GI decision making Flashcards
what degree of pain is associated with requirement for surgery
severe and lethargic. basically the increased pain = increased sx risk
what GI parameter is suggestive of surgery
absent borborygmi
what is a definitive rectal finding that supports surgical need
distended small intestine
unless theres an impaction what response is considered surgical candidates
those that respond poorly to analgesics
what is the most useful test for peritoneal fluid analysis
gross appearance. abn color = 80% chance of surgery
what peritoneal fluid color is 98% predictive of surgery
visible hemolysis - very red
what peritoneal fluid lactate is suggestive of surgery
serially progressive lactate or a lactate of >4 at admission
what HCT carries a grave prognosis
> 60
what serum lactate is associated with death
> 6
what are our prognostic parameters
HR, PCV, blood lactate, mm
what abdominal US finding is highly suggestive of surgery
amotile distended small intestine
what general things are highly suggestive of surgery
red abdominal fluid
severe pain
absent borborygmi
high peritoneal fluid lactate
how does all of the prognostic indicators help guide our decision making
run tests that will yield significant information that will help us tell prognosis or likelihood of surgery. do not waste time and money
