Approach to the Critical Patient

Immediate risk stratification

Instability screen

Sepsis pathway

Necrotizing infection exclusion

Monitoring and access

Monitoring

Access

Early source control focus

Source control decision points

History

Symptom characterization

Illness timeline

Local symptoms

Systemic symptoms

Wound context and exposures

Wound type

Exposures

Hardware or foreign material

Host risk factors

Immunocompromise

MRSA risk

Medication and allergy history

Physical Exam

Wound and soft tissue exam

Local inspection

Palpation and functional assessment

Neurovascular status

Systemic exam and toxicity

Vital sign abnormalities

End organ dysfunction screen

Regional lymphatic findings

PITFALLS

Common misses

Differential Diagnosis

Infectious causes

Skin and soft tissue infection spectrum

Exposure specific infections

Noninfectious mimics and complications

Mimics

Complications

Laboratory Tests

Core labs for severity and complications

Severity labs

Inflammation and necrotizing support

Microbiology

Culture strategy

Pitfalls

Glycemic and pregnancy considerations

Metabolic considerations

Pregnancy related testing

Diagnostic Tests

Scoring Systems

Clinical severity scores

Necrotizing risk score

MRI

Deep infection evaluation

Performance and limits

CT

Indications

Interpretation pearls

Contrast considerations

Ultrasound

Point-of-care applications

Limitations

Disposition

Admission and escalation criteria

ICU level of care

Inpatient admission

Surgical consultation triggers

Discharge criteria and follow-up

Outpatient eligibility

Follow-up planning

Treatment

Source control and wound care

Drainage and debridement

Local wound management

Antibiotics for nonpurulent infection

Mild cellulitis without systemic toxicity

Moderate to severe nonpurulent infection

Antibiotics for purulent infection

Abscess with minimal cellulitis

Outpatient MRSA coverage options

Severe purulent infection

Polymicrobial and special exposure regimens

Surgical site infection with deep involvement

Bite wound infection

Saltwater exposure

Freshwater exposure

Necrotizing infection concern

Analgesia, antipyresis, and supportive care

Pain control

Tetanus prophylaxis

Glycemic optimization

Special Populations

Pregnancy

Diagnostic considerations

Antibiotic safety

Consultation triggers

Geriatric

Presentation differences

Medication considerations

Disposition bias

Pediatrics

Weight based dosing

Special risks

Background

Epidemiology

Incidence context

Microbiology patterns

Pathophysiology

Local infection mechanisms

Abscess formation

Necrotizing infection mechanism

Therapeutic Considerations

Antibiotic selection principles

Duration principles

Evidence level integration

Patient Discharge Instructions

copy discharge instructions

Wound infection care

Pain and fever control

Return to emergency care now for

Follow-up plan

References

Guidelines and core sources

Evidence based references

Coding references

Source file

SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.