Tasty Morsels of EM 012

8 Jul

I keep a little, ever-expanding note on my phone where I jot down little morsels of goodness that I pick up while listening to or reading one of the many excellent sites/podcasts in the useful resource section.

I’ll try and transfer them here for your enlightenment.

From Billy Mallon over on EM Core Content (free video)

  • big difference between cellulitis and nec fasciitis; one confined to skin; one to the deeper tissues
  • some things that might make you think of nec fasc:
  1. necrotic skin
  2. bullous changes
  3. dishwater coloured drainage from the bullae/tissue
  4. everyone’s favourite: pain out of proportion
  5. crepitus
  6. people with DM, immunosuppression, lines in situ or water exposure
  • the important thing is not antibiotics but surgery
  • to convince a surgeon you might need some imaging and MRI probably best
  • bugs:
  1. Group A Strep
  2. MRSA (with PVL)
  3. Clostridia
  4. Vibrio when seawater involved

4 Replies to “Tasty Morsels of EM 012

  1. Great post–as per ushe.

    Have you read “Complications” by Gawande? He’s got a gripping story about a young girl with suspected nec fac. Big part of it was making the decision of if he should or should not operate…seems that is one of the main hurdles in the initial phases before limbs start falling off and everyone goes, “oh shit, that is nec fac”.

    I may have already harassed you with regard to that book, if so…my apologies.

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