (2): 94-104

    Abstract

    Frostbite injury occurs when exposure to cold results in frozen tissue. To screen drugs and other field therapies that might improve the outcome for a frostbite victim, it would be helpful to have a reliable and cost-effective preclinical in vivo model.We sought to create a novel mouse skin model of induced frostbite injury. This model would allow quantification of the surface area of involved skin, histology of the wound, rate of wound healing, and skin loss in a standardized fashion after the frostbite injury.Thirty-six mice were studied. Standardized 2.9-cm diameter circles were tattooed on the mouse dorsum. Magnets frozen in dry ice (-78.5°C) were used to create a frostbite injury on skin within the circle, either as a continuous 5-minute freeze or as 3 repeated freeze (1-minute) and thaw (3-minute) cycles. Appearance, healing rate, skin surface area loss, and histology were recorded until the wounds were healed.The amount of skin surface area loss was approximately 50% for both freeze methods. Although the time to surface skin healing was similar for both freeze methods, the initial healing rate was significantly (P = .001) slower in mice exposed to the freeze-thaw cycles compared with the continuous freeze model. Histopathology reflected inflammatory changes, cell death, and necrosis.This novel in vivo mouse model for frostbite allows quantification of affected skin surface area, histology, healing rate, and skin loss and has the potential of being utilized to screen future treatment modalities.

    View details for Web of Science ID 000320290400002

    View details for PubMedID 23481507

  • Wilderness Medicine, 6th edition (textbook) Wilderness Medicine, 6th edition (textbook) Auerbach PS (editor) 2012; Elsevier
  • Civil-Military Collaboration in the Initial Medical Response to the Earthquake in Haiti NEW ENGLAND JOURNAL OF MEDICINE Auerbach, P. S., Norris, R. L., Menon, A. S., Brown, I. P., Kuah, S., Schwieger, J., Kinyon, J., Helderman, T. N., Lawry, L. 2010; 362 (10)

    View details for DOI 10.1056/NEJMp1001555

    View details for Web of Science ID 000275365900007

    View details for PubMedID 20181962

  • Physicians and the environment JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION Auerbach, P. S. 2008; 299 (8): 956-958

    View details for Web of Science ID 000253413200026

    View details for PubMedID 18314440

  • Detection of concussion using cranial accelerometry. Clinical journal of sport medicine Auerbach, P. S., Baine, J. G., Schott, M. L., Greenhaw, A., Acharya, M. G., Smith, W. S. 2015; 25 (2): 126-132

    Abstract

    To determine whether skull motion produced by pulsatile cerebral blood flow, as measured by cranial accelerometry, is altered during concussion.In phase 1, to identify a specific pattern indicative of concussion, cranial accelerometry of subjects who sustained a concussion underwent analysis of waveforms, which was compared with accelerometry from subjects without a concussion (baseline). In phase 2, this concussion pattern was tested against prospectively acquired, blinded data.High school tackle football practice and game play.Eighty-four football players.Subjects had accelerometry measurements and concurrent 2-lead electrocardiograms. In players with a concussion, multiple sequential measurements were obtained. Sport Concussion Assessment Tool 2 was used to assist clinical determination of concussion.Whether a characteristic waveform pattern of cranial accelerometry occurs in subjects with concussion.Phase 1 demonstrated a consistent pattern correlated to concussion. Phase 2 found this pattern in 10 of 13 subjects with concussion (76.9% sensitivity). Seventy-nine of 82 baseline plus nine postseason (total = 91) recordings from nonconcussed subjects did not show the concussion pattern (87% specificity).In subjects with concussion, we observed a unique pattern determined by cranial accelerometry. This may provide a method to noninvasively detect and longitudinally observe concussion.There is no objective, real-time, noninvasive, and easily accessible measure for concussion. If accelerometry is validated, it could provide a critical diagnostic tool for sports medicine physicians.

    View details for DOI 10.1097/JSM.0000000000000117

    View details for PubMedID 25010149

  • Wilderness Medical Society Practice Guidelines for the Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia: 2014 Update. Wilderness & environmental medicine Zafren, K., Giesbrecht, G. G., Danzl, D. F., Brugger, H., Sagalyn, E. B., Walpoth, B., Weiss, E. A., Auerbach, P. S., McIntosh, S. E., Némethy, M., McDevitt, M., Dow, J., Schoene, R. B., Rodway, G. W., Hackett, P. H., Bennett, B. L., Grissom, C. K. 2014; 25 (4): S66-85

    Abstract

    To provide guidance to clinicians, the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for the out-of-hospital evaluation and treatment of victims of accidental hypothermia. The guidelines present the main diagnostic and therapeutic modalities and provide recommendations for the management of hypothermic patients. The panel graded the recommendations based on the quality of supporting evidence and the balance between benefits and risks/burdens according the criteria published by the American College of Chest Physicians. The guidelines also provide suggested general approaches to the evaluation and treatment of accidental hypothermia that incorporate specific recommendations. This is an updated version of the original Wilderness Medical Society Practice Guidelines for the Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia published in Wilderness & Environmental Medicine 2014;25(4):425-445.

    View details for DOI 10.1016/j.wem.2014.10.010

    View details for PubMedID 25498264

  • Wilderness medical society practice guidelines for the prevention and treatment of acute altitude illness: 2014 update. Wilderness & environmental medicine Luks, A. M., McIntosh, S. E., Grissom, C. K., Auerbach, P. S., Rodway, G. W., Schoene, R. B., Zafren, K., Hackett, P. H. 2014; 25 (4): S4-S14

    Abstract

    To provide guidance to clinicians about best practices, the Wilderness Medical Society convened an expert panel to develop evidence-based guidelines for prevention and treatment of acute mountain sickness, high altitude cerebral edema, and high altitude pulmonary edema. These guidelines present the main prophylactic and therapeutic modalities for each disorder and provide recommendations about their role in disease management. Recommendations are graded based on the quality of supporting evidence and balance between the benefits and risks/burdens according to criteria put forth by the American College of Chest Physicians. The guidelines also provide suggested approaches to prevention and management of each disorder that incorporate these recommendations. This is an updated version of the original WMS Consensus Guidelines for the Prevention and Treatment of Acute Altitude Illness published in Wilderness & Environmental Medicine 2010;21(2):146-155.

    View details for DOI 10.1016/j.wem.2014.06.017

    View details for PubMedID 25498261

  • Wilderness medical society practice guidelines for the prevention and treatment of frostbite: 2014 update. Wilderness & environmental medicine McIntosh, S. E., Opacic, M., Freer, L., Grissom, C. K., Auerbach, P. S., Rodway, G. W., Cochran, A., Giesbrecht, G. G., McDevitt, M., Imray, C. H., Johnson, E. L., Dow, J., Hackett, P. H. 2014; 25 (4): S43-54

    Abstract

    The Wilderness Medical Society convened an expert panel to develop a set of evidence-based guidelines for the prevention and treatment of frostbite. We present a review of pertinent pathophysiology. We then discuss primary and secondary prevention measures and therapeutic management. Recommendations are made regarding each treatment and its role in management. These recommendations are graded on the basis of the quality of supporting evidence and balance between the benefits and risks or burdens for each modality according to methodology stipulated by the American College of Chest Physicians. This is an updated version of the original guidelines published in Wilderness & Environmental Medicine 2011;22(2):156-166.

    View details for DOI 10.1016/j.wem.2014.09.001

    View details for PubMedID 25498262

  • Implementing an emergency medical services system in kathmandu, Nepal: a model for "white coat diplomacy". Wilderness & environmental medicine Walker, R., Auerbach, P. S., Kelley, B. V., Gongal, R., Amsalem, D., Mahadevan, S. 2014; 25 (3): 311-318

    Abstract

    Wilderness medicine providers often visit foreign lands, where they come in contact with medical situations that are representative of the prevailing healthcare issues in the host countries. The standards of care for matters of acute and chronic care, public health, and crisis intervention are often below those we consider to be modern and essential. Emergency medical services (EMS) is an essential public medical service that is often found to be underdeveloped. We describe our efforts to support development of an EMS system in the Kathmandu Valley of Nepal, including training the first-ever class of emergency medical technicians in that country. The purpose of this description is to assist others who might attempt similar efforts in other countries and to support the notion that an effective approach to improving foreign relations is assistance such as this, which may be considered a form of "white coat diplomacy."

    View details for DOI 10.1016/j.wem.2014.04.006

    View details for PubMedID 24954196

  • Migraine Headache Confounding the Diagnosis of Acute Mountain Sickness WILDERNESS & ENVIRONMENTAL MEDICINE Karle, F. J., Auerbach, P. S. 2014; 25 (1): 60-68

    Abstract

    A 36-year-old man with a history of migraine headache attempted to hike from Lukla, Nepal, to Mount Everest Base Camp. On the sixth day of hiking, he had a migraine headache. After achieving resolution with typical therapies and rest, he ascended higher. Another headache developed that was interpreted to be a migraine. The headache was treated, and he ascended higher, after which severe symptoms of acute mountain sickness developed, necessitating his evacuation by helicopter. Persons with headaches in daily life may present challenges to diagnosis when traveling to high altitude. Careful evaluation and decision making are needed to achieve proper diagnosis and treatment of acute mountain sickness.

    View details for Web of Science ID 000332593100010

    View details for PubMedID 24462763

  • Core Content for Wilderness Medicine Fellowship Training of Emergency Medicine Graduates ACADEMIC EMERGENCY MEDICINE Lipman, G. S., Weichenthal, L., Harris, N. S., McIntosh, S. E., Cushing, T., Caudell, M. J., Macias, D. J., Weiss, E. A., Lemery, J., Ellis, M. A., Spano, S., McDevitt, M., Tedeschi, C., Dow, J., Mazzorana, V., McGinnis, H., Gardner, A. F., Auerbach, P. S. 2014; 21 (2): 204-207

    Abstract

    Wilderness medicine is the practice of resource-limited medicine under austere conditions. In 2003, the first wilderness medicine fellowship was established, and as of March 2013, a total of 12 wilderness medicine fellowships exist. In 2009 the American College of Emergency Physicians Wilderness Medicine Section created a Fellowship Subcommittee and Taskforce to bring together fellowship directors, associate directors, and other interested stakeholders to research and develop a standardized curriculum and core content for emergency medicine (EM)-based wilderness medicine fellowships. This paper describes the process and results of what became a 4-year project to articulate a standardized curriculum for wilderness medicine fellowships. The final product specifies the minimum core content that should be covered during a 1-year wilderness medicine fellowship. It also describes the structure, length, site, and program requirements for a wilderness medicine fellowship.

    View details for DOI 10.1111/acem.12304

    View details for Web of Science ID 000331297500013

  • Wilderness Medical Society Practice Guidelines for the Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia WILDERNESS & ENVIRONMENTAL MEDICINE Zafren, K., Giesbrecht, G. G., Danzl, D. F., Brugger, H., Sagalyn, E. B., Walpoth, B., Weiss, E. A., Auerbach, P. S., McIntosh, S. E., Nemethy, M., McDevitt, M., Dow, J., Schoene, R. B., Rodway, G. W., Hackett, P. H., Bennett, B. L., Grissom, C. K. 2014; 25 (4): 425-445

    Abstract

    To provide guidance to clinicians, the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for the out-of-hospital evaluation and treatment of victims of accidental hypothermia. The guidelines present the main diagnostic and therapeutic modalities and provide recommendations for the management of hypothermic patients. The panel graded the recommendations based on the quality of supporting evidence and the balance between benefits and risks/burdens according the criteria published by the American College of Chest Physicians. The guidelines also provide suggested general approaches to the evaluation and treatment of accidental hypothermia that incorporate specific recommendations.

    View details for Web of Science ID 000346895300010

    View details for PubMedID 25443771

  • In Reply to Evidence-Based Treatment of Jellyfish Stings in North America and Hawaii ANNALS OF EMERGENCY MEDICINE Auerbach, P. S. 2013; 61 (2): 253-254
  • Getting the evidence. The challenge of implementing evidence-based medicine in tough global environments. Health management technology Auerbach, P. S. 2012; 33 (12): 18-20

    View details for PubMedID 23301420

  • Prehospital Medical Care and the National Ski Patrol: How Does Outdoor Emergency Care Compare to Traditional EMS Training? WILDERNESS & ENVIRONMENTAL MEDICINE Constance, B. B., Auerbach, P. S., Johe, D. H. 2012; 23 (2): 177-189

    Abstract

    The purpose of this study was to identify the differences between the educational curricula, skill sets, and funds of knowledge required for certification as an Outdoor Emergency Care Technician (OEC-T), Emergency Medical Technician (EMT), and Emergency Medical Responder (EMR).We directly and in detail compared topics and skills presented in the OEC-T curriculum with those presented in the EMT and EMR education and training curricula.The information and skills taught in the OEC-T curriculum are in general more extensive than those taught in EMR training but are not equivalent to EMT. The OEC-T program has more depth in environmental medical issues, such as altitude illness, hyperthermia and hypothermia. Completion of the EMR program is 112 hours shorter and constitutes 30% of the duration of the EMT program. Completion of the OEC-T program (for certification only and not including additional "on-hill" patroller training) is 80 hours shorter and is half the duration of the EMT program.The OEC-T curriculum includes a skill set and fund of knowledge that exceeds those of the EMR program, but does not include all the knowledge needed for an EMT program. The OEC-T program prepares out-of-hospital providers to care for patients in the wilderness, with special emphasis on snowsports pathology. The EMT program places a greater emphasis on medical disease and emergency medication administration. These differences should be considered when determining staffing requirements for agencies caring for patients with snowsports pathology.

    View details for Web of Science ID 000305098100017

    View details for PubMedID 22656667

  • The expanded scope of emergency medical practice necessary for initial disaster response: lessons from Haiti. Journal of special operations medicine : a peer reviewed journal for SOF medical professionals Menon, A. S., Norris, R. L., Racciopi, J., Tilson, H., Gardner, J., McAdoo, G., Brown, I. P., Auerbach, P. S. 2012; 12 (1): 31-36

    Abstract

    A team of emergency physicians and nurses from Stanford University responded to the devastating January 2010 earthquake in Haiti. Because of the extreme nature of the situation, combined with limited resources, the team provided not only acute medical and surgical care to critically injured and ill victims, but was required to uniquely expand its scope of practice. Using a narrative format and discussion, it is the purpose of this paper to highlight our experience in Haiti and use these to estimate some of the skills and capabilities that will be useful for physicians who respond to similar future disasters.

    View details for PubMedID 22427047

  • Wilderness Medical Society Practice Guidelines for the Prevention and Treatment of Frostbite WILDERNESS & ENVIRONMENTAL MEDICINE McIntosh, S. E., Hamonko, M., Freer, L., Grissom, C. K., Auerbach, P. S., Rodway, G. W., Cochran, A., Giesbrecht, G., McDevitt, M., Imray, C. H., Johnson, E., Dow, J., Hackett, P. H. 2011; 22 (2): 156-166

    Abstract

    The Wilderness Medical Society convened an expert panel to develop a set of evidence-based guidelines for the prevention and treatment of frostbite. We present a review of pertinent pathophysiology. We then discuss primary and secondary prevention measures and therapeutic management. Recommendations are made regarding each treatment and its role in management. These recommendations are graded based on the quality of supporting evidence and balance between the benefits and risks/burdens for each modality according to methodology stipulated by the American College of Chest Physicians.

    View details for Web of Science ID 000292013700012

    View details for PubMedID 21664561

  • In Tribute to Charlie Houston WILDERNESS & ENVIRONMENTAL MEDICINE Rennie, D., Powers, P., Schoene, R. B., Hackett, P., Auerbach, P. S., Hornbein, T., Roach, R. C. 2010; 21 (2): 89-97

    View details for Web of Science ID 000279235900001

    View details for PubMedID 20591367

  • Wilderness Medical Society Consensus Guidelines for the Prevention and Treatment of Acute Altitude Illness WILDERNESS & ENVIRONMENTAL MEDICINE Luks, A. M., McIntosh, S. E., Grissom, C. K., Auerbach, P. S., Rodway, G. W., Schoene, R. B., Zafren, K., Hackett, P. H. 2010; 21 (2): 146-155

    Abstract

    To provide guidance to clinicians about best practices, the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for the prevention and treatment of acute mountain sickness (AMS), high altitude cerebral edema (HACE), and high altitude pulmonary edema (HAPE). These guidelines present the main prophylactic and therapeutic modalities for each disorder and provide recommendations for their roles in disease management. Recommendations are graded based on the quality of supporting evidence and balance between the benefits and risks/burdens according to criteria put forth by the American College of Chest Physicians. The guidelines also provide suggested approaches to the prevention and management of each disorder that incorporate these recommendations.

    View details for Web of Science ID 000279235900013

    View details for PubMedID 20591379

  • Environmental Education for Providers and Patients-What's a Doctor to Do? WILDERNESS & ENVIRONMENTAL MEDICINE Auerbach, P. S. 2009; 20 (3): 197-198

    View details for Web of Science ID 000270288800001

    View details for PubMedID 19737045

  • Marine catfish sting causing fatal heart perforation in a fisherman WILDERNESS & ENVIRONMENTAL MEDICINE Haddad, V., de Souza, R. A., Auerbach, P. S. 2008; 19 (2): 114-118

    Abstract

    Many marine catfish have serrated bony stings ("spines"), which are used in defense against predators, on the dorsal and pectoral fins. While catfish-induced injuries are generally characterized by the pain associated with envenomation, the stings in some species are sufficiently long and sharp to cause severe penetrating trauma. Most injuries are to the hands of victims, commonly fishermen. We report the death of a fisherman caused by myocardial perforation from a catfish sting. To our knowledge, this is the first such description in the medical literature.

    View details for Web of Science ID 000256509600007

    View details for PubMedID 18513109

  • A Case of Elevated Liver Function Tests After Crown-of-Thorns (Acanthaster planci) Envenomation WILDERNESS & ENVIRONMENTAL MEDICINE Lin, B., Norris, R. L., Auerbach, P. S. 2008; 19 (4): 275-279

    Abstract

    The crown-of-thorns starfish (Acanthaster planci) inhabits coral reefs, largely throughout the Indo-Pacific region. Its dorsal surface is covered with stout thorn-like spines. When handled or stepped on by humans, the spines can puncture the skin, causing an immediate painful reaction, followed by inflammation and possible infection. Initial pain and swelling may last for days. Effects of envenomation on the liver have been demonstrated previously in animal models, but hepatic toxicity has not previously been described in humans. We describe elevated liver enzymes in a 19-year-old female associated with A planci spine puncture wounds. To our knowledge, this is the first documented report of transaminitis in a human after A planci envenomation.

    View details for Web of Science ID 000261716100008

    View details for PubMedID 19099322

  • The relevance and future of wilderness medicine. Travel medicine and infectious disease Auerbach, P. S. 2005; 3 (4): 179-182

    View details for PubMedID 17292036

  • Environmental injuries - Foreword DM DISEASE-A-MONTH Leikin, J. B., Aks, S. E., Andrews, S., Auerbach, P. S., Cooper, M. A., Jacobsen, T. D., Krenzelok, E. P., Shicker, L., Wiener, S. L. 1997; 43 (12): 813-916

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