What are the key criteria for urgent referral of a patient with suspected necrotizing fasciitis?

Key criteria for urgent referral of a patient with suspected necrotizing fasciitis include:

• Presence of rapidly worsening symptoms or signs of severe infection, such as severe pain out of proportion to clinical findings, systemic illness, or sepsis.
• Signs suggesting a more serious illness or condition, including necrotizing fasciitis itself or sepsis.
• Systemic signs such as fever, raised white blood cell count, or other markers of systemic inflammatory response.
• Urgent clinical assessment by a senior decision maker and immediate initiation of broad-spectrum intravenous antibiotics without delay.
• Prompt referral to specialist care for further management, including possible surgical intervention and critical care support if indicated.

These criteria align with the need for rapid recognition and treatment escalation to reduce morbidity and mortality associated with necrotizing fasciitis.

References: NICE NG19, NICE NG51