Toxic Epidermal Necrolysis

Nurses General Nursing

Published

There's a middle-aged man who came in to our burn unit who has Toxic Epidermal Necrolysis due to a sulfa drug. He has skin sloughing that went from 60% of his body today to over 80% - just on my 12 hour shift. His eyes are sloughing and his GI tract (so far his mouth) is starting to blister. This is really quite upsetting to see and I keep getting welled up thinking about his face today... he is in so much pain and is so terrified... Has anyone seen a good outcome of this disease... good outcome as in someone who has lived?

Specializes in Cardiac.
Septra and Bactrim ARE sulfa drugs though. That really isn't an unusual way to get sulfa. Celebrex and Bextra I was not familiar with (as far as causing TEN) Do they act on some of the same receptors (as sulfa) or something? Or do they just cause TEN in and of themselves?

Pat

Well, one of the more popular drugs which has caused this is really ibuprofen. Bextra only caused less than 20 cases before they pulled it off the market. Ibuprofen has caused many cases. Both are anti-inflammatories.

http://www.stevens-johnson-syndrome.com/

Up Vote Up Vote ×

He died.

Up Vote Up Vote ×
Specializes in Emergency Room.

I'm so sorry - it seems that you were really affected by this patient.

What did he end up dying from?

Up Vote Up Vote ×

He went from our unit to the ICU, so I'm not exactly sure right now. He wound up having massive pulmonary edema a couple of days ago though, so I would imagine it would be that.

It's just really, really sad. The entire situation... I've only been a nurse for 5 months, and I just started in the burn unit the day he was there. I don't know if it's for me emotionally. Apparently I cry too easily when I see people in severe, deadly pain. I didn't cry infront of the family or infront of him or any other staff. Just when I was alone after. I don't think that's such a bad thing since I'm human and it's horrible watching that... The crying let's it out and stuff. But yeah, I just don't know about burn nursing for me.

How do other people deal with kind of thing emotionally?

Up Vote Up Vote ×
Specializes in Rehab, Step-down,Tele,Hospice.

Wow, really sorry to hear that. It is hard dealing with things like this esp being a new nurse. Don't aplogize for having normal human emotions I have cried many a tear over pts and outcomes, life is strange, bittersweet.

Hang in there, and if you need to talk to someone professionally, thats ok too.

Up Vote Up Vote ×
+ Add a Comment