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By Michelle Lin
Medical Doctor
Specialty: Emergency Medicine
Blog: http://academiclifeinem.blogspot.com
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Michelle Lin's Twitter Updates

@precordialthump I totally forgot about the EKG library! Awesome stuff. Keep up the great work (when do you sleep?!) 259 days ago
@emeducation Perfect, thanks for the suggestions! Turns out one is co-authored by Jeff Tabas. He already gave them all books. 259 days ago
Recommendations for an EKG resource to review bread & butter cases for senior residents? Pre-graduation panic setting in for our residents. 259 days ago
@danipedia Good point. I use the studies to convince the trauma consults NOT to get c-spine imaging on EVERYONE (citing distracting injury)! 264 days ago
@doctorflash Hi there. Just wanted to drop a note to thank you for all the extra traffic you're sending to blog. Much appreciated!! 275 days ago
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Paucis Verbis: Antibiotics and open fractures

Posted Jan 20 2012 12:00am

Open fractures come in all shapes and sizes. Sometimes fractures create only a small, innocuous-looking puncture through the skin. Other times they look grossly contaminated with organic material and have significant soft tissue injury. The major concern is wound infection. Prophylactic antibiotics are essential in the ED.
Typically antibiotics are first-generation cephalosporins. When do you start adding more coverage with high-dose penicillin or aminoglycosides?
Pearl: Once you have significant soft tissue injury, you are automatically have a Type III open fracture and should add an aminoglycoside.


You can download this PV card:  [ MS Word ] [ PDF ] See  other Paucis Verbis cards .

Reference: Hoff WS, Bonadies JA, Cachecho R, Dorlac WC. East Practice Management Guidelines Work Group: update to practice management guidelines for prophylactic  antibiotic use in open fractures. J Trauma. 2011 Mar;70(3):751-4.

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