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When Does Gas Gangrene Become Fatal After Its Onset?
Question: My questions are related to an incidence of profound hypothermia, frostbite, and gas gangrene in a pediatric patient.
From the materials I have read, I understand that wet and gas gangrene may spread and become fatal quickly. However, I have not seen any sort of "time frame" given other than wet/gas gangrene can be fatal if not acted upon within 48 hours. Is there an average time frame between Clostridium perfringens entrance into a frostbite wound and the onset of visibly noticeable symptoms?
Since frostbite distorts the appearance of the flesh does it make gangrene much harder to notice to the naked eye? Could gas gangrene be overlooked in an unresponsive individual as it begins to spread due to frostbite injury?
If hypothermia leads to cardiac arrest and CPR is performed successfully is it possible for an individual to regain consciousness before their core temperature is warmed to normal levels? Is it possible for a patient to regain consciousness during a femoral vein to femoral artery bypass rewarming?
Is it standard for victims of severe frostbite which results in deep tissue damage and necrosis to be taken for imaging tests or tissue culture examinations (before any signs of infection or other complications)?
From the materials I have read, I understand that wet and gas gangrene may spread and become fatal quickly. However, I have not seen any sort of "time frame" given other than wet/gas gangrene can be fatal if not acted upon within 48 hours. Is there an average time frame between Clostridium perfringens entrance into a frostbite wound and the onset of visibly noticeable symptoms?
Since frostbite distorts the appearance of the flesh does it make gangrene much harder to notice to the naked eye? Could gas gangrene be overlooked in an unresponsive individual as it begins to spread due to frostbite injury?
If hypothermia leads to cardiac arrest and CPR is performed successfully is it possible for an individual to regain consciousness before their core temperature is warmed to normal levels? Is it possible for a patient to regain consciousness during a femoral vein to femoral artery bypass rewarming?
Is it standard for victims of severe frostbite which results in deep tissue damage and necrosis to be taken for imaging tests or tissue culture examinations (before any signs of infection or other complications)?
Brief Answer:
Details below.
Detailed Answer:
Hello,
Thanks for posting your query.
The exact time frame between the time of infection and the onset of symptoms is not specified in the literature. It can vary from 24-72 hours.
The gas gangrene can be overlooked due to unresponsive patient and the skin color changes due to the frost bite.
It is best to go for a tissue culture for proper diagnosis. This is not routinely done but is preferred if there are any signs of contamination of the wound.
Before the rise of core temperature it is difficult to regain consciousness even if CPR is done. During femoral vein to femoral artery bypass rewarming consciousness might be regained but that also depends on the physical condition of the patient.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Details below.
Detailed Answer:
Hello,
Thanks for posting your query.
The exact time frame between the time of infection and the onset of symptoms is not specified in the literature. It can vary from 24-72 hours.
The gas gangrene can be overlooked due to unresponsive patient and the skin color changes due to the frost bite.
It is best to go for a tissue culture for proper diagnosis. This is not routinely done but is preferred if there are any signs of contamination of the wound.
Before the rise of core temperature it is difficult to regain consciousness even if CPR is done. During femoral vein to femoral artery bypass rewarming consciousness might be regained but that also depends on the physical condition of the patient.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much! I do have a few basic questions regarding post-operation critical care.
Are unconscious individuals with severe frostbite restrained in any way so that they do not cause further accidental damage to the tissue? Is it common practice to bind the hands/arms to prevent injury while sleeping?
I have read that it is standard to change wrapping for frostbite 2-4 times daily. Is this correct, and what is the preferred kind of wrap for frostbite wounds?
If an individual is intubated for ventilation and they are on a prescription medication (10 mg Prozac capsule daily in this case) how would the medication be administered? Would it be administered via IV?
Thanks again and have a wonderful day!
XXXX
Are unconscious individuals with severe frostbite restrained in any way so that they do not cause further accidental damage to the tissue? Is it common practice to bind the hands/arms to prevent injury while sleeping?
I have read that it is standard to change wrapping for frostbite 2-4 times daily. Is this correct, and what is the preferred kind of wrap for frostbite wounds?
If an individual is intubated for ventilation and they are on a prescription medication (10 mg Prozac capsule daily in this case) how would the medication be administered? Would it be administered via IV?
Thanks again and have a wonderful day!
XXXX
Brief Answer:
Details below.
Detailed Answer:
Hello.
Thanks for writing again.
The unconscious individuals do not need to be kept restrained. The hands and arms are not bound usually.
A sterile non adherent dressing is used like a loose bandage to avoid any tissue damage and it is changed 2-4 times a day to avoid any infection.
If the patient is on Prozac then it can be given through oral feeding tube. It is usually not given if the patient is unconscious. That depends on the physical condition of the patient.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Details below.
Detailed Answer:
Hello.
Thanks for writing again.
The unconscious individuals do not need to be kept restrained. The hands and arms are not bound usually.
A sterile non adherent dressing is used like a loose bandage to avoid any tissue damage and it is changed 2-4 times a day to avoid any infection.
If the patient is on Prozac then it can be given through oral feeding tube. It is usually not given if the patient is unconscious. That depends on the physical condition of the patient.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Note: For further follow-up it is advisable to consult an emergency medicine specialist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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