Topics in Emergency Medicine

This specialty is also well represented on the examination and in
daily practice of emergency medicine-urgent care.



Q: What is a Felon?

A: It is a pyogenic infection of the distal pulp space of the finger. Usually due to
staphylococcal or streptococcal infections. Best therapy: Incision and Drainage
followed by 7-10 days oral antibiotics, against gram-positive organisms.




Q: What is a Fat Embolism Syndrome?

A: It occurs in patient with severe long bone injuries/fractures. The symptoms are due to
dislodged fat globules...causing an embolism, several days after the trauma.
Pts. usually exhibit hypoxia, restlessness, bilateral CXR infiltrates and kidney failure.
Treatment is supportive.




Q: What is Gas Gangrene (Myonecrosis)?

A: It is an infection caused by Clostridium perfringens. It causes rapid necrosis of fascia,
muscle and tendon. It usually occurs in traumatized or diabetic patients. Clinically, there
is palpable gas (crepitations) of the skin (also visible on X-rays) and intense pain.
Treatment: Aggressive IV antibiotics, surgical debridement and hyperbaric oxygen.




Q: What is Erysipelas?

A: It is cellulitis involving the facial structures (cheeks/nose) due to group A Strep Pyogenes.
The lesions is very painful, erythematous and edematous.
Treatment: Oral dicloxacillin. In PCN allergic patients, erythromycin.




Q: What is a External Hordeolum?

A: It's also called a Sty. An infection usually due to Staph. aureus, involving the eyelash
follicles. Treament: Usually self limited, after spontaneous drainage of the abscess.
Warm wet compresses 3-4 times daily for 15-20 mins. helps the healing process.
Bacitracin ointment can be supplemented.




We'll return soon....keep up the good work.