osteolyelitis

[fakemusician]

i have a question and i hope to find anwsers here. i have a patient who fell and injured his great toe badly. when he was admitted to our home health service, he'd been in the hospital for a few days and they have sewn back his toe. during my 2 weeks of care he did not have a temperature, foul smell to the site, or purulent drainage. the toe was tender to touch but i thought it was from the trauma, and it had some escar on top of the top. last week i sent him to the MD due to his pain, i thought the escar had to be removed. came to find out the MD decided he had osteomyelitis and they are going to amputate the toe. i was not aware that the bones were exposed from the initial injury.

was there something i could've done different? the patient is now upset and he think if i had sent him to the doctor he may could save the toe, but i am thinking back really hard and i couldn't think of any signs of symptoms that would've told me something was wrong. i'd like to know what else i coul've done so i can provide better care in the future

[wound warrier]

It does not sound to me that you did anything wrong. Do you know if he had a fever? That may have been a clue that he had an infection. Eschar on a toe could mean arterial problems, which in turn could mean poor healing of the toe.

[fakemusician]

he did not have temperature. i was later told that they should've taken care of it in the ER when the patient first presented himself, and that he was just upset about the amputation and wanted to take it out on somone.

thanks for your reply