A Brief Overview of Blast Injury Patterns

Show Notes

General ID Workshop Take Home Points

1. Know your local antibiogram. This is the best way to tailor your management to your patient.
2. Search for recent old cultures from your patients and order antibiotics based on this information.

Skin + Soft Tissue Take Home Points

1. Antibiotics aren’t required for most simple abscesses. I+D and if no overlying cellulitis, no antibiotics needed.
2. Not all abscesses need packing. If they’re small and on the extremeties, it’s reasonable to leave them unpacked.
3. Not all patients need MRSA coverage for cellulitis. Most cellulitis without abscess is strep.
4. Necrotizing Fasciitis can be tough to pick up. The LRINEC scoring system is one method to help. Most patients will be toxic but look for pain that’s out of proportion to the examination.

Relevant Links

AliEM – The Not-So-Sick Health-Care Associated Pneumonia Patient: New Treatment Strategy

EM Lyceum – Abscess

Disaster Management

START Triage System

Blast Related Traumatic Brain Injury: Military Acute Concussion Evaluation (MACE)