Approach to the Critical Patient

Immediate threats and escalation

Initial priorities

Early specialist involvement

Immediate management targets

Neurovascular and functional baseline

Documentation set

History

Exposure and timeline

Bite context

Hand function at time of injury

Host risk and infectious risk

Comorbid risk

Medication risk

Immunization and bloodborne risk

Physical Exam

Wound and local infection findings

Wound assessment

Infection severity

Tendon, joint, and compartment focused exam

MCP joint involvement clues

Extensor tendon involvement clues

Compartment syndrome screening

PITFALLS

Common misses

Differential Diagnosis

Primary and limb-threatening diagnoses

Infection syndromes

Structural injury syndromes

Mimics and co-injuries

Noninfectious considerations

Co-pathogens and complications

Laboratory Tests

Infection severity and operative readiness

Baseline labs when systemic signs or deep infection concern

Sepsis labs when unstable

Microbiology from the site

Culture strategy

Diagnostic Tests

Scoring Systems

Deep infection screening patterns

Radiographs

Plain films

MRI

Soft tissue and bone complication evaluation

CT

Alternative imaging when MRI not feasible

Disposition

Admission and operative pathways

Admit criteria

Transfer criteria

Discharge criteria and follow-up

Discharge only when low risk

Follow-up timing

Treatment

Immediate life-saving interventions

Stabilization when systemic toxicity

Source control urgency

Wound care and irrigation

Local management principles

Tetanus prophylaxis

Antibiotics and dosing

Empiric pathogen coverage

Oral regimen for low-risk outpatient

IV regimen for deep infection concern or admission

Penicillin allergy pathways

MRSA coverage when indicated

Operative and procedural pathways

Joint penetration or septic arthritis concern

Abscess pathway

Analgesia strategy

Special Populations

Pregnancy

Antibiotic selection

Imaging considerations

Geriatric

Higher complication risk

Medication safety

Pediatrics

Unique considerations

Weight-based antibiotic dosing

Background

Epidemiology

Frequency and risk

Pathophysiology

Mechanism

Complication pathways

Therapeutic Considerations

Core principles

Evidence framing

Patient Discharge Instructions

Copy discharge instructions

Discharge bundle

References

Evidence-based sources and guidance

Clinical guidance set

Evidence level mapping for this tool

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