Pain Out Of Proportion: Messy Neck Kid (Messy NEC CID) remember the poop prank

Remember the IG poop toilet paper exchange prank…kids got pain way out of proportion screaming & running to the sink. Imagine wiping peanut butter on the kids neck…. Messy NEC CID Messy( risk factors atherosclerotic disease = mess) NEC -nuts -extremity -“C” food… seafood Comp Ischemic limb Dislocation 1. Mesenteric Ischemia: - Vascular occlusive emergency - Varied presentation, including severe pain and associated vomiting or hematochezia - Pain may not worsen with abdominal palpation - Only 25% will have hemoccult-positive stool 2. Necrotizing Fasciitis: - Type I: NUTS: Polymicrobial, trunk and perineal area, associated with immunocompromised states (DM, etc) - Type II: Extremity: Streptococcus pyogenes +/- Staphylococcus aureus, occurs in healthy, young, immunocompromised hosts, located on extremities - Type III: “C” food… seafood: Vibrio vulnificus, least common, associated with exposure to warm seawater and severe liver disease - Signs and symptoms include erythema, pain beyond erythema, swelling, crepitus or necrosis, induration, bullae, fever, and hypotension 3. Compartment Syndrome: - Clinical condition caused by fractures, soft-tissue injuries, burns, or circumferential dressings - Commonly affects young people, especially with high-energy injuries - Main symptom is severe pain out of proportion to the injury - Other symptoms include pallor, paresthesia, paresis, and pulselessness (late findings) Get someone to check compartment pressures! 4. Ischemic Limb: - Document neurovascular status, color, and temperature - Associated with compromised blood flow to the limb - Assessment includes examination of pulses, skin color, and temperature *Concerned but has thready pulse: Doppler, ABI & CT angiogram limb 5. Acute Joint Dislocations: - Common in wrist, hip, and ankle joints - Assess for dislocation along with fractures on X-rays

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