Increase in I&D's in the South?

  1. I was just wondering if other places through out the South were experiencing a marked increase in wounds w/ staff that require I&D..... what the old folks called "risens".
    I have recently moved back down South after being away several years and I have never in my life seen so many of these type infections. In our ER, we are doing up to 10 a day. I moved back the Thursday before Katrina hit (I've always had great timing).......
    I've heard that it could actually be due to Katrina.....
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  2. 48 Comments

  3. by   Thakkis
    You're seeing these probably for the same reason as all of rural America is seeing them. Methamphetamine. It's huge in the South and causes all sorts of MRSA lesions.
  4. by   rjflyn
    Personally I think it is plain and simply the lack of or infrequency of bathing. These patients need to learn what Dial soap is. Its rare that I see one of these so called risens is on someone with good hygiene habits. More often than not they look like they just drug their clothes out of the road ditch.

    RJ
  5. by   Gompers
    I could see it being a combination of the Katrina aftermath and crystal meth use. Makes sense that there would be an increase at this time.

    I have a friend who has had several I&Ds. I finally asked him what soap he used. He was only using stuff like Ivory and Dove. Well, when you've got a nasty staph wound draining down your arm and chest, don't you think some Dial might be a good idea? I suggested he switch. He hated the Dial because it was so drying and has switched back to the Ivory and Dove. He continues to have wounds.
  6. by   RN30241
    I wish I had a dollar for every patient that presented to triage with a "spider bite" that turns out to be folliculitis. Forget hygiene teaching...these folks turn all shades of purple when they haughtily inform me that THEY had looked it up on the internet and their next door neighbor's cousin's first wife's brother looked at it and THEY said it was a Brown Recluse spider bite....(sigh) the people we have to put up with sometimes.
  7. by   LeahJet
    While it is true that a lot of the patients we see for this problem are hygenically challenged and/or most likely meth users, we are seeing all walks of life... "Clean" people, too.
    I just think that we see more of the lower socio-economic group in the ED for the this problem due to the age old reasons....lack of insurance/primary MD/education.
    I agree that a good anti bacterial soap is called for, too. Maybe even Phisoderm.
    But thanks for the input...I haven't thought of the Meth factor.
    Last edit by LeahJet on Jan 6, '06
  8. by   LeahJet
    Quote from Gompers
    I could see it being a combination of the Katrina aftermath and crystal meth use. Makes sense that there would be an increase at this time.

    I have a friend who has had several I&Ds. I finally asked him what soap he used. He was only using stuff like Ivory and Dove. Well, when you've got a nasty staph wound draining down your arm and chest, don't you think some Dial might be a good idea? I suggested he switch. He hated the Dial because it was so drying and has switched back to the Ivory and Dove. He continues to have wounds.
    I heard a doc telling pts. with re-occuring wounds that they should rub a little antibiotic ointment just inside the nostrils qd. I have no idea if this works but it sounds interesting....
  9. by   Nurse Valium
    I'm not sure where "South" ya'll are referring to but at the ER in Smithville, Tx we see (seems like) up to 30-40% for I&Ds. Same thing, all walks of life, all ages, socioeconomic backgrounds, etc.
    Weird!!
    (This was pre- and post-Katrina)
  10. by   plumrn
    We had a Doc prescribe Bactroban, if I remember right??, in both nostrils daily. She had MRSA infections.
  11. by   perle1
    Here out west (southeast arizona) we have the same thing, people from all walks of life. We're also seeing an increasing number of Cdiff patients from home.
  12. by   ClaireMacl
    Reading this and coming from the UK, I know nothing of Dial. I do however believe that antibacterial soaps and the like might actually do more harm than good in the long term! Bare in mind that I don't have the research at hand at the moment, but I know that I've read in medical journals about allergies and asthma increasing in houses which are kept meticulously clean in childhood, children vaccinated and not exposed to chicken pox etc as we were as children developing the more dangerous equivalents later on, good bacteria on the skin being killed off with the bad by antibacterial agents etc!

    I grew up in a house where my mum kept the place so clean I'm sure I could have eaten off the floor and yet I have asthma and so many allergies I couldn't list them

    I'll stick to using antibacterial stuff when I have a wound or I am at work and just good old fashioned hygiene the rest of the time
  13. by   Gompers
    Quote from LeahJet
    I heard a doc telling pts. with re-occuring wounds that they should rub a little antibiotic ointment just inside the nostrils qd. I have no idea if this works but it sounds interesting....
    Probably because that's where MRSA is colonized. I've seen Bactroban used, like plumrn mentioned, and it did get rid of MRSA. I don't think regular antibiotic ointment would work, but who knows. It's a good thought.
  14. by   Gompers
    Quote from ClaireMacl
    Reading this and coming from the UK, I know nothing of Dial. I do however believe that antibacterial soaps and the like might actually do more harm than good in the long term! Bare in mind that I don't have the research at hand at the moment, but I know that I've read in medical journals about allergies and asthma increasing in houses which are kept meticulously clean in childhood, children vaccinated and not exposed to chicken pox etc as we were as children developing the more dangerous equivalents later on, good bacteria on the skin being killed off with the bad by antibacterial agents etc!

    I grew up in a house where my mum kept the place so clean I'm sure I could have eaten off the floor and yet I have asthma and so many allergies I couldn't list them

    I'll stick to using antibacterial stuff when I have a wound or I am at work and just good old fashioned hygiene the rest of the time
    Dial is a very popular brand of antibacterial soap here. It's sold for handwashing and also in bar and gel form for bathing. Lots of scents, formulas, etc.

    While I agree that using antibacterial products like crazy might not be a great idea in a healthy household, I think it's really important to use it in a family where there is currently a staph outbreak going on. This friend of mine has a roommate and they share a bathroom and hand towels. I think while he has these wounds that are actually weeping, it's vital that he use something that might help stop the spread, both to his roommate and to other parts of his body. Now, I don't know if the antibiotic in Dial would kill the staph he has going on (they haven't told him if it's MRSA, just that it's staph), but it can't hurt.

    Normally, I myself don't use an antibacterial soap except for handwashing and dishwashing. But if I started having wounds, you'd better believe I would switch!!!

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