Post-op Fever

Question 1

five main causes of post-op fever:

Answer 1

Pneumonia
wound site
urinary catheter
osteomyelitis
Cannula site
DVT
Chest Infection

Question 2

what is considered immediate post-op fever?

Answer 2

24-48 hours, usually benign

Question 3

why would you get post-op fever?

Answer 3

tissue damage

liquifying haematoma

Question 4

Rare causes of post-op fever?

Answer 4

clostridial myonecrosis

malignant hyperthermia

Question 5

when is acute post-op fevre?

Answer 5

within first week

Question 6

when is sub-acute fever?

Answer 6

after first week

Question 7

risks factors for subacute fever?

Answer 7

surgical sites
IV sites
DVT
antibiotics
nosocomial infections

Question 8

delayed post-op timeline?

Answer 8

> 1month

Question 9

what can happen in delayed post-op timeline?

Answer 9

surgical site

viruses and transfusion

Question 10

what would spiking temperatures/swinging fever indicate?

Answer 10

abscesses

Question 11

you are called to see someone with post-op fever, what to look for to help diagnose?

Answer 11

surgical notes

anaesthetic notes

Question 12

What important associated features of fever to ask?

Answer 12

rigours: bacterial infections

myalgia

Question 13

how to check cannula?

Answer 13

palpate
put down the dressing
look to see if red

Question 14

how to check the wound site?

Answer 14

must take down the dressing to see it.

look for haematoma, erythema, haematoma, wound breakdown, discharge

Question 15

what palpation of wound site is dangerous?

Answer 15

crepitations
tender
crepitus

Question 16

what lines have no inflammation at insertions site?

Answer 16

CENTRAL LINES

Question 17

Sepsis defined as?

Answer 17

t >38.5 or 100
RR >25
WCC >14000
Severe sepsis = plus organ dysfunction
increased lactate: anaerobic metabolism

Question 18

what is SIRS?

Answer 18

systemic inflammatory response syndrome
can be infectious
non-infectious: burns, big sx

Question 19

Abx treatment of choice for MSSA?

Answer 19

fluclox

Question 20

mild Penicillin allergy for MSSA Rx?

Answer 20

Cefazolin

Question 21

what class of Abx is vancomycin?

Answer 21

glycopeptide

Question 22

2 most common places you see hospital-acquired pneumonia.

Answer 22

stroke

post-surgical

Question 23

what antibiotic use for ventilator associated pneumonia?

Answer 23

tazocin (piperacillin+tazobactam)

Question 24

take home message for post-op fever?

Answer 24

remove foreign material, lines, cathethers, that are not needed