Episode 69 - Cellulitis and Other Skin and Soft Tissue Infections

In this episode, Sam Ashoo, MD interviews Kyle Howarth, MD and Joby Thoppil, MD, PhD - two of the authors of the May, 2022 EMP article on Cellulitis and Skin and Soft Tissue Infections (www.ebmedicine...) . Listen to the discussion to hear more about the emergency department management of cellulitis and necrotizing skin infections.
Episode 69 - Emergency Department Management of Cellulitis and Other Skin and Soft-Tissue Infections (www.ebmedicine...)
EMplify - May 2022
Episode Outline:
1. Why cellulitis/skin infections?
2. Terminology
• Erysipelas vs cellulitis vs fasciitis
• Purulent cellulitis
3. Most common pathogens
4. Special situations
5. Necrotizing infection classification system - is this helpful in the ED, and if so, why?
6. Differential - unilateral vs bilateral presentation
7. Prehospital care
8. ED evaluation
• History - what should we be asking?
• Examination: SSTI vs NSTI
9. Diagnostics
• POCUS: “cobblestoning” and fluid collection
• Xray: subcutaneous gas
• CT: when is this helpful?
10. Labs
• Blood cultures - if given the option, are they helpful?
• Wound cultures - any role for these?
• Routine labs (CBC, BMP, etc) - are they helpful?
• LRINEC score - what is it and should we be using it?
11. Treatment
• NSTI antibiotics
• Abscesses
12. Special populations
• IV drug users
• Diabetic patients
• Immunocompromised patients
13. Wound irrigation and loop drainage
14. Disposition

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