Human and Animal bites/Burns/Foreign bodies/MRSA

Question 1

Burns

Answer 1

See sheet

Question 2

Soak in sterile towel that was soaked in ice water. Continue irrigation for 20-30 minutes.

Answer 2

Tetanus shot
pain medication
clean intact vesicles with scrub and rinse in saline. If bullae are open cleanse with normal saline.
Leave intact bullae intact!
Cover with adhesive coating. Silvadene or leave open and wash daily for partial thickness

Question 3

Tar burns

Answer 3

leave tar on and cover with a bacotracom and it will dissolve away.

Question 4

Superficial will heal in 7-21 days

Answer 4

Do not put ice directly on burn

no systemic antibx

Question 5

Foreign body in ear

Answer 5

Kill the insect before removing. Mineral oil or lidocaine. If TM is intact water can remove a foreign body
Can use a hook, etc. to grab stuff. 
Can use magnet or suction
DO NOT irrigate a disc or battery
or a bean as it could swell.

Question 6

Foreign body- nose

Answer 6

Consider sedation, 4% lidocaine will shrink the nasal mucoas. Use magnet, forceps, or whatever you need.

Question 7

Foreign body throat

Answer 7

Check airway. Do not sweep blindly. CT scan can be used if FB can’t be seen on x-ray

Question 8

Bites

Answer 8

irrigate, cluture if over 72 hours old. Report to HD. Tetanus, Rabies prophylaxis if needed. Return for check in 2 days

Question 9

Dog bite

Answer 9

90%

Potential complications

Question 10

Cat bites

Answer 10

highly infectious

Question 11

Human bites

Answer 11

potentially more serious

Question 12

insect bites

Answer 12

Get hx, treat with local application of mild to moderate topical steroids.
Use DEET. Do not use Antihistamine creams. Of no value.

Question 13

MRSA

Answer 13

The CA-MRSA lesion often has a dark or black center and is often attributed to spider bites.
Wound cultures should be obtained as a general rule of all skin abscesses serious enough to require antimicrobial treatment.

Question 14

MRSA

Answer 14

Pustules do not require anesthesia for drainage. Very small ones can be opened with an 18 gauge needle.
Cleanse would with normal saline and cover with ointment and a dressing. Warm compresses at home.

Question 15

MRSA

Answer 15

obtain culture on pus-containing lesions.
Use antimicrobial to cover CA-MRSA
Wash hands with soap and water.
Don't share towels
Cover skin abrasions-clean dry bandage

Question 16

MRSA- Tx

Answer 16

resistant to beta-lactam agents (penicillins and cephalosporins)
Instead, use Clindamycin, Tetracyclines (Doxy and Minocycline)
Trimethoprim-Sulfamethoxazole (not FDA approved), Rifampin (use only in combination) Linezolis (consult an infectious disease doc)

Question 17

Meningococcemia -suspician

Answer 17

with rash and nuchal rigidity

Question 18

Stevens-Johnson syndrome

Answer 18

Epidermal detachment, bullare, mucosal ulcerations and truncal target lesions

Question 19

Necrotizing fascitis (scaled skin syndrom)

Answer 19

painful, red, swollen, and warm area with sharp margins. Spreads rapidly seen in patients with DM and immunocompromised.