op care Flashcards
when to stop warfarin before surgery
- 5 days. interim LMWH
what INR needs to be corrected preop
1.4
when to blood transfuse preop
<90 or <100 hb and elderly, CVD, Resp disease
when to give plt preop
- <50
when to stop doac pre surgery
- minor surgery = 24hrs
- major = 48hrs
when to stop therapeutic dose LMWH preop
- 48hrs , if high risk then heparin infusion
when to stop clopi/aspirin/dipyradimole preop
7 days
when should you consult haematolgy before stopping anti plts preop
- if stent <1yr
when to stop cocp preop and when to restart
- 4 weeks
- 2 weeks after
when do you do a group and save vs a x match preop
- g and S if blood loss not expected
how long should you delay surgery after MI
- 6 months
what HTN BP is needed to delay susrgery
180 S, or 110 DS
ideally, how long before surgery shld patients stop smoking
- 8 weeks , worst case = 12hrs
How logn to delay surgery if infection
- 6 weeks
what HBA1C would mean surgery can only go ahead if urgent
> 10% aka more than 80mmol
when to stop MOAI before surgery
- 2 weeks before
how to supress MRSA in a carrier
if found in nose - mupirocin tds 5days
if found in skin - chlorhexidine gluconate OD 5 days - apply esp to axilla, groin and eprineum
what abx are given in mrsa
- vancomycin
- teiciplanin
- linezolid
what surgery usually gets abx preop
- GI
classification of surgical procedures according to wound infection risk
clean; incising uninfected skin without opening viscus
clean contaminated - intra op breahc of viscus but not colon
contaminated
- breach of viscus + spillage or opening of colon
dirty - site pre contaminated with pus, faeces etc
what size sutures are normally good for skin
3-0
4-0
how long after can you remove sutures on face and neck and scalp
- 5 days
- earlier in kids
how long after sutures on abdomen or proximal limbs can you remove them
- 10 days
how long after sutures on distale xtremities can you remove them
- 14 days
