14. Post-op Fever and complications Flashcards
what is malignant hyperthermia?
a life threatening elevation in body temp after inhalation of general anesthetics (halothane) or muscle relaxants (succinylcholine)
*the patient does not resequester Ca2+ in malignant hyperthermia
s/s of malignant hyperthermia
- fever
- increased boy temp
- hyperhydrosis
- hyperkalemia
- metabolic/resp acidosis
- tachypnea
- tachycardia
- muscle spasms
- arrythmias
how do you treat malignant hyperthermia?
- stop administration of anesthesia
- hyperventilate with 100% O2
- correct acidosis
- cool patient (ice bath)
what medication can be administered to reverse effects of malignant hyperthermia?
dantrolene
-1mg/kg rapid IV push until symptoms subside
What is normal body temp?
97.7-99.5F
or 36.5-37.4C
what is febrile temp?
> 100.4 F (or 38C)
what is heat pyrexia and when does it occur?
occurs during surgery and up to 1 hour post-op
what is the cause of heat pyrexia?
trauma of procedure resulting in inflammation (cytokines released) ; increased permeability and prostaglandins
what are some causes of post-op fever?
(rmr mnemonic- wind, water, wound, walking, wonder drugs) wind: atelectasis water: UTI wound: wound infection walking: DVT/ thrombophlebitis wonder drugs: drug fever
when does post-op fever due to atelectasis occur?
POD 1-2
when does post-op fever due to UTI occur?
POD 2-3
when does post-op fever due to wound infection ocur?
POD 3-7
when does post-op fever due to DVT/thrombophlebitis occur?
POD 5-7
when does post-op fever due to drugs occur?
POD > 7
causes of anytime fever
drug fever
catheter fever
reaction to blood transfusion
