EMQ ANSWERS
For questions on page
716
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ANSWER 1
- False. Although no direct causative effect has been established, non-steroidal anti-inflammatory drugs may depress neutrophil function.1 2
- False. Gas in the soft tissues on plain x ray is highly specific but not sensitive, reported in 57% of cases.3 4
- True. Initial presentation is typically non-specific erythema and swelling (a cellulitis), but with disproportionate pain.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
- 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
- False. There is no evidence to suggest a preference for crystalloid over colloid;9 an initial 300–500 ml colloid bolus is acceptable.7
- 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
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See page for answers
Emerg. Med. J. 2008 25: 716.[Extract] [Full Text] [PDF]
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