36 year old male presents to ED with swelling and discolouration of his foot after stepping on a piece of coral 1 week ago. The patient reports fever and vomiting.
O/E HR 160 BP 120/70 Temp 37 RR 24 Sats 99 FiO2 .4
CPR >5 seconds, peripherally shut down with mottled skin
Left foot – swollen, grey/blue in colour extending up to groin. Pulses present
pH 7.30 Na 138mmol/l
pCO2 25mmHg K 4.0 mmol/l
pO2 156mmHg Cl 102 mmol/l
HCO3 13mmol/l Cr 415 umol/l
B/E -11 Lactate 9.5 mmol/l
- Describe and interpret the ABG?
- What is necrotising fasciitis and how is it managed?