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EM Educator

The EM Educator Series: When sepsis care becomes not so straightforward

Welcome back to the EM Educator Series. These posts provide brief mini-cases followed by key questions to consider while working. The featured questions provide important learning points for those working with you, as well as vital items to consider in the evaluation and management of the specific condition discussed. This week we discuss sepsis in various scenarios.

em@3am

EM@3AM: Diabetic Foot Ulcer

A 58-year-old morbidly obese female patient with uncontrolled diabetes and peripheral arterial disease presents with an open wound to the central plantar aspect of her foot. She reports no pain, does not recall an injury, and is not sure how long she has had the ulcer. On exam, there is a 3.5 cm circular wound with thick yellow material in the center, and the edges of the wound are pink and warm to the touch. What is the diagnosis, and what are your next steps?

em@3am

EM@3AM: Endocarditis

A 26-year-old female presents with fevers and chills. She is febrile and tachycardic, with normal BP. You think you hear a murmur on exam, and on further questioning, she says she regularly uses IV drugs. What should you consider, and what are your next steps?