Post-op Fever Flashcards
five main causes of post-op fever:
Pneumonia wound site urinary catheter osteomyelitis Cannula site DVT Chest Infection
what is considered immediate post-op fever?
24-48 hours, usually benign
why would you get post-op fever?
tissue damage
liquifying haematoma
Rare causes of post-op fever?
clostridial myonecrosis
malignant hyperthermia
when is acute post-op fevre?
within first week
when is sub-acute fever?
after first week
risks factors for subacute fever?
surgical sites IV sites DVT antibiotics nosocomial infections
delayed post-op timeline?
> 1month
what can happen in delayed post-op timeline?
surgical site
viruses and transfusion
what would spiking temperatures/swinging fever indicate?
abscesses
you are called to see someone with post-op fever, what to look for to help diagnose?
surgical notes
anaesthetic notes
What important associated features of fever to ask?
rigours: bacterial infections
myalgia
how to check cannula?
palpate
put down the dressing
look to see if red
how to check the wound site?
must take down the dressing to see it.
look for haematoma, erythema, haematoma, wound breakdown, discharge
what palpation of wound site is dangerous?
crepitations
tender
crepitus
what lines have no inflammation at insertions site?
CENTRAL LINES
Sepsis defined as?
t >38.5 or 100 RR >25 WCC >14000 Severe sepsis = plus organ dysfunction increased lactate: anaerobic metabolism
what is SIRS?
systemic inflammatory response syndrome
can be infectious
non-infectious: burns, big sx
Abx treatment of choice for MSSA?
fluclox
mild Penicillin allergy for MSSA Rx?
Cefazolin
what class of Abx is vancomycin?
glycopeptide
2 most common places you see hospital-acquired pneumonia.
stroke
post-surgical
what antibiotic use for ventilator associated pneumonia?
tazocin (piperacillin+tazobactam)
take home message for post-op fever?
remove foreign material, lines, cathethers, that are not needed
