IBCC Episode 118 - Necrotising Fasciitis

The Internet Book of Critical Care Podcast

Adam Thomas

Foam, Medicine, Health & Fitness, Science, Criticalcare, Medicaleducation

5 • 714 Ratings

🗓️ 28 October 2021

⏱️ 25 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this episode, we cover that scary presentation where your patient goes from seemingly well, to skin melting off and in multi organ failure.

Come take a listen for all things clinical presentation, anti-toxin antibiotics regimes, skin cut downs and surgical debridement.

Transcript

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0:00.0	All right, so welcome back to the Internet Book of Critical Care Podcast.
0:08.4	I'm here with Adam Thomas and we're going to talk about necrotizing fasciitis.
0:12.0	Josh, I missed you.
0:13.5	It's been a bit of a minute.
0:14.8	We just realized I've been negligent of my duties and haven't talked to you in a while.
0:18.4	How are you doing, by the way?
0:19.6	I'm good, I'm good.
0:20.6	But for the record, no matter how many force fires there are in BC and what the current
0:24.3	pandemic state of the world is, we need you on the podcast. So you have to be here. I'm back at
0:28.8	it. All right. Nothing better than a comeback cast than hepatorino syndrome and now necrotizing fasciitis. So Josh, let's get into it because this is
0:38.1	a really fun podcast to go through more importantly because it's one of those things that can be
0:42.2	super, super scary when you have patients in front of you who walk in, they've got pain out of
0:47.0	proportion of exam and then they just really fall apart right in front you. So let's talk about
0:51.4	presentation, those labs, those images, and the basic
0:54.9	bedside test that we should all endeavor to make sure the patient has. And then we'll really get
0:59.5	into the meat and potatoes. We're going to talk about management, all things resuscitation,
1:03.4	what bug juice to pick, how do you cut out the dead stuff, and then what are your adjuvant
1:07.6	therapies to this? So Josh, straight to the basics. I remember on my exams,
1:12.7	there's like these types, type one, type two, type three. It goes in the chart and then it
1:17.4	immediately empties my mind. So what are the classifications and what's the general concept here?
1:22.7	So before we dive into the different types, the general concept is that the fascia is this layer of kind of connective tissue.
1:29.6	It's not incredibly well vascularized and it's deep to the skin.
	...

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