A 38-year-old male with type 1 diabetes mellitus presents with two days of severe thigh pain. You are called to see him because of hypotension. On examination he is drowsy, BP 80/60 mmHg, HR 140 beats/min and temperature of 40.2°C. There is gross swelling on the medial aspect of his right thigh with obvious cellulitis and visible central necrosis.
Describe the management priorities in the first 24 hours and briefly justify your responses.
Surgical Referral and post-operative management
Routine ICU care of patient with severe sepsis
This question is identical to Question 24 from the first paper of 2011.
The discussion section from that previous question is reproduced below, to simplify revision
A boringly algorithmic answer to this question would look something like this:
The key points to remember are:
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