maggots? - page 3

Hi Everyone, Does anyone have any experience with patients coming into the ED with maggots on them? What do you use to remove them? Just thinking about it gives me the willies and I want to be... Read More

  1. by   EMT-2-RN
    Working in the ER I took care of a patient who was a burn victim 2 years prior. He was homeless and his legs had horrible wounds all over with dressings that looked like they had been there for at least a month. The smell was terrible. When taking of the patients socks and shoes, there were not only maggots but ants and small spiders crawling around. I had seen maggots in wounds before, but not like this. There were thousands. I tried soaking his wounds, flushing with betadine and Hydrogenperoxide. Nothing worked. As soon as you could scrape the maggots off and out of his wounds more would crawl out from. We did the best we could but I believe this man ended up having to have his legs amputated. It was certainly something to see.
  2. by   Ninaer
    7 years ago, I had a pt with the exact same thing. She lived with her husband and did not know anything about it. The reason why she had come to the hospital was that she became very lethargic. Too make the long story short, she had a rotting left breast/gangrenous/with strong odor/ and was very jaundiced.
  3. by   DoubleblessedRN
    Quote from Hellllllo Nurse
    Pt was a lady in her 40s- well dressed and appeared clean. She had a fungating CA of the breast. She kept it covered all the time at home, and never looked at it, even when bathing.
    Well, we convinced her to let us take the dressing off- and there were maggots in her rotting breast.
    EEEEWWWWW!! I once saw the EXACT same thing.
  4. by   northshore08
    bringing back memories....
    I agree that the smell is usually related to "other things" about the patient, not the maggots. My biggest memory about this subject was a morbidly obese bed-bound pt with tunnelling bedsore; you could see them under the skin. I believe she went off for debridement...I remember brushing the little buggers off the bed while cleaning up, and thinking how they looked like soft grains of rice.
    I, for one, am grateful for decon showers.
  5. by   EMTandNurse2B
    I have a very strong stomach, but I draw the line here. I have yet to see maggots on a living human (thanks to a kind coworker who removed them from between the homeless psych pt's toes), but when I do I'm pretty sure I will faint.
    The problem with community acquired maggots, as another poster pointed out, is that there are several kinds, and not all of them stay on the surface. Some kinds eat living flesh as well and will burrow into the person and literally eat them from the inside out.
    I grew up on a farm, and saw this happen twice to long-haired rabbits. Once the process starts, and the maggots are inside, they are just about impossible to get out. Now, I imagine that a human being so much larger, it would be much easier to save them, but the limb/etc might have to go.
    That said, ever since the rabbit incident, I DO NOT handle maggots very well. This ER nurse will be on the floor, despite her reputation for handling anything without even gagging. There is a line!
  6. by   Heatherheartsou
    I just had to do a maggot removal yesterday. The patient was a homeless gentleman with bilat lower ext. cellulitus. He came in by EMSA for leg pain... but wow. He had maggots all over his legs and feet. He was also suffering from some psych issues (obviously) and he had lice. Anyway, we rolled him on the gurney to the decontamination shower to hose the suckers off because no one wanted to touch him until he had been bathed. The whole time he denied having maggots. He thought we were lying to him. But he also thought he was God... so.... We wore hazmat suits, face shields, taped our gloves down, etc. He is someone I will never forget, unfortunately.
  7. by   aknurs
    Quote from Jilaweez
    I have heard about maggot therapy before and when they remove them from the wounds of pts. they have grown 10x's their original size and are easy to remove. I would think a person walking into the ED would need a bar of soap and a hose. Yuck!
    Soap & water are your friends . :wink2: Maggots are not as bad as someone coming in with roaches running from their clothing and out of their bag of medications. At least the maggots don't scurry off.
  8. by   AnnieOaklyRN
    Magots happen, mostly on elderly patients with wounds and people at home htat cannot care for themselves. All it takes is a fly, and I dont think the eggs are visible to the naked eye until they become magets, so I can see how it happens.

    They are not all that bad, maggots are good, they eat only the rotting dead tissue and leave the healthy stuff alone. I suppose, though in the wild they may add to the bacteria in the wound.


    Sweetooth
  9. by   Athena1970
    We had a homeless man come in with the entire top of his foot swollen (with maggots). The nurse didn't realize it at first and was feeling for pulses, and "it all moved"....

    I do believe at some point they were going to debride, but in the meantime, I got several bottles of betadine and had the man soak his foot in it.......those things just poured out.......we had him soak for about 15 minutes and, of course, by then, the betadine was thick with maggots.....some of which seemed to still be squirming around.......it was pretty awful, although he seemed to take it all in stride while most of the ED staff was horrified.

    I hope not to see that again!
    A.
  10. by   klcrn1987
    We have a pt that is a frequent flyer that routinely comes in with maggots in her bilat lower legs. She has elephantits and isn't very good at taking care of herself. All you have to do is say the initials "JH" in our place and everyone shudders!!

    I've never had to deal with her when she first comes in but I think I could handle the maggots before I could do roaches.....I DON'T do roaches...

    I think for me it would be more the smell than actually seeing the maggots....by the time they get maggots, the wounds are usually pretty nasty....
  11. by   redtshirt
    Quote from RNontheroad
    I fortunately have not been witness to the maggot thing but have heard my share of horror stories... Ugghhh.
    What I have seen that was really interesting (and disturbing at the same time) was medical leeches. The patient had severed 3 of his fingers and they were using leeches to help revascularize the digits. Apparently they excrete something in their saliva that helps improve blood flow to the re-attached part.
    Luckily the docs and wound care team took charge of the whole thing and there was really nothing for me to do but monitor the site. Not sure I could have handled pulling them off etc.

    I saw leeches used on two patients. One had amputated four digits and had three surgically put back on. One digits vascular supply wasn't great and blood was pooling in the tip. A leech was used to relieve pain because leeches have a natural painkiller and they also contain blood thinning agents so they can feed better. When full they fall off and have to be disposed of in alcohol (not exactly pleasant). To get them to latch on dextrose can be used and to get them off saline is used. The other patient was a burns patient who had a graph redone and it wasn't taking at one edge. Neither patient minded the leeches once their benefits were explained.
  12. by   mommalumps
    Quote from Hellllllo Nurse
    I've never worked ER, but did have a pt with maggots in hospice.
    Pt was a lady in her 40s- well dressed and appeared clean. She had a fungating CA of the breast. She kept it covered all the time at home, and never looked at it, even when bathing.
    Well, we convinced her to let us take the dressing off- and there were maggots in her rotting breast.
    No doc on the unit. We just remained calm, and poured hydrogen peroxide over the area w/ the pt leaning over the bathroom sink. It really foamed up and "sizzled." That got rid of the maggots.
    SIZZLED????!!! Ohhhhh, Wooooowwww
    The more I think about it, we ARE doing G*D's work...... Nurses Rock!!!
  13. by   MadzDAD
    Had a homeless guy come in from E.R. to the floor. His story was that he was hit and dragged by a car for a few yards, but finally sought tx after a couple weeks...Nasty road rash over his belly, 2nd and 3rd degree wounds at different stages of healing. No evidence of maggots, but once I started to clean wound with some NS I thought I saw some bubbling, I paused, rechecked the bottle thinking that I might have used hydrogen peroxide by mistake...nope it was NS... I elevated the bed more, flipped on more lights, got closer, swiped over a patch of loose scab....to unveil clusters of writhing maggots...some big and fat others looked liked they just hatched. Ughh!

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