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Emergency Medicine Journal 2008;25:783
© 2008 BMJ Publishing Group Ltd and the College of Emergency Medicine.

EMQ ANSWERS

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716

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ANSWER 1

  1. False. Although no direct causative effect has been established, non-steroidal anti-inflammatory drugs may depress neutrophil function.1 2
  2. False. Gas in the soft tissues on plain x ray is highly specific but not sensitive, reported in 57% of cases.3 4
  3. True. Initial presentation is typically non-specific erythema and swelling (a cellulitis), but with disproportionate pain.4
  4. True. Protein-synthesis inhibiting antibiotics such as clindamycin are indicated. Although no definitive study exists, animal studies and retrospective paediatric studies suggest improved outcome.5 6


ANSWER 2

  1. True. This is the definition applied to severe sepsis by the Surviving Sepsis Campaign7 and provides the basis for identifying patients for early goal-directed therapy.8
  2. False. There is no evidence to suggest a preference for crystalloid over colloid;9 an initial 300–500 ml colloid bolus is acceptable.7
  3. False. An anatomical source of sepsis should be identified within 6 h; appropriate intravenous antibiotics should be started as early as possible and always within 1 h of identifying . . . [Full text of this article]


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Emerg. Med. J. 2008 25: 716. [Extract] [Full Text] [PDF]

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The journal is co-owned by and the official journal of College of Emergency Medicine

Official journal of British Association for Immediate Care: BASICS, Faculty of Pre-Hospital Care, Irish Society for Immediate Care and Swedish Society for Emergency Medicine: SweSEM

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