Anaesthetics and peri operative care Flashcards
prophylactic antibiotics are needed for which surgical?
appendicectomy
signs of ileus post op?
abdominal pain / bloating / vomiting
airway management
oropharyngeal mask
> easy to insert
> no paralysis
ideal for short procedures
when is a laryngeal mask not suitable?
high pressure ventilation
non fasted patients cannot have a?
laryngeal mask airway
> poor control against reflux of gastric contents
basilar skull fracture and underlying coagulopathy is a contraindication for?
nasopharyngeal airway use
what airway management is preferred if cervical spine injury potential?
jaw thrust
errors in insertion of an endotracheal tube can result in?
oesphageal intubation
what is a tracheostomy?
reduces the work of breathing
> dead space
useful in slow weaning
post operative ileus management?
NBM
nasogastric tube if vomiting
IV fluids
correct elctrolyte imbalances
total parental nutrition
what investigation is important in post op ileus?
deranged electrolytes
> check potassium / magnesium/ phsophate
flat trace on ETCO2?
means oesophageal intubation as expired air from lungs contains co2
no trace = wrong place
tracheo-oesophageal fistula
due to long term intubation
food contents aspirated
if only 1 meal is being missed?
DM prior to surgery
which medication to omit?
which to change
SLGT-2 inhibitors
sulfonylureas
> omit the dose on day of surgeryg / morning dose
insulin and prior to surgery
reduce long acting by 20%
day before, day of and day after
twice daily insulin?
halve the usual morning dose on day of surgergy and day after
preoperative anaemia ?
haemoglobin of 58g/L ?
> blood transfusion
colonoscopy requires?
bowel prep
> laxatives taken day before
> Not eating for 24 hours before
anstomatic leak can cause ___ _____ following GI surgery
new onset atrial fibrillation following gastrointestinal surgery
anastomatic leak investigation and management?
CT abdomen > anastomatic leak
surgical emergency > need to go back to theatre
for patients taking prednisolone and undergoing surgery?
important to supplement with hydrocortisone
OCP prior to surgery when should you stop if at high risk of clots?
4 weeks before
post op fever
day 1-2
wind
> pneumonia, aspiration, pulmonary oedema
Post Op Fever
Water?
day 3-5
UTI
