[billsnurse]

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 prepared if it comes my way.

Thanks

[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!

[deeDawntee]

Believe it or not, I have heard that they are actually beneficial and should be removed only after proper antibiotic therapy has been started. Presumably they consume the dead tissue and help to control some of the infection...I heard of an MD having them removed and a patient going into septic shock so quickly that the patient almost died.

[LVNwannaBE2007]

we had a guy come in the ed he was 40 y/o and had cerebral palsy.... his mother was taking care of him for lack of better words....... he came in with wounds all over him and feces etc and they had to take him in the decontamination room and hose him off.... very sad story where APS had to step in... this happened when i was a student adn now hes one of my residents in a LTC facility

[nurz2be]

Originally Posted by billsnurse

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 prepared if it comes my way.

Thanks

As I was with my preceptor on ED rounds, a lady come in and we went in to do history and check her. Upon entering the room you could smell the infection that was someone on and in her. It was somewhat like the smell of an old huge cyst. Anyways, she said in her workup that she is diabetic, insulin dependent and that her foot was bothering her x 6 days and could not walk this particular day and called 911. When the nurse took off her house slipper, it was black and green and there were maggots all in her foot. I thought at first I would pass out, I didn't. I actually went in for a closer look. The nurse immediately called for the ER Doc and the on call ortho doc. Obviously her foot was not salvageable, she was in complete denial for about 2 hours. Finally, she relented when her children arrived and were informed that this infection could still and might have already spread to her blood. It was in grossest most interesting thing I have witnessed as of yet. The Ortho doc said that the maggots might have actually kept her foot from worsening more quickly than it had to this point. The nurse said she had seen burn patients have maggots placed on them after their initial OR scrub, to help with keeping any infection away.

It was creepy and interesting at the same time.

[xxchaffxx]

In one of my coursework classes our teacher was telling us about her ER days. She said that one time, this lady came into the ER is hysterics. She was a quad, and had a trach. The friends that were supposed to be taking care of her were on drugs, so obviously they weren't doing a very good job. Anyways, she had maggots in her trach, and she couldn't do anything about it because she was paralyzed. Eek!! I hope I never ever see that!!

[meimeiy]

Okay. I could stomach the others but the one with trach is just disgusting.

[pedsnurze1]

Originally Posted by xxchaffxx

In one of my coursework classes our teacher was telling us about her ER days. She said that one time, this lady came into the ER is hysterics. She was a quad, and had a trach. The friends that were supposed to be taking care of her were on drugs, so obviously they weren't doing a very good job. Anyways, she had maggots in her trach, and she couldn't do anything about it because she was paralyzed. Eek!! I hope I never ever see that!!

How did this turn out?

[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.

[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.