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Posted

http://spotted.horsecity.com/pages/photo_p...mp;gallery=3514

It doesnt really say what he did, but the looks of it, the surrounding tissue is not healing properly and he may need skin grafting to replace dead tissue or he may end up with amputation of the thumb and half a palm. If he's not careful flesh eating disease could also start.

I would for an injury like this soak it in saline to clean the open wound and with a lot of soaked gauze and start an IV, giving him morphine for the pain, and transport ASAP.

Vitals at this point are good but could deteriate quite quickly giving the fact it's close to all arteries and infection can set quite quickly, other than what you see here, it's already started.

Posted

Is it a burn? It kinda look like its exploded.

Posted
It doesnt really say what he did

I don't know, I would be very curious how this happen. Being a basic and never seeing an electrical burn I am wondering if this is an exit or entrance wound of an electrical burn. As for a standard of care if it turn out to be just that area I would just stop the burning process, apply dry sterile dressing and bandage, and transport. Of course going through the assessment from top to bottom with ABCs being first.

Posted

ok, I've seen an injury like this before

There could be a couple of reasons

1. Brown recluse bite

2. Electrical burn but this guy would be toast if that's the exit wound. He'd more than likely be dead

3. Cigarette burn that got infected

4. Septic joint or a laceration that got infected and they split the skin to take care of the pressure

5. He's the brother of the guy on the comcast digital voice commercial who got the snake bite and the foot is black. It's a snake bite that's gone bad

Too many things could be going on with him but I suspect number 1 or number 5

Posted

They stole that picture from another website, would be my guess. It's a Brown Recluse spider bite. They have an OTC fluid available to dilute the venom of spider bites, and reduce tissue necrosis. However, it's not available in the US or Canada. I believe it's from the UK, seen it in one of those e-pharmacy's while buying an EpiPen that my md wouldn't prescribe. :D

Posted

like I said, brown recluse bite. Had a patient with the exact same wound post brown recluse bite

Posted

Seen a lot of spider bites, but never one that bad looking. It does however make sense. How long do you think it would take after the bite till it looks like that?

Posted

with no post bite care, probably about a week or two

Posted

its a spider bite of somesort. i would clean the wound as best as possible and then have the doc take it from there. the eschar tissue would be removed and debreided, antibiotics would be started but other than that theres not much you can do.

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