Post Op Fever Flashcards
What are the causes of an immediate (24-48 hours) post op fever?
Usually benign
Trauma and damage to tissue
Transfusion/Medication reaction
Rare, more serious
- Malignant hyperthermia
- Uncommon causes of surgical site infection: Clostridial myonecrosis
What constitutes an adequate wound swab?
Swab deep in the wound
or if possible swab fluid that can be exuded out
What are the big 5 causes of post op fever?
Pneumonia
IV site infection
Wound infection
DVT
UTI
What is septic shock (cf to severe sepsis)
Severe sepsis +
Hypotension
What are causes of infection in the acute period (first week)?
Hospital-acquired pneumonia/aspiration pneumonia
IV site infection with bacteraemia
Surgical site infection
Urinary tract infection (only if they’ve had a catheter recently)
What does a spiking pattern of fever commonly reflect?
An abscess
What do you look for when examining a surgical wound?
Erythema
Haematoma
Wound breakdown
Discharge
Palpate for tenderness, flutuance, crepitus
What are causes of infection in the sub-acute period (after the first week)?
Surgical sites
IV sites
DVT
Drug reactions (antibiotics, phenytoin)
Other nosocomial infections
What do you do on Ex of post op fever?
Vitals
Surgical wound
Lungs
IV site/spinal site
Legs
Skin (rash)
What are criteria of sepsis?
Clinical evidence of infections - eg chest, IV site, wound
Plus 2 or more of:
T>38 or <36
HR >90
RR >20
WBC >14,000 or >10% band forms
What is the Abx of choice for Staph wound infection?
Flucloxacilin
Cefazolin if allergic to penicilin and MSSA
Vancomycin if MSRA
What symptoms can reflect septicaemia?
Rigors
Myalgia
What are the most common causes of nosocomial pneumonia?
Anaerobic, gram negative bacili - E. coli, Klebsiella, Enterobacter, Pseudomonas
Then MRSA
What is malignant hyperthermia?
Uncontrolled muscle contraction in response to aesthetics
What is severe sepsis cf sepsis?
Sepsis +
Organ dysfunction - eg AKI or confusion
Impaired tissue perfusion - reflected by increased serum lactate
