Any of the following is acted on immediately. The life-threatening necrotizing infection is escalated to EMS first; provider notification and orders follow.
Red flags — act immediately
Fournier’s gangrene — perineal or genital pain out of proportion to the exam with dusky or necrotic skin, crepitus, and systemic toxicity → activate EMS — a surgical emergency in which delay is fatal.
A deep, unstageable, or deep-tissue perineal or sacral pressure injury → offload and notify (staging and treatment in Wounds).
A perineal or genital wound infection with spreading erythema and systemic signs → notify urgently.
Incontinence-associated dermatitis being treated as a pressure injury, or the reverse → correct the plan and notify; the wrong treatment risks deterioration.
A catheter-associated entry-site infection or significant trauma → notify (cross-reference Urinary/Renal).
A severe candidal infection with denudation → notify for antifungal treatment.
