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Hôpital régional de Sudbury Regional Hospital
CELLULITIS CARE MAP
INCLUSION CRITERIA:
 Acute Mild/Moderate Cellulitis (inflammation & redness)
 Fever (temperature greater than/equal to 38.0°C)
 Mild/Moderate Pain associated with Cellulitis
EXCLUSION CRITERIA:
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Chronic Cellulitis
Suspected necrotizing fasciitis, osteomyelitis, or septic arthritis
Infected diabetic or decubitis ulcers
Postoperative wound infections
Orbital Cellulitis
TESTS (Medical Directive # EDOS01)
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Bloodwork: CBCD, Electrolytes, Urea, Creatinine, Random Glucose, Calcium
Blood Cultures X 2 if temperature greater than/equal to 38.0°C
Wound Care swab from infected site
Baseline & daily INR level if patient on Warfarin (Coumadin) and receiving fluoroquinolones antibiotics
ASSESSMENT
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Vital Signs (temperature, pulse, blood pressure, respiration, oxygen saturation)
Postural Vitals – Lying down for full 5 minutes and Standing (High Fowler’s if unable to stand) for full
2 minutes
Mental Status including any changes from baseline
Hydration Status (mucus membranes)
C/O pain, type and location
Affected area of Cellulitis (mark & measure area, drainage)
TREATMENT OPTIONS (Medical Directive # EDOS04)
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Saline lock
Intervenous therapy
MEDICATIONS*********CHECK ALLERGIES & MEDICATION COMPATIBILITY******
(Medical Directive # EDOS03)
FIRST LINE
Cephalexin
Ceftriaxone
SECOND LINE
Cloxacillin
Clindamycin
ORAL
500mg QID X 7 days (max) or until physician r/a
PARENTERAL
--1gm daily X 7-10 days
500mg QID X 7 days (max) or until physician r/a
300 – 450 mg QID X 7 days (max) or until physician r/a
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MEDICATIONS*********CHECK ALLERGIES & MEDICATION COMPATIBILITY******
(Medical Directive # EDOS03)
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Acetaminophen (Tylenol) 325-975mg po (650mg pr) q4hrs prn
Hôpital régional de Sudbury Regional Hospital
ONGOING MEASURES
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Review wound care C&S results & adjust medications accordingly
Monitor and mark the border of the affected area daily. Notify LTC if affected area is
increasing
Nutrition – Regular diet or as ordered (encourage fluids unless contraindicated)
Activity as tolerated – if non-ambulatory patient ensure repositioning q2hrs
Physiotherapy
Occupational Therapy
REFERENCES
Dong, S., Kelly, K., Oland, R., Holroyd, B., Rowe, B. (2001). ED Management of Cellulitis: A review of Five
Urban Centers. American Journal of Emergency Medicine, 19(7), 535-540).
Murray, H., Stiell, I., & Wells, G. (2005). Treatment failure in emergency department patients with cellulitis.
Canadian Journal of Emergency Medicine, 7(4), 228-234.
Rosser, W., Pennie, R., Pilla, N., and the Anti-infective Review Panel. (2005). Anti-infective guidelines for
community-acquired infections. Toronto: MUMS Guideline Clearinghouse.
Seaton, R., Bell, E., Gourlay, Y., & Semple, L. (2005). Nurse-led management of uncomplicated cellulitis in the
community: evaluation of a protocol incorporating intravenous ceftriaxone. Journal of Antimicrobial
Chemotherapy, 55, 764-767.