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