Remember the IG poop toilet paper exchange prank…kids got pain way out of proportion screaming & running to the sink.
Imagine wiping peanut butter on the kids neck….
Messy NEC CID
Messy( risk factors atherosclerotic disease = mess)
NEC
-nuts
-extremity
-“C” food… seafood
Comp
Ischemic limb
Dislocation
1. Mesenteric Ischemia:
- Vascular occlusive emergency
- Varied presentation, including severe pain and associated vomiting or hematochezia
- Pain may not worsen with abdominal palpation
- Only 25% will have hemoccult-positive stool
2. Necrotizing Fasciitis:
- Type I: NUTS: Polymicrobial, trunk and perineal area, associated with immunocompromised states (DM, etc)
- Type II: Extremity: Streptococcus pyogenes +/- Staphylococcus aureus, occurs in healthy, young, immunocompromised hosts, located on extremities
- Type III: “C” food… seafood: Vibrio vulnificus, least common, associated with exposure to warm seawater and severe liver disease
- Signs and symptoms include erythema, pain beyond erythema, swelling, crepitus or necrosis, induration, bullae, fever, and hypotension
3. Compartment Syndrome:
- Clinical condition caused by fractures, soft-tissue injuries, burns, or circumferential dressings
- Commonly affects young people, especially with high-energy injuries
- Main symptom is severe pain out of proportion to the injury
- Other symptoms include pallor, paresthesia, paresis, and pulselessness (late findings)
Get someone to check compartment pressures!
4. Ischemic Limb:
- Document neurovascular status, color, and temperature
- Associated with compromised blood flow to the limb
- Assessment includes examination of pulses, skin color, and temperature
*Concerned but has thready pulse: Doppler, ABI & CT angiogram limb
5. Acute Joint Dislocations:
- Common in wrist, hip, and ankle joints
- Assess for dislocation along with fractures on X-rays
