Use of Infrared Thermography in Diagnosing Necrotizing Fasciitis in the Emergency Department: A Case Study

Objective: Necrotizing fasciitis is a difficult diagnosis with a very high mortality. However, thermal imaging has the potential to identify increasing skin temperature and rapid progression. Materials and methods: We used repeat photographs taken with a thermal camera to visualize changes in skin temperature over time. Results: An unstable male patient presented at the emergency department. Thermal imaging showed increased skin temperature of his left foot with a rapid increase and progression in extent within 1 hour. Necrotizing fasciitis was suspected and later confirmed. Conclusions: We believe thermal imaging could be an important adjunct for the diagnosis of suspected necrotizing fasciitis

Comparing restrictive versus liberal oxygen strategies for trauma patients-the TRAUMOX2 trial:protocol for a randomised clinical trial

INTRODUCTION: Supplemental oxygen is commonly used in trauma patients, although it may lead to hyperoxaemia that has been associated with pulmonary complications and increased mortality. The primary objective of this trial, TRAUMOX2, is to compare a restrictive versus liberal oxygen strategy the first 8 hours following trauma. METHODS AND ANALYSIS: TRAUMOX2 is an investigator-initiated, international, parallel-grouped, superiority, outcome assessor-blinded and analyst-blinded, randomised, controlled, clinical trial. Adult patients with suspected major trauma are randomised to eight hours of a restrictive or liberal oxygen strategy. The restrictive group receives the lowest dosage of oxygen (>21%) that ensures an SpO(2) of 94%. The liberal group receives 12–15 L O(2)/min or FiO(2)=0.6–1.0. The primary outcome is a composite of 30-day mortality and/or development of major respiratory complications (pneumonia and/or acute respiratory distress syndrome). With 710 participants in each arm, we will be able to detect a 33% risk reduction with a restrictive oxygen strategy if the incidence of our primary outcome is 15% in the liberal group. ETHICS AND DISSEMINATION: TRAUMOX2 is carried out in accordance with the Helsinki II Declaration. It has been approved by the Danish Committee on Health Research Ethics for the Capital Region (H-21018062) and The Danish Medicines Agency, as well as the Dutch Medical Research Ethics Committee Erasmus MS (NL79921.078.21 and MEC-2021-0932). A website (www.traumox2.org) is available for updates and study results will be published in an international peer-reviewed scientific journal. TRIAL REGISTRATION NUMBERS: EudraCT 2021-000556-19; NCT05146700

Additional file 2: Table S1. of Paediatric medical emergency calls to a Danish Emergency Medical Dispatch Centre: a retrospective, observational study

Assigned dispatch codes. A table showing the assigned dispatch code for every included paediatric medical emergency call. (XLSX 20Â kb