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Necrotizing fasciitis


ReD

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i work at the only trauma facility for approx 4 counties, we got a transfer from another hospital. pt had Necrotizing fasciitis to the R arm and it extended to his R pectorial muscle as well.

the story other hospital gave us was IVDA and they missed. we were told "i think its a bug bite", either way ot dosent matter. we took 'em straight to the OR.

my question is, how many of ya'll have seen Necrotizing fasciitis? the nurse who had this pt said shed seen 3 cases in 20 or so years, and that this one wasnt that bad(as far as NF goes). arm was just really swollen and a lil bit of compartment syndrome going on. had palpable radial pulse upon arrival and when going to OR approx 30min later there was not one and cap refill was about 3secs.

she said the other case she had seen was in the lower abd and groin that spread down to the proximal theighs bilaterally.

i wish i could have gone and watched in the OR.

[edit]for those who dunno what Necrotizing Fasciitis is, http://www.nnff.org/ [/edit]

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i work at the only trauma facility for approx 4 counties

I wouldn't let anybody from Harris hear you say that. :?

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I currently work in wound care and hyperbarics and we have seen bout 5 or 6 cases this past year. Normally the treatment is OR then HBO tx's. and keep doing it til the NF is gone. It can be fatal. I would not want it in my chest area. All of ours where in the abd and thighs. We even had one pt die from it. I think it started as a soider bite and went to NF and about a week later she had died. that was bout the worse case i had seen.

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That's the thing. I doesn't usually look that bad from the outside, but inside the infection is spreading extremely rapidly, following the layers between muscles and other tissues (fascia). Surgical debridement, washout, and possible amputation are needed to prevent sepsis and death. This can kill someone very quickly, like in a day or two. Diagnosis is by biopsy, but we'll go to the OR with it on CT findings (inflammation, fluid or air where it shouldn't be) or just a high suspicion. HBO can be tried after surgical debridement, because usually the patient is left with huge gaping wounds after surgery.

I've seen several cases of this. Bad juju.

'zilla

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I wouldn't let anybody from Harris hear you say that. :?

LOL well ok, the only one thateveryone except CF likes going to.

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  • 3 weeks later...

I work for the local police department as a CAHOOTS medic that deals with high risks groups; drug addicts, homeless, runaways etc. and the rise in the number of untreated cases in this population is frightening. Recently my partner and I arrived for a police assist at a local run down motel. When we pulled into the parking lot an experience officer was leaning out of his car vomiting. He told us "this is the worse thing I've ever seen." My partner and I tried to imagine what could possibly be wrong. Our patient was alert, oriented, in good health except that both of his arms had been eaten away down to the bone. He was an admitted IV drug user and had been for years. A few months back he developed an abscess that went untreated and eventually spread. He reported no pain, just a general irritation and a constant weeping which was actually the flesh turning liquid and sliding off his body. I cant possibly express what this looked or smelled like in words. My partner and I did everything we could to get him to go to the hospital with us but he refused care and the police eventually arrested him for public health reasons. Get this, the guy was working detailing the interiors of cars and didnt want to miss a day to go to the hospital.

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I work for the local police department as a CAHOOTS medic that deals with high risks groups; drug addicts, homeless, runaways etc. and the rise in the number of untreated cases in this population is frightening. Recently my partner and I arrived for a police assist at a local run down motel. When we pulled into the parking lot an experience officer was leaning out of his car vomiting. He told us "this is the worse thing I've ever seen." My partner and I tried to imagine what could possibly be wrong. Our patient was alert, oriented, in good health except that both of his arms had been eaten away down to the bone. He was an admitted IV drug user and had been for years. A few months back he developed an abscess that went untreated and eventually spread. He reported no pain, just a general irritation and a constant weeping which was actually the flesh turning liquid and sliding off his body. I cant possibly express what this looked or smelled like in words. My partner and I did everything we could to get him to go to the hospital with us but he refused care and the police eventually arrested him for public health reasons. Get this, the guy was working detailing the interiors of cars and didnt want to miss a day to go to the hospital.

i SOOOOOOOOOOOOOOO wish u could have gotten a picture of that guy. and how bad was it to not make his arms useless?

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